Heart Failure: Eating a Healthy Diet
Why is diet important for heart failure?
Diet is critical in the treatment of heart failure. Sodium is the key nutrient that must be controlled in order to improve the status of your heart failure (prevent fluid buildup). But some other nutrients or substances also play a role as well. Heart failure can become more severe if diet and medicine recommendations for heart failure are not closely followed. Medicine and diet therapy are most effective when used together in the treatment of heart failure.
Taking your medicines and following the diet your doctor has recommended for you will make it easier for you to breathe and help you feel better and be able to do more of your normal daily activities. A registered dietitian can help you make needed dietary changes by providing meal-planning guidelines that are realistic and specifically tailored to your individual needs and preferences.
Why do you need to limit sodium or fluid?
Limiting sodium to help treat heart failure cannot be overemphasized, especially as the condition progresses. If you consume too much sodium, it will cause your body to retain excess fluid. Excess fluid in the body will cause swelling, breathing difficulties, and fatigue.
Your doctor will tell you how much sodium you can eat each day. Most people need to limit sodium to less than 2,000 mg each day.
For tips on limiting sodium, see:
Fluid intake is not routinely restricted. It may be restricted in advanced cases to maintain your body's electrolyte balance. Closely following your low-sodium diet will help to decrease or eliminate the need for fluid restriction. It is very important that you watch for any signs of fluid gain (swelling or increase in body weight) and report them to your doctor.
For more information, see Heart Failure: Watching Your Fluids.
Do you need supplements or vitamins?
You can get most of your vitamins by eating a heart-healthy diet that is rich in fruits and vegetables.
Your doctor might recommend a multivitamin/mineral supplement if you are undernourished or cannot completely meet your nutritional needs through food.
If you take a diuretic (water pill) for heart failure, this medicine might change your dietary needs for potassium, magnesium, calcium, and zinc. Ask your doctor if you should take supplements or eat certain foods to get enough of these minerals.
Potassium. If you take a diuretic, ask your doctor if you need to take a potassium supplement or if you need to watch the amount of potassium in your diet. If you take a loop diuretic or thiazide diuretic, your doctor may suggest that you get extra potassium because these medicines lower your potassium levels. But if you take a potassium-sparing diuretic, you might not need to get extra potassium in your diet.
For more information, see Diuretics and Potassium Supplements.
Magnesium. Just like potassium, blood levels of magnesium are generally low with extensive diuretic use. Magnesium plays a role in holding on to potassium in the body. So if you need to replenish potassium, you need to consume enough magnesium also to optimize the body's ability to retain the potassium you are consuming.
Good food sources of magnesium include seeds, nuts, legumes, unmilled cereal grains, and dark green vegetables.
Calcium and zinc. Long-term use of diuretics can also deplete your body of calcium and zinc. Adequate calcium must also be consumed to prevent bone loss, which can occur in people who are not able to be physically active. Good food sources of calcium include milk and milk products, calcium-fortified foods and beverages, broccoli, greens, and kale. Good food sources of zinc include meat, fish (especially oysters), poultry, and milk and milk products.
Should you limit alcohol or caffeine?
Caffeine can increase heart rate and cause changes in your heart rhythm. So you may need to limit your intake of caffeine.
What if you need extra calories and nutrients?
In severe heart failure, more calories are often needed because of the increased workload of the heart and lungs. But calorie requirements will vary, based on your current nutritional status.
If you are underweight or malnourished, you will need to increase your intake to obtain sufficient calories and protein to prevent the loss of muscle tissue, maintain or gain weight, and achieve a healthy level of protein (albumin) in the blood.
In individuals whose activity is very limited (those who are bedridden), it is important to obtain sufficient calories and protein to prevent the development of pressure ulcers (bed sores). Increased food intake is often difficult for individuals with moderate to severe heart failure because of the congestion, poor appetite, shortness of breath, and nausea that are often caused by this condition or by the medicines used to treat it.
The body's increased energy demands along with the obstacles to sufficient intake can often lead to malnutrition in people with heart failure. The following is a list of suggestions to help you boost your appetite (by reducing fatigue) and to help you increase your calories and protein with as little volume and discomfort as possible.
Tips for increasing your calorie and protein intake:
How does heart failure change how your body regulates and uses nutrients?
As heart failure progresses, the heart loses its ability to pump strongly, and blood flow throughout the body decreases. This causes a number of reactions throughout the body. Decreased blood flow to the kidneys hinders their ability to remove excess sodium from the body.
Reduced cardiac output from ineffective pumping stimulates the kidneys to retain fluid. Retained fluid causes congestion in the lungs and difficulty breathing. Excess sodium in the body results in the release of a hormone called aldosterone that causes the body to retain fluid as well. Fluid builds up in the body and causes congestion in the lungs, which makes breathing difficult. Also, fluid may build up in the wall of your intestines, which can make it difficult to absorb nutrients from your food. If your body does not receive the nutrition that it needs, you will lose muscle tissue and your body will not be able to fight off infections.
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