My current cardiologist said at our first appointment, five or six years ago, that "being overweight doesn't cause AF, and losing weight won't make it go away." (I was not overweight then, but have put on weight during the last nine months of daily beta blockers. No doubt it's partly due to sluggishness caused by the drugs, but from what I've read, women seem particularly susceptible to weight gain on BBs.)
This was directly contradicted by the specialist cardiac nurse who performed my cardioversion this winter: "Many people are able to get out of AF by losing 10% of their body weight."
My GP said, "Intermittent fasting is unsafe for anybody on blood thinners. It will cause the dose to build up too much in your blood." (He is of South Asian origin, obese, probably diabetic, and told me recently that he has been taking beta blockers since he was 18. He went through medical school while on BBs?!?! I can barely get out of bed!)
The specialist cardiac nurse (again) said, "Liquid will also dilute your blood, so as long as you stay hydrated, intermittent fasting is fine."
A quick online search reveals a body of research on middle-aged and elderly Muslims who fast for religious reasons despite taking cardiac drugs. The consensus is that fasting improves their cardiac health.
I find this very interesting. I've been adopting the 16/ 8 intermittent fast eating plan for some time ( some days it did not fit into my schedule though)
I can only say that i feel much healthier and energetic after a 15/16 hour fast. Ive also lost weight without feeling deprived.
On the other hand I have had 2 dc cardioversions this year 🤔 I really don't think this has anything to do with restricted eating though. My INR remains stable.
Interesting thanks. I have stomach issues and cannot eat anything 4 hrs. before bedtime. Add that to the hours l sleep and l have intermittent fasting. My condition has not deteriorated in 6 years, in fact with changing lifestyle and diet my condition has improved. Sometimes, l think one can become obsessed with the media. There is always something or someone scaremongering, or causing sensationalism, with a health issue. I would have to have very good evidence to believe everything l read. I suppose journalists have to find something to put in the news and earn their wages. Perhaps this will be of interest to many, so thanks for sharing. Keep well.
It’s also important to recognise that the “study” was just an abstract and it hasn’t been peer reviewed yet. So whether this 91% increase figure holds out remains to be seen. One study isn’t a body of evidence, though the evidence for time restricted eating for benefits other than weight loss are not really conclusive, at least not yet. When I first heard about it, I had bad ectopics and it seems that aged fruit flies (yes, really!) had fewer heartbeat irregularities on TRE! So of course I thought I’d give it a go, but alas no! The ectopics carried on and eventually AF happened. My conclusion? What’s good for fruit flies might not translate well to humans! 🤣
It depends what you mean by intermittent fasting. Many people mean time restricted eating ie an overnight fast. It’s good to give your digestive system a rest overnight and not to eat too late into the evening. As to how long your overnight fast should be, that’s about what suits you best. If you want to fast, you need to know your ‘why’. You mention weight loss so if you are habitually eating in the evenings while watching telly, it might cut out those calories and make some difference. It won’t magically cause weigh loss if you’re not reducing your total daily energy intake, though.
I am at the low end of the BMI spectrum so I don’t want to lose weight. I’ve never been overweight or anything near it so weight isn’t a factor in my AF. My overnight ‘fast’ is about 14h. I never skip breakfast. I need three substantial meals a day. My weight is stable. I have IBS and late night eating doesn’t do me any favours. So that’s my ‘why’. I also believe diet quality is probably more important than whether a 16h fast is better than a 14h fast (for me anyway). I follow a mostly plant based diet with the emphasis on whole foods. It’s not everybody’s preferred way of eating but hey, my BP is good, my cholesterol is low and so is my waist circumference, so I’ll do me, you do you, LOL! The best diet is the one you can stick to in the long term and which meets your health goals. There are many roads to Rome, as they say! If IF/TRE appeals to you, give it a try. 12/12, 14/10 or 16/8 are options you could try quite safely. Always know your ‘why’.
Weight wasn't a factor in my AF when I was diagnosed either. I don't know if it has become a factor now, and whether losing weight will make much difference. I'm turning 60 in a few weeks. I'd like to get back to my normal size, which was still my normal in my late 50s, not decades ago.
In the Year from Hell I had a fracture, followed by Covid, followed by the onset of persistent AF which used to be paroxysmal, all contributing to reduced physical activity just as post-menopause fully bedded in; compounded by going onto daily beta blockers which I'd avoided for years. Hey presto: weight gain, even without a junk food/snacking habit (nope). I was never a heavy drinker, but I gave up when I had to start taking daily drugs for AF.
Even if losing weight doesn't stop my AF (I'm prepared for that possibility, since my own cardiologist told me it wouldn't), it should help my mildly osteoarthritic knees (a knee specialist told me that 2lbs is like 14lbs when you climb stairs, so 20lbs = 140lbs of extra pressure) -- and let me get back into clothes that have become too tight.
