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Clinical Articles, Lead Article

Extra-virgin olive oil reduces AF risk

In the absence of proven interventions for the primary prevention of atrial fibrillation (AF), extra-virgin olive oil in the context of a Mediterranean dietary pattern may reduce the risk of AF, according to a post hoc analysis of the PREDIMED (Prevención con Dieta Mediterránea) trial published recently.1

Participants were randomly assigned to 1 of 3 diets: Mediterranean diet supplemented with extra-virgin olive oil, Mediterranean diet supplemented with mixed nuts, or advice to follow a low-fat diet (control group). Incident AF was adjudicated during follow-up by an events committee blinded to dietary group allocation.

Among 6,705 participants without prevalent AF at randomisation, the authors observed 72 new cases of AF in the Mediterranean diet with extra-virgin olive oil group, 82 in the Mediterranean diet with mixed nuts group, and 92 in the control group after median follow-up of 4.7 years.

The Mediterranean diet with extra-virgin olive oil significantly reduced the risk of AF (hazard ratio, 0.62; 95% confidence interval, 0.45–0.85 compared with the control group). No effect was found for the Mediterranean diet with nuts (hazard ratio, 0.89; 95% confidence interval, 0.65–1.20).

Dr Miguel Á Martínez-González (University of Navarra, Navarra, Spain)

Dr Miguel Á Martínez-González (University of Navarra, Navarra, Spain)

Speaking to BJC Arrhythmia Watch, co-author Dr Miguel Á Martínez-González (University of Navarra, Navarra, Spain) said: “This is the first time that a large randomised trial has provided first-level evidence of protection against new-onset AF by a dietary intervention. Adherence to the Mediterranean diet was monitored every three months using…objective biomarkers of compliance (e.g. alpha-linolenic acid in plasma and urinary hydroxytyrosol) in random samples of participants. The participants received personalised advice and small-group sessions on a quarterly basis during an average follow-up of 4.7 years”.

“The randomised design provided a strong basis for causal evidence, because all other factors were kept balanced in the three groups, and the only difference was the intervention. We provided participants (only in the first group) with 1 litre per week of extra-virgin olive oil given as a gift (at no cost) for them and their families. The risk reduction was strongest in this group. In addition, we assessed the changes in the consumption of extra-virgin olive oil in each participant during follow-up, and  increased consumption of this oil was strongly associated with a lower risk of developing AF. All analyses took into account and controlled for other known risk factors of AF,” Dr Martínez-González added.

“The demonstrated anti-inflammatory and antioxidant effects of extra-virgin olive oil are likely to explain the mechanisms for this reduction in risk,” he concluded.


1. Martínez-González MA, Toledo E, Arós F, et al. Extravirgin olive oil consumption reduces risk of atrial fibrillation: the PREDIMED (Prevención con Dieta Mediterránea) trial. Circulation 2014;130:18–26.​CIRCULATIONAHA.113.006921

Published on: August 5, 2014

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association

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