{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T11:27:47Z","timestamp":1787570867807,"version":"build-2736575974"},"reference-count":30,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"unspecified","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"the Meiji Yasuda Health Insurance Company and Research Institute"},{"name":"the Intramural Research Fund for the Cardiovascular Diseases of the National Cerebral and Cardiovascular Center","award":["23-B-9"],"award-info":[{"award-number":["23-B-9"]}]},{"DOI":"10.13039\/501100002241","name":"Japan Science and Technology Agency","doi-asserted-by":"publisher","award":["JPMJPF2018"],"award-info":[{"award-number":["JPMJPF2018"]}],"id":[{"id":"10.13039\/501100002241","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Health and Labour Sciences Research Grants of the Ministry of Health, Labour and Welfare of Japan","award":["20FA1002"],"award-info":[{"award-number":["20FA1002"]}]},{"name":"Grants-in-Aid for Scientific Research in Japan","award":["B, No. 16H05252"],"award-info":[{"award-number":["B, No. 16H05252"]}]},{"DOI":"10.13039\/100020237","name":"Japan Health Research Promotion Bureau","doi-asserted-by":"crossref","award":["2024-B-05"],"award-info":[{"award-number":["2024-B-05"]}],"id":[{"id":"10.13039\/100020237","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,14]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background and aim<\/jats:title>\n                    <jats:p>Evidence of an association between carbohydrate intake and atrial fibrillation (AF) incidence remains limited. We investigated the association between carbohydrate and staple food consumption and AF risk in a Japanese urban population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Our population-based prospective cohort study included 5229 adult participants (mean age 56.9 years; 46.5% men) who completed a Food Frequency Questionnaire. Multivariable-adjusted Cox regression models were used to assess the association between carbohydrate intake (g\/day) and staple food consumption (rice, noodles and bread) and AF incidence after adjusting for confounding factors. During 68\u2009668 person-years of follow-up (mean, 13.1 years), 226 individuals developed AF. Total and simple carbohydrate intakes were associated with an increased AF risk in men (HR and 95%\u2009CI for Q4 vs Q1 were 2.51 (1.06 to 5.96)\u2009and 3.29 (1.33 to 8.13), respectively). In contrast, there were no significant associations between total carbohydrate, simple or complex carbohydrate intake and AF risk in women (HR and 95%\u2009CI for Q4 vs Q1 were 1.33 (0.27 to 6.65), 2.75 (0.74\u201310.26) and 1.04 (0.38-2.83), respectively). We found no association between staple foods and AF risk in men or women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings imply that the association between carbohydrate intake and AF risk is influenced by the type of carbohydrates. We found a positive association between high intake of simple carbohydrates and AF risk in men whereas the association was negative for complex carbohydrate intakes. Meanwhile, the results in the women\u2019s group were inconclusive.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-109639","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T11:15:26Z","timestamp":1787570126000},"page":"e109639","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Association of carbohydrate, rice, noodle and bread consumption and atrial fibrillation risk in a Japanese urban population: a prospective cohort study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9235-0707","authenticated-orcid":false,"given":"Paramita","family":"Khairan","sequence":"first","affiliation":[{"name":"Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"},{"name":"Department of Internal Medicine, Universitas Muhammadiyah Jakarta, Faculty of Medicine, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2739-9609","authenticated-orcid":false,"given":"Yuka","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"},{"name":"Division of Health Sciences, The University of Osaka Graduate School of Medicine, Faculty of Medicine, Suita, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Kokubo","sequence":"additional","affiliation":[{"name":"Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3335-2243","authenticated-orcid":false,"given":"Ahmed","family":"Arafa","sequence":"additional","affiliation":[{"name":"Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko M","family":"Nakao","sequence":"additional","affiliation":[{"name":"Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"},{"name":"Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chisa","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"},{"name":"Department of Cardiology, Preventive