{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T18:17:35Z","timestamp":1790965055907,"version":"4.1.0"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,5,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The influences of low\u2010carbohydrate diets in cardiovascular disease are controversial. Few studies have examined the relationship of carbohydrate intake and risk of incident atrial fibrillation (\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              ). We aimed to evaluate the association between carbohydrate intake and the risk of incident\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              in the ARIC (Atherosclerosis Risk in Communities) Study.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We included 13\u00a0385 participants (age, 54.2\u00b15.8\u00a0years; 45.1% men and 74.7% white) who completed a dietary questionnaire at baseline (1987\u20131989) in the\n              <jats:styled-content style=\"fixed-case\">ARIC<\/jats:styled-content>\n              Study. The primary outcome was incident\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              , which was identified by ECG performed during study examinations, hospital discharge codes, and death certificates. We used multivariable Cox hazard regression models to assess the association between carbohydrate intake and incident\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              . We further explored the effects of specific food source (animal versus plant based) used to replace carbohydrate intake in the low\u2010carbohydrate intake setting. During a median follow\u2010up of 22.4\u00a0years, 1808 cases (13.5%) of\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              occurred. The hazard ratio for incident\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              associated with a 1\u2010\n              <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n              (9.4%) increase in carbohydrate intake as a percentage of energy intake was 0.82 (95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 0.72\u20130.94), after adjustment for traditional\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              risk factors and other diets factors. Results were similar when individuals were categorized by carbohydrate intake quartiles (hazard ratio, 0.64; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 0.49\u20130.84; comparing extreme quartiles). No association was found between the type of protein or fat used to replace the carbohydrate and risk of incident\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              .\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Low\u2010carbohydrate diets were associated with increased risk of incident\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              , regardless of the type of protein or fat used to replace the carbohydrate.\n            <\/jats:p>\n          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