Heart failure is defined as the point at which the heart fails to pump enough blood throughout the body, resulting in fluid retention in the feet, ankles, legs and lungs. It also causes fatigue, weakness, shortness of breath and night coughs. CDC statistics show that heart failure costs 300,000 lives every year in the United States and is the number one reason for hospitalization of people over 65. Heart failure can be managed with medical nutrition therapy, lifestyle, medications, and heart transplant when all other options are exhausted. These treatments will not cure heart failure but can slow down the progression of the disease, improve your quality of life and prolong your lifespan.
Sodium
Because of the fluid buildup, sodium and fluid are the primary dietary concerns for heart failure patients. Sodium retains water and raises the blood pressure. High blood pressure weakens heart muscles, which in turn leads to heart failure. The American Heart Association recommends no more than 1,500mg of sodium a day, which is equivalent to 3/4 tsp. of salt.
Besides table salt, sodium is found in almost all fresh foods and particularly high in processed foods. Many seasonings and baking products also contain sodium, including soy source, monosodium glutamate or MSG, baking powder and baking soda. Make sure to check the food label for the amount of sodium per serving, especially when shopping for packaged high sodium foods such as cheese, canned soup, processed meats, and baked goods. Eating fresh foods will help to lower sodium intake because fresh produces generally contain less sodium.
Fluid
Heart patients often need to watch out for excess fluid intake and weight gain. Sudden weight gain signals fluid retention that warrants medical attention. Excess fluid worsens heart failure symptoms by raising the blood pressure and inducing fluid buildup and hyponatremia, a potentially deadly condition with low sodium concentration in the serum. The heart failure guidelines by the American Heart Association recommend that fluid intake be restricted to less than 2 liters or about 9 cups per day.
Cholesterol
One of the leading causes for heart failure is coronary artery disease, in which the artery that supply to the heart becomes hardened and narrowed in a process known as atherosclerosis. Heart failure patients with atherosclerosis need to limit saturated fat, trans fat and cholesterol in the diet to control the level of LDL cholesterol in the blood. High LDL cholesterol precipitates atherosclerosis. According to the American Heart Association, heart patients should limit saturated fat to less than 7 percent of daily calorie and dietary cholesterol to less than 200 mg, and keep trans fat as low as possible. You can lower saturated fat and cholesterol by avoiding fatty animal foods such as whole fat dairies, egg, fatty meat, poultry with skin, butter and lard. Choose extra lean meat and fish instead. Avoid foods high in trans fats such as fried chicken, french fries, margarine stick, and baked products.
Weight Loss
For patients with heart failure, weight loss may not be desirable due to the potential risk of cachexia, a life-threatening condition with extensive muscle wasting and fat loss. About 10 percent of heart failure patients have cachexia, based on the data by the American Heart Association. According to a study published in the Journal of Heart Lung Transplant in 1999, cachexia is associated with reduced survival for heart transplant patients. The American Heart Association states that people with the best survival from heart failure have a slightly obese body mass Index of 30 to 32 kg/m2. You may need high protein, high calorie foods to prevent cachexia if you are underweight. Check with your dietitian for the amount of daily calorie you need to prevent weight loss associated with heart failure or a heart transplant.
References
- Circulation: State of the Science: Promoting Self-Care in Persons with Heart Failure; Riegel B. et al.; 2009
- Centers for Disease Control and Prevention: Heart Failure Fact Sheet
- National Institutes of Health Senior Health: Heart Failure
- MedlinePlus: Heart Failure --- Fluids and Diuretics
- "The Journal of Heart and Lung Transplantation"; Are preoperative obesity and cachexia risk factors for post heart transplant morbidity and mortality: a multi-institutional study of preoperative weight-height indices. Cardiac Transplant Research Database (CTRD) Group; K.L. Grady et al.; 1999
