As a nutrition support pharmacist, you should advise on the best diet for your patients with heart failure. Previously, the focus on preventing and treating heart failure was to restrict excess sodium intake in order to prevent excess fluid load. While sodium control is still important, macronutrient nutrition may be more important in prevention than previously thought, and a special role has emerged to avoid foods that contain saturated fats. Give some tips...
Avoid saturated fats and fried foods. For example, avoid eating a large amount of red meat, this will increase the risk of heart failure. Also, daily egg consumption was found to increase the risk of heart failure by 30% compared to individuals who did not eat or limit eggs to 3 per month, so only one egg per week is recommended. However, it is recommended to consume fish (omega-6 to omega-3 fats) that may slightly reduce the risk of heart failure and help reduce red meat consumption.
Health-promoting dietary pattern. Diets following both Mediterranean and DASH (Dietary Approaches to Stop Hypertension) style, as well as dietary patterns that are lower in meat, higher in unsaturated fat, and higher in fish, have all been associated with significant reductions in the risk for heart failure.
Eat at least 5 fruits and vegetables per day. Vegetables appear to be more protective against heart failure than fruits, and eating 5 or more daily servings combined has been associated with a 20% lower risk compared to those who eat half of this amount.
Sodium reduction. Restricting excess sodium is important in reducing the risk of heart failure. Recommend restricting salt to 2000-3000 mg/day (half of typical U.S. daily sodium intake). Monitor potassium and magnesium levels, patients with heart failure are at high risk of hypomagnesemia due to medications like diuretics and may increase toxicity of digoxin. Give high-dose thiamine (300 mg/day), it was found to significantly improve ejection fraction in heart failure patients
Monitor anemia and give iron supplements, Also Coenzyme Q10 supplementation may be tried by patients, coenzyme Q10 may improve stroke volume, cardiac output, cardiac index, and end-diastolic volume in patients with heart failure.
References
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Ahaye A, Gaziano J, Djoussé L. Red meat consumption and risk of heart failure in male physicians. Nutr Metab Cardiovasc Dis. 2011;21(12):941-6. Available at: https://pubmed.ncbi.nlm.nih.gov/20675107
Nettleton JA, Steffen LM, Loehr LR, et al. Incident heart failure is associated with lower whole-grain intake and greater high-fat dairy and egg intake in the Atherosclerosis Risk in Communities (ARIC) study. J Am Diet Assoc. 2008;108(11):1881-7. Available at: https://pubmed.ncbi.nlm.nih.gov/18954578
Tektonidis TG, Åkesson A, Gigante B, et al. Adherence to a Mediterranean diet is associated with reduced risk of heart failure in men. Eur J Heart Fail. 2016;18(3):253-9. Available at: https://pubmed.ncbi.nlm.nih.gov/26781788
Rautiainen S, Levitan EB, Mittleman MA, et al. Fruit and vegetable intake and rate of heart failure: a population-based prospective cohort of women. Eur J Heart Fail. 2015;17(1):20-6. Available at: https://pubmed.ncbi.nlm.nih.gov/25382356
Konerman MC, Hummel SL. Sodium restriction in heart failure: benefit or harm? Curr Treat Options Cardiovasc Med. 2014;16(2):286. Available at: https://pubmed.ncbi.nlm.nih.gov/25382356
Katta N, Balla S, Alpert MA. Does Long-Term Furosemide Therapy Cause Thiamine Deficiency in Patients with Heart Failure? A Focused Review.Am J Med. 2016;129(7):753.e7-753.e11. Available at: https://pubmed.ncbi.nlm.nih.gov/26899752
Mortensen SA, Rosenfeldt F, Kumar A, et al. The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC Heart Fail. 2014;2(6):641-9. Available at: https://pubmed.ncbi.nlm.nih.gov/25282031
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