Diet and Exercise in Patients with Atrial Fibrillation

[Music] hello my name is rohit matha i'm a cardiac electrophysiologist here at sanger heart and vascular institute as part of atrium health and my name is sadr patella and i'm one of the nurse practitioners at sanger heart and vascular and we're here to talk to you about atrial fibrillation and how diet and exercise affect afib so we get asked a lot about diet and exercise in our clinic and so here we're here today to talk about food choices and how we can make diet simpler for patients when it comes to treating afib so ro you get asked this question a lot how does diet affect atrial fibrillation so diet affects atrial fibrillation quite a bit i would argue that diet actually is the main predictor of atrial fibrillation and risk so when we think about cardiovascular disease and atrial fibrillation is a marker of cardiovascular disease diet affects it heavily so what are the things that are kind of the misnomer so the idea that low-fat diets help with cardiovascular disease is actually a bit of a myth and has actually been really changing in a lot of the sciences has put forth so today we really look a lot at sugars and glycemic index of our foods and afib is no different so whether it be the risk that alcohol gives to increasing afib burden a large driver of that is actually the glycemic index that's associated with alcohol so we have a few foods here on the table for us and so when we look at things we should always really look at the label so this is a this is a sparkling soda and it seems like it should be healthy because it's nice and orange but when i look at the label that has a total of 26 grams of sugar so when we look at that that's about 10 of the total sugar you should get in the course of a day now imagine if you drink 10 of these you've now exceeded your total sugar requirement for the day now for instance we look at a superfood like sweet potatoes sweet potatoes actually have high carbohydrates but overall a low glycemic index meaning that they're fairly good sugars and a lower amount of sugars in general so as a general rule what we would suggest are thinking things that come out of the ground so think green leafy vegetables avocados sweet potatoes apples anything that have their own skin and their own packaging if it comes in more artificial packaging so think about things like granulated sugar flour and the tray is candy that we always snack on in the middle of the day even something as ubiquitous as rice so white rice has a tremendous sugar content our breads so we should look at other grains like quinoa and brown rice and oats as things that we can substitute for the things that have higher sugars like the white breads and the uh the white rices so if i was going to pick a sugar if we had if we're going to cook cook with sugar what would you suggest would be a good choice well in general again things found in nature so natural sugars like so like agave syrups maple syrup which is one of my favorites uh honey those are all things that tend to have you know still sugar content but they're more natural sugars and so a lot of the phyto nutrients that are contained within will help manage the effects that the sugar has on our disease and specifically atrial fibrillation [Music] so i get asked this all the time in clinic are there any specific diets that are better for atrial fibrillation and that we should be telling patients what to eat a great great point and great question sadra so you know a big part of it is i like to deal with general guidelines because i think if we give patients rules to follow versus specific diets to follow i think it helps so in general we would recommend foods that have a low glycemic index there's actually data from a group in australia that actually looks at this specifically in upwards of a 90 drop in atrial fibrillation risk and what this means is that you can literally go online and look up a glycemic index and if the number is below 55 that would be a low glycemic index food so for instance granulated sugar would be very high on the glycemic index but when you look at something like agave sugars would be very low on the glycemic index so two things that are probably equally sweet that have vast differences in glycemic index so low glycemic index diets and specifically the things that i tend to favor are things like plant-based diets pescetarian diets when we start looking at some of the fad diets so and specifically there are several where we have to be very careful because they can promote cardiovascular disease and promote atrial fibrillation the thing that comes to mind most frequently is actually the ketogenic diet so i strongly discourage patients from actually using the ketogenic diet even though it helps people lose weight that weight comes at a cost which is really cardiovascular disease and atrial fibrillation so when it comes to caffeine this is another question i get asked all the time is caffeine effect does caffeine affect afib great question you know for decades and decades and decades we've given the advice that caffeine can materially affect your atrial fibrillation and really over the past three to four years there have been two definitive studies that have answered this number one when you look at coffee drinkers number one the first study really showed that there was no deleterious effect so patients that drank coffee were at no higher risk of atrial fibrillation than others the other thing that was kind of interesting is the following year a study came out actually looking at the the incidence of atrial fibrillation in coffee drinkers and specifically they actually ended up having a lower risk of atrial fibrillation in general so why i wouldn't suggest going off on a coffee bins to prevent your atrial fib what i can say is that if you're like me and you really need that cup of joe in the morning it's absolutely fine to have again be mindful what you put in the cup of coffee