Cardiovascular disease

Heart failure, which is a syndrome characterized by left ventricular dilation or hypertrophy, is caused by

cardiac dysfunction that results from myocardial muscle dysfunction or loss. Heart failure leads to

neuro-hormonal and circulatory abnormalities that cause fluid retention, shortness of breath, and fatigue.

The leading causes of heart failure include hypertension, coronary heart disease, and diabetes mellitus. Referral to a registered dietitian for medical nutrition therapy is recommended for individuals who have heart failure. A minimum of four visits with a registered dietitian can lead to an improved dietary pattern and quality of life and decreased edema and fatigue. Medical nutrition therapy in conjunction with optimal pharmacological management may also reduce hospitalizations.

Signs and symptoms

  • difficulty breathing, especially when lying flat in bed or with exertion
  • waking up breathless at night
  • frequent, dry, hacking cough
  • poor tolerance to exercise, or on exertion
  • sudden weight gain caused by edema or ascites
  • frequent urination
  • swelling in the lower extremities (especially the ankles)
  • fatigue, dizziness, weakness, or fainting
  • early satiety, nausea, and abdominal swelling or bloating

Adverse health outcomes associated with heart failure are:

  • reduced tolerance to exercise or activity
  • stroke
  • peripheral vascular disease
  • renal failure

Nutrition intervention

Specific nutrition interventions are effective in managing the signs and symptoms of heart failure. Nutrition interventions should be customized based on the patient’s individualized needs and the nutrition diagnoses identified by the comprehensive nutrition assessment. Hypertension is often associated with heart failure; therefore, dietary and lifestyle management strategies for treating hypertension should be applied to heart failure patients who have hypertension.

  • Monitored energy expenditure
  • Protein (daily protein intake should be at least 1.37 g/kg in clinically stable depleted patients and 1.12 g/kg in normally nourished patients)
  • Sodium (Limit sodium to 2,000 mg/day and do not exceed 3,000 mg/day)
  • Fluid intake: Fluid requirements are based on the presence of edema, ascites, shortness of breath, and hyponatremia and the frequency of weight fluctuations. Fluid restriction improves these clinical symptoms and the patient’s quality of life (Grade II) (3). For patients with heart failure, daily fluid intake should be between 1.4 and 1.9 L (48 to 64 oz), depending on clinical symptoms.
  • Vitamin and minerals: add thiamine, folate, vitamin B12 and vitamin B6. Add minerals too like potassium, magnesium and calcium.
  • Avoid alcohol
  • Avoid caffeine


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