I have read everywhere that it's very hard for post-menopausal women on beta blockers to lose weight. I don't have much patience, and I don't need to join a club to get myself weighed. (I also hate food substitutes: fake ice cream so I can pretend I'm not dieting? No thanks.) Hardcore fasting seems to yield quick results, giving strong motivation to deal with deprivation, and it seems to have become medically respectable with the Fast 800, which is what I've been planning to do. It's both intermittent fasting (a restricted window for eating) and calorie restriction.
I have an equestrian friend who keeps her weight down with regular fasts, 24--36hrs of no eating, alternating with a day of normal healthy eating. She does endurance races of 100+ miles; she needs stamina, and fasting for as long as 36hrs doesn't seem to be a problem. (She doesn't have AF, but she's in her early 70s.) That's no longer an option for me because the blood thinner I'm on has to be taken once a day with food. Hence I looked to the Fast 800 so I'll still get enough food to line my stomach.
I think I can do it, but I've been getting conflicting information from medics about whether it's safe. I want the final ruling from my cardiologist. My plan was to start after cardioversion, allowing a little time to settle into NSR. Then I fell back out of rhythm on the third day.
Starting all the drugs (metoprolol + flecainide + rivaroxaban) five months ago coincided with the first-ever onset of IBS-like symptoms, and I wondered if I'd have to add that to my crosses to bear. However, since a nasty D&V episode last month (ending up with me in an ambulance with fast AF which wasn't responding to drugs) I have gone semi-demi low-FODMAP and upped the probiotics, and all GI symptoms have calmed down.
You’ve certainly had a lot going on, that’s for sure.
I had the Michael Mosely books from the library so I’m familiar with his Fast 800. I was curious about IF for metabolic health but there’s no way that Fast 800 would be wise for me given that I need to prevent weight loss. Much of the benefit of IF appears to be from the weight loss from what I can tell. There are people who have had success on Fast 800 and they have seen their metabolic markers improve, so it’s all about what works for the individual and what they can sustain in the long term. Everyone has a different biology and even on this group people have varying health goals, apart from making their AF disappear (and let’s face it, we’d love that!) so different people will have different strategies. Perhaps you could see if your local library has his books, or check if they’re available as ebooks via the library, and then see what might suit you better. You might be able to modify/customise Fast 800 to suit your particular needs but still get the results you want.
Medication can certainly interfere with digestion too. I did the entire low FODMAP thing with a registered dietitian during lockdown/covid restrictions so I was able to give it 100% and was absolutely disciplined about the reintroduction phase — which is the most important part, really. It helped with my IBS symptoms and allowed me to identify what foods were causing the greatest symptoms. I’ve had some success with increasing my tolerances to those foods, and it’s always a work in progress. It’s important for the long term health of the gut microbiome to have as diverse a range of plant fibres in the diet as possible, so I feel that it’s important to have as few “off limits” foods as possible. All this self-care is hard work!
You are lucky to see a consultant. I have had Af for around 12yrs & have had no follow up checks since I was put on anti coagulants when diagnosed. A few yrs back my GP changed me from dabligratran to edoxaban that is all the intervention I have received.
Yes it is shocking that you've not seen a cardiologist. My GP referred me to a cardiologist, I read the reply to the GP on the NHS app - this patient does not need to be seen - she's on the appropriate treatment. The GP referred me again and the reply was the same. Stalemate. I needed that appointment so I could get the go ahead with some planned surgery.I then saw a cardiologist privately and he did an echo and I've got 2 leaky valves and enlarged heart muscle. Fortunately the private guy also works at the local NHS hospital and he's put me on his caseload for further investigation. He wasn't too impressed with his colleagues. But I have got the go ahead for the surgery. Hoops and red tape.
Totally unacceptable. Push for a cardiology appointment, even if there is a long wait. Or, dare I say it -- I'm very anti-privatisation of the NHS, but the waiting times right now are scary. So if you can afford to, book a private cardiology check-up to get in there faster so that you know if your condition has changed and you need different treatment.
You could also book a private echogram ahead of the private appointment so that you have something to show the cardiologist immediately, thereby getting the most out of your private session. I did this in the autumn at my GP's suggestion, due to the six-month wait for an "urgent" cardiology check-up (my first in four years due to the pandemic).
I am shocked Ito read read here that "hydration thins the blood" since, so far as I understood the composition of the blood is very closely maintained by the kidneys, mainly, through a process called homeostasis. The reservoir of fluid that the kidneys use to keep blood volume constant is in the abdominal cavity, called the "splanchnic bed". Drinking liquid maintains this reservoir, but has no direct effect on blood viscosity.
I shall do some more reading now - spurred by your post.