Medicine, Tokyo Medical University, Shinjuku, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koutatsu","family":"Maruyama","sequence":"additional","affiliation":[{"name":"Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"},{"name":"Department of Bioscience, Ehime University Graduate School of Agriculture, Matsuyama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5760-9285","authenticated-orcid":false,"given":"Kengo","family":"Kusano","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"2026082404152068000_16.8.e109639.1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.i4482","article-title":"Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis","volume":"354","author":"Odutayo","year":"2016","journal-title":"BMJ"},{"key":"2026082404152068000_16.8.e109639.2","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1038\/s41569-022-00820-8","article-title":"Epidemiology and modifiable risk factors for atrial fibrillation","volume":"20","author":"Elliott","year":"2023","journal-title":"Nat Rev Cardiol"},{"key":"2026082404152068000_16.8.e109639.3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.023163"},{"key":"2026082404152068000_16.8.e109639.4","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1253\/circj.CJ-17-0277","article-title":"Development of a Basic Risk Score for Incident Atrial Fibrillation in a Japanese General Population - The Suita Study","volume":"81","author":"Kokubo","year":"2017","journal-title":"Circ J"},{"key":"2026082404152068000_16.8.e109639.5","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.k1453","article-title":"Lifetime risk of atrial fibrillation according to optimal, borderline, or elevated levels of risk factors: cohort study based on longitudinal data from the Framingham Heart Study","volume":"361","author":"Staerk","year":"2018","journal-title":"BMJ"},{"key":"2026082404152068000_16.8.e109639.6","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000748"},{"key":"2026082404152068000_16.8.e109639.7","doi-asserted-by":"crossref","first-page":"2163","DOI":"10.1111\/jce.15803","article-title":"Lifestyle changes in atrial fibrillation management and intervention","volume":"34","author":"Yang","year":"2023","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2026082404152068000_16.8.e109639.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.12.023"},{"key":"2026082404152068000_16.8.e109639.9","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1016\/j.clnu.2023.06.013","article-title":"Carbohydrate-based diet may increase the risk of cardiovascular disease: A pooled analysis of two prospective cohort studies","volume":"42","author":"Jo","year":"2023","journal-title":"Clin Nutr"},{"key":"2026082404152068000_16.8.e109639.10","doi-asserted-by":"crossref","DOI":"10.1186\/s12916-022-02712-7","article-title":"Associations between types and sources of dietary carbohydrates and cardiovascular disease risk: a prospective cohort study of UK Biobank participants","volume":"21","author":"Kelly","year":"2023","journal-title":"BMC Med"},{"key":"2026082404152068000_16.8.e109639.11","doi-asserted-by":"crossref","first-page":"e419","DOI":"10.1016\/S2468-2667(18)30135-X","article-title":"Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis","volume":"3","author":"Seidelmann","year":"2018","journal-title":"Lancet Public Health"},{"key":"2026082404152068000_16.8.e109639.12","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.119.011955","article-title":"Low-Carbohydrate Diets and Risk of Incident Atrial Fibrillation: A Prospective Cohort Study","volume":"8","author":"Zhang","year":"2019","journal-title":"J Am Heart Assoc"},{"key":"2026082404152068000_16.8.e109639.13","doi-asserted-by":"crossref","DOI":"10.1186\/s40001-024-01781-z","article-title":"Genetically predicted dietary macronutrient intakes and atrial fibrillation risk: a Mendelian randomization study","volume":"29","author":"Zhang","year":"2024","journal-title":"Eur J Med Res"},{"key":"2026082404152068000_16.8.e109639.14","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1093\/jn\/nxac039","article-title":"Importance of Carbohydrate Quality: What Does It Mean and How to Measure It?","volume":"152","author":"Campos","year":"2022","journal-title":"J Nutr"},{"key":"2026082404152068000_16.8.e109639.15","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.1016\/j.numecd.2021.03.001","article-title":"Simple versus complex carbohydrates and health: A frequently neglected problem","volume":"31","author":"Puddu","year":"2021","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"2026082404152068000_16.8.e109639.16","unstructured":"Food and Agriculture Organization of the United Nations and World Health Organization . 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