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Dietary Self-management in Heart Failure: High Tech or High Touch?

  • Heart Failure (W Tang, Section Editor)
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Opinion statement

Dietary management of heart failure (HF) has largely been focused on sodium and fluid restrictions. Although safety and efficacy of these interventions in HF remain unclear, a daily sodium intake between 2000 and 3000 mg/day appears to be safe in these patients. Ongoing clinical research will inform on the safety and efficacy of a more restrictive sodium intake to less than 1500 mg/day. Data shows that routine fluid restriction in HF regardless of symptoms may be unnecessary; however, in patients with signs of congestion, fluid restriction to 2.0 L/day may be advisable. Recently, more attention has been paid to other nutritional aspects of HF beyond sodium and fluid intake, although there is still little evidence available to guide nutritional management of HF. Assuring that patients meet daily requirements for key micronutrients, such as calcium, magnesium, potassium, folate, vitamin E, vitamin D, zinc, and thiamine, is essential in order to prevent deficiencies. More appropriate macronutrient composition of the diet is still to be determined; however, a diet containing 50–55% carbohydrates, 25–30% fat, and 15–20% protein seems acceptable for patients with HF with or without non-end-stage renal disease. Additionally, increased protein intake may be considered in malnourished/cachectic patients. Consulting a registered dietitian is especially helpful for patients with recent HF exacerbations or for patients with multiple comorbidities who may need to follow several dietary restrictions and may benefit of individualized dietary counseling in order to ensure appropriate intake of energy, protein, and micronutrients. Today, there are still several knowledge gaps in guiding the dietary management of HF. In this article, we review current recommendations for the dietary management of HF and the evidence supporting this practice.

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Authors and Affiliations

  1. National Council of Science and Technology (CONACYT), National Institute of Cardiology ‘Ignacio Chavez, Mexico, Mexico

    Eloisa Colin-Ramirez BSc, MSc, PhD

  2. Faculty of Health Sciences, University of Ontario Institute of Technology, Ontario, Canada

    JoAnne Arcand PhD, RD

  3. Division of Cardiology, Department of Medicine, and Canadian VIGOUR Centre, University of Alberta, 2-132 Li Ka Shing Centre for Health Research Innovation, Edmonton, Alberta, Canada

    Justin A. Ezekowitz MBBCh, MSc

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  1. Eloisa Colin-Ramirez BSc, MSc, PhD
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  3. Justin A. Ezekowitz MBBCh, MSc
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Correspondence to Justin A. Ezekowitz MBBCh, MSc.

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Eloisa Colin-Ramirez and JoAnne Arcand each declare no potential conflicts of interest. Justin A. Ezekowitz holds a Population Health Investigator award from Alberta Innovates-Health Solutions and is the Principal Investigator of a the SODIUM-HF trial funded by the Canadian Institutes of Health Research.

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Colin-Ramirez, E., Arcand, J. & Ezekowitz, J.A. Dietary Self-management in Heart Failure: High Tech or High Touch?. Curr Treat Options Cardio Med 19, 19 (2017). https://doi.org/10.1007/s11936-017-0515-9

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