I think your cardiologist might be right (well, he ought to be...); but that the evidence is more complex. I have read of a phenomenon called the "fat paradox" which shows that some or even many obese people can be entirely healthy - which is clearly the case. One suggestion I read was that there are three kinds of fatty or adipose tissue, and that only one of these is known to be unhealthy. Obesity can lead to an increase in this tissue around the major organs, including the heart and this is read to atherosclerosis - but thin people can also get this.
Oops, that was my clumsy phrasing. The cardiac nurse didn't say that hydration thins the blood, she said that adequate hydration would prevent too much rivaroxaban from building up in my bloodstream. You're way ahead of me on the kidneys (things I've never had to learn about previously).
Even her comment on rivaroxaban sounds suspect. “Hydration” and blood levels of anything are - well, I’d have thought - not that closely connected. Still, at least she seemed properly concerned and interested in your health rather than too busy!
There is more emphasis on the waist circumference measurement as a marker of abdominal obesity now, rather than relying on BMI — though I’m not a BMI naysayer. We all know the caveat of the very muscular, very lean super fit gym guy, and as a GP once said, those are not the ones they are concerned about.
There is some controversy over the “fat but fit” body type, but again, the typical middle aged person coming in to the GP surgery isn’t going to be like that. I think there’s a bit of wishful thinking going on. I knew one overweight woman who joined a spin class and after about 2 classes the BMI chart was all wrong because she’d been to two spin classes and therefore had “built muscle”. Sadly her blood work wasn’t good.
Sometimes someone’s genes go in their favour and they can be metabolically in the normal range but classified as “overweight”. Weight isn’t a marker of health on its own. People of “normal” BMI get sick all the time.
I’d never heard of the “fat paradox” until a couple of years ago when it was mentioned in a medical research paper I was reading. And I’m sure you’re right. I feel quite sure that genetics plays an enormous role in long term health, though - more than is often considered.
Indeed. I've met "fat but fit" quite a few times. Two friends I've known for 30 years, obese (there is no other word) before I knew them and that has never changed. They are not related. One became a professional dancer in her 40s and is still performing and teaching at 63. She is gifted and has a big fan club. The other has had an astonishing career trajectory from shop assistant at 30 to finishing her PhD this year at age 64, with no intention of retiring this decade. Neither has any health problems and they are rarely ill with even common viruses. If obesity caused AF, they should both have developed it long ago -- and my mother, at 50kg, shouldn't have it at all (and before anybody replies '50kg may be overweight for her height', she was 5'9" in her prime and is now 5'6").
Yes, the plural of 'anecdote' is not 'data', but my point remains. What I admire most about the first two women is that they prioritised living their lives over trying to lose weight (one has tried to diet, one has not) and get social approval. Maybe they will be felled eventually by poor health, but in the meantime they're still having a very good run.
Badly needed inspiration for me if I'm stuck on cardiac drugs for the rest of my life and can't shift the recently added pounds.
It’s certainly a very individual situation. Where people accumulate weight matters, whether it’s around and within the internal organs (bad) or whether it’s subcutaneous and around the hips and thighs (better). As women, we see the shift in weight distribution after the menopause as oestrogen promotes weight gain around ghe hips, thighs and upper arms, whereas post menopause we tend to gain more belly fat (which also serves as a storage site for estriol, a weaker form of oestrogen). Lifestyle also plays a role so if your “fat but fit” friends have always been physically fit and active then it’s less likely they’ll build up the unhealthy visceral fats around their organs. Genetics also plays a part on where we are more prone to store fat. So the weight on the scale isn’t really the be all and end all. Everything has to be seen within the bigger picture. Weight is not a good proxy for health at all. I’ve never been close to overweight and if anything I’ve faced more of a “there can’t be much wrong with you” attitude because of that. There is a bias at the other end of the spectrum too where you’re assumed to be healthy because of appearance, so it has been hard to be taken seriously at times. One consolation of being older is that I’m taken more seriously now.
Depends upon the style of intermittent fasting - there is quite a good Zoe Podcast/YouTube video discussing.
Something else I came across recently is that IF with long fasting interval times is not good for older brains which require more glucose to work - we are all familiar with the term HANGRY - which there is some truth in although won’t be reaching for a certain chocolate bar to appease!
I have come to understand that for every study you find showing one viewpoint, there will be at least another 10 showing the opposite - efficacy of aspirin for example.
Another recent Zoe research showed how the bioavailabilty of food varies with some people metabolising and absorbing something like 80% of the calories consumed whilst others less than 50% which sort of explains why some people eat huge meals yet never put on an ounce!
I only started to lose weight with IF but I found my ideal ‘window’ of opportunity - fast from about 7.00pm until 10.00am - 12-15 hour window and do not have any snacks between meals. As I need to take 4 tablets at 12 hour intervals and another 3 with food I do have to be rather regimented with food intake but try to listen to my body and eat when I feel hunger so sometimes ‘food’ is literally a teaspoon of organic yogurt so I can take my first tablet - which I better go do now before I wilt.