so when you load it up with granulated sugars versus things like honey agave syrups or maple syrup which is my favorite then it's absolutely fine to have so what are some other things in regards to diet and health and well-being that affect atrial fibrillation now great question so you know the things that we always point to are things like that are in front of us right food but you know weight and specifically not so much weight but fitness becomes important and you know say i know you're going to show us a lot about this in just a second but really kind of controlling weight through the the active choice of good foods the other thing is you know it's summertime a lot of people like to go out maybe have a beer or a glass of wine alcohol is another thing you have to be under you have to have under control when you think about atrial fibrillation so moderate to large amounts of alcohol and that could mean something as simple as two glasses of wine at night can considerably increase your risk of atrial fibrillation so that's something that we always ask our patients to back off on and specifically look at again low glycemic index alcohols as well if you are going to have a drink make sure that the sugar content of that drink is controlled the other thing is sleep and this is the one thing that i think has been under recognized when we look at patients that have atrial fibrillation a large majority of patients have co-existing sleep apnea so if you're if your spouse or partner tells you hey you're snoring a lot at night or if you they've kind of been kicked out of the bedroom because you're throwing so much it's probably worth seeing a sleep specialist because these are things that can contribute meaningfully to atrial fibrillation risk [Music] so it appears that you know diet plays a beneficial role when when when we use the right things when it comes to our atrial fibrillation but you know exercise tends to get a little confusing so say dr help me understand is is exercise helpful is it hurtful like what's the verdict on this yes so exercise is helpful in in the treatment of atrial fibrillation and multiple studies have actually shown it can reduce the number of days patients are in afib so we highly encourage exercise once diagnosed with afib [Music] so if a patient asks they're you know they're they go in and out of atrial fibrillation you know when they exercise wouldn't they potentially promote their afib at that time wouldn't they wouldn't that cause them to go into afib no not necessarily so the rule of thumb for patients is think about what your heart rate is at rest and if it goes up to it should actually elevate when you exercise right that's a normal response to exercise the question is is if you're fast at rest over 110 beats a minute while sitting you might actually be an afib and so therefore if you don't feel well you could stop but the end to exercise in a bib is safe as well it just really depends on your baseline resting heart rate so cedric you know you've told us that exercise helps when it comes to atrial fibrillation but i'm confused i you know i don't exercise regularly so how do i get started what are the types of exercises that i need to be doing sure that's a great question so just like afib it's highly individualized so you have to tailor the exercise program based on that patient's specific needs and ability right but the american college of cardiology recommends about 150 minutes a week of moderate exercise these types of exercises are brisk walking climbing stairs taking hikes doubles tennis and even pushing your lawnmower can be considered moderate exercise but i will say it doesn't have to be intense to be considered effective and that's the take home when it comes to exercise so that was helpful in terms of helping me get started on an exercise program but like i get home late right and at work i how do i find time at work how do i find time after work what are the tools you can help me with in terms of implementing right that's important so we just spoke about how atrial fibrillation is influenced by exercise and it can actually reduce the number of episodes of afib so when patients find value in that and that they know they're going to have less afib days that can motivate them to want to exercise so i recommend patients start small set weekly goals even daily goals today i'm going to go for a bike ride tomorrow i'm going to go for a hike and commit to that it takes 90 days to make a habit and so if you can incorporate start small and then work yourself bigger so henry we spend a lot of time in atrial fibrillation thinking about heart rate heart rate heart rate so what's a good heart rate so that's also very individualized based on your own resting heart rate but with exercise we expect your heart rate to go up that's a normal response and as you exercise and condition yourself that will get easier and the sensation will get better so even if i'm in atrial fibrillation all the time i expect my heart rate to go up during exercise absolutely so yes we can expect your heart rate to get elevated now obviously if you're short of breath or having some limitations you should stop so we all can do a little bit better when it comes to diet and exercise i think that we can all grape on that and i know after talking to you about some of my choices with sugar i'm going to probably lay off candy a little bit more and you're going to do some more sit-ups of course of course absolutely so you know i think a big part of what we've all learned today is that you know food is medicine and exercise is medicine so i really think we need to commit to those things even as small small doses every little bit helps and zeta thanks for helping us understand that yes let's make it fun for our patients absolutely [Music]

Channel: Atrium Health

Views: 186,417

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Id: cFviI7890QM

Length: 12min 22sec (742 seconds)

Published: Tue Sep 21 2021