Features September 2019 Issue

Managing A-fib with Food

Learn what you can eat, and what you can't, to minimize the distressing symptoms of a racing heart.

People with paroxysmal atrial fibrillation (A-fib) can experience sudden bouts of a racing heart that occur without warning. Although the term paroxysmal means the underlying cause is unknown, common symptom triggers have been identified. Many involve foods or are related to eating habits.

"We know that caffeine, alcohol and certain foods often trigger A-fib symptoms," says Julia Zumpano, RD, LD, a Cleveland Clinic dietitian working with heart patients.

"The trigger in coffee is caffeine, which is also found in tea, cola, energy drinks and some over-the-counter medications. If your heart rhythm reacts to caffeine, these might cause A-fib, too," she cautions.

More Common Than You Think

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A healthy diet, like the Mediterranean diet, may help reduce the likelihood of experiencing A-fib. symptoms. Alcohol and caffeine are common A-fib triggers. Finding your threshold for tolerance may allow you to consume these products in a limited fashion.

A survey of 1,295 A-fib patients published earlier this year found that 74% had experienced at least one trigger on a list that included a bout of exercise and lack of sleep, in addition to caffeine and alcohol.

When asked to write in additional triggers, 20% mentioned stress or anxiety. Others reported that drinking cold beverages, eating cold foods, eating a large meal, a high-sodium diet, becoming dehydrated or sleeping on their left side caused symptoms.

Triggers were twice as common in people with a family history of A-fib. Those most likely to have two or more triggers included women, Hispanics, younger patients, those with obstructive sleep apnea and those with a family history of A-fib, as well.

What You Eat Matters

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Changing your diet may also help reduce A-fib symptoms.

Zumpano advises starting by eliminating junk foods. "Processed foods, fast foods, fried foods and convenience foods are all high in salt and low in nutrients and can be classified as ‘junk,'" she says.

This means giving up luncheon meats; anything that comes in a box, bag or can; baked goods; and any foods containing sugar, including most fruit juices.

In their place, Zumpano recommends adopting a Mediterranean-style diet. This diet eliminates or minimizes red meat in favor of fish and skinless poultry. Three-fourths of your plate should be filled with vegetables, whole grains or legumes. Olive oil replaces butter and other oils, and fruit and nuts are used for snacks.

Nutritious foods that you should make a point of eating on a regular basis include:

Fresh berries and other fresh fruits

Whole grains, such as quinoa, brown rice, barley and oats

Extra-virgin olive oil

Almonds, walnuts and hazelnuts

Fish high in omega-3 fatty acids: salmon, sardines, herring, tuna and mackerel.

"If you are overweight or have diabetes or other health issues, ask your doctor how best to modify your diet to help control your A-fib," she advises.

How to Eat Wisely

You may not have to give up all your favorite foods, if you make a fewadjustments.

Replicate your favorite frozen food or comfort food using low-salt, low-fat and healthier ingredients.

Eat moderate portions.

Eat earlier in the day and never after 7 p.m.

Have one bite of dessert.

"These steps take self-control, but they will allow you to enjoy many of your favorite foods without triggering A-fib," says Zumpano.

Finding Your Threshold

If your heart starts racing while you're enjoying a caffeinated beverage or a glass of vino, don't panic: You may not have to give them up entirely. Instead, take the following steps to determine how much you can tolerate before symptoms start:

- Stop the suspected trigger for a few days.

- Reintroduce it in a small amount.

- If you remain symptom-free, drink a little more. Keep close track of how much you consume.

At the point your symptoms return, you have reached your threshold.

"If you are highly sensitive, you may have to give up the beverage or switch to an alternative, such as decaffeinated coffee, herbal tea or carbonated water," Zumpanosays.

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