Thank you for the detailed reply. Yes, I must spend some time with Zoe (I used to sign in every day but stopped) and see what they have to say about IF. I don't get hangry, but I do get vague and aimless, although this is also a side effect of my drugs so it's hard to say when it's due to blood sugar and when it's the drugs.
I also read somewhere -- possibly in that study of people who fast for religious reasons -- that what kind of blood thinner makes a difference to being able to fast or not: it seems to be preferable to take a single daily dose, longer-acting one (like rivaroxaban, which I'm on) than a multi-dose, shorter-acting one (is that what you're on?). I've been taking mine at dinner, not too close to my bedtime dose of BB + anti-arr., but I don't know if there's a more optimal time.
If I get the go-ahead to start fasting, what I will probably do is have two 400cal meals at (late) breakfast and (late) lunch, take rivaroxaban with lunch (so I'm not taking it on a stomach that has recently fasted 12+hrs), and then fast until the next morning. Obviously, snacking between meals defeats the purpose of fasting. I'm not an all-day grazer so I shouldn't struggle with that. I've read 'not even milk in tea/coffee' when fasting, nothing that triggers digestion. I'm good with water (gave up caffeine years ago).
I am looking forward to getting started. I wanted to start in January but needed input from cardiology, which has been inconclusive, and then having cardioversion in the middle of it...
)Given that the amount of time required daily for the Ramadan fast differs considerably for different times of the year and for different geographical areas there are too many confounding factors to make any blanket statements. I linked to two of these studies and read them. The one that studied risk factors for cardiovascular disease did show an improvement in such things as lipid profiles but the study that actually looked at people presenting with cardiovascular events showed no difference in fasting and non fasting times. Ramadan is not just a month of fasting - it is also a time of feasting with large and rich Iftar meals often eaten very late at night. People then have to go to bed in order to get up early for the predawn meal. In northern latitudes in summer this can mean not breaking the fast till 10pm or later . What the second study showed was different times of presentation with the cardiovascular events. It is well known within the Muslim world that hospital visits increase at night due to overindulgence in Iftar meals and that people often put on weight rather than lose it.
The participants in the intermittent fasting study were only asked about what they ate over two days, at the beginning of the research. The death figures were 8 years later, and we've no idea whether those who reported restricting their eating to an eight-hour window or less continued this. So it seems like a poor piece of research.
There's an article on the British heart Foundation website titled "Can intermittent fasting double your risk of dying from heart problems? " which also points out some other weaknesses in the study - it was self-reported, also observational, which can't show cause and effect. and seems to go against what previous studies have suggested about the short-term benefits of intermittent fasting,
I think we all have to figure out what is right for ourselves and we share what we learned but it is now way written in stone what works. For me I also deal with Low blood sugar and for me I think it plays a huge roll in AF. I didn’t always understand that. I do not have diabetes, but I have to make sure I eat like a diabetic. Go figure. I need enough nourishment to complete the task at hand. If I want to take a 2 mile hike I better have enough food in me to supply that walk, and a couple of times I didn’t. I crash and then that releases several stress hormones and it sometimes takes all day to feel right again after eating.
I said all that to say: Yes I think intermittent fasting can take a toll on the heart, as I was intermittent fasting for awhile and trying to loose weight and exercising and all the things they say we must do, and drink plenty of water. For me and I suspect for others as well, it doesn’t help long term. I was depleting my energy and my minerals and setting off all kinds of stress hormones. Since I stopped that and eat when I am hungry and drink when thirsty and make sure I am eating whole fruit I have not had an AF episode in almost 1.5 years. Which is very remarkable for me. I stay away from grains except rice and I am maintaining my weight which is maybe 10 pounds over what THEY say is normal. I decided I don’t care what THEY say and I will tell my doctor the same thing.
A huge valuable lesson is do your homework as you are, ask questions but figure out what you need for yourself. Experiment with things and take note how you feel, listen to your body.
Hello Redactrice, that study included people doing intermittent fasting not by choice but skipping meals because they were too busy... I have done intermittent fasting for more than 2 years, and I stayed sinus rhythm 98% of the time. I only eat a big lunch with whole food rich in magnesium and potassium. Everyone is different, I do it to reduce inflamation in my body, in the 60s, people did not snack so much between meals and there was less cancer.
The weight issue is a conundrum re: AF. Two close friend - One is obese, mid 70's, no AF, the other mid-60's fit and slim, active, recently diagnosed with AF. There must be many components at play beside weight I would imagine.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
AF without fast pulse? 
AF and fast heartbeat 
to filter coffee or not too filter coffee with intermittent AF 
Difference in type of AF fast or slow!
Fast AF - How long to wait before heading to hospital?
