Heart & Vascular

Advanced heart failure and diet: What you need to know


February 9, 2022

For advanced heart failure patients, a healthy diet is imperative. Here, a Vanderbilt expert answers our questions on why diet matters and what guidelines need to be followed.

Heart failure is a chronic disease where the heart muscle becomes weakened, lessening its ability to pump blood. Prevalent in the South, this condition is progressive and must be treated with medications and lifestyle changes—and key among these changes is adopting a heart-healthy diet. Here, Dawn Pedrotty, M.D., a cardiologist with the Vanderbilt Heart and Vascular Institute and an expert in advanced heart failure disease, explains why diet makes such a difference in the lives of her patients.

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Why is a healthy diet important for AHF patients? 

“Dietary indiscretions—eating and drinking things that are off-limit, or things that should only be consumed in moderation—are one of the primary causes for what is known as ‘decompensation of heart failure,’ which can result in fluid retention that’s first noted as rapid weight gain,” said Pedrotty. “This retention, or edema, can also affect your gut and can lead to your oral medications not being absorbed well. Your diuretic (fluid pill) might not work as well either, which could result in more fluid retention and weight gain. Eventually this requires IV medications to treat and hospitalization.”

What foods and drinks are off-limits?

“Foods high in salt should always be off limits. Salt causes water retention which will cause fluid to build up and result in decompensation of your heart failure. You should also reduce red and processed meat intake. Research published in the Journal of American Medical Association in 2020 found a higher intake of processed meat (like hot dogs) and unprocessed red meat was associated with a small increased risk of coronary heart disease, stroke and heart failure. In terms of drinks, cut back or omit alcohol from your diet as it can affect your heart rate and worsen your heart failure. Alcohol can also interact with heart failure medications.”

What foods should be top-of-mind in terms of their health benefits for AHF patients?

“The Mediterranean diet is a heart-healthy diet that focuses on eating vegetables, fruits, whole grains and healthy fats (olive oil, nuts) with weekly servings of dairy, fish, poultry, beans and eggs. Meals should be built around plant-based foods. Patients who also have diabetes should favor more vegetables over fruits due to the natural sugars in fruits.”

What about eggs and cholesterol?

“Eggs are a great source of protein, and data suggests most healthy people can eat seven eggs a week without concern about additional cholesterol.  If you are struggling with cholesterol or are concerned you can always just eat the egg whites, which still have protein and no cholesterol.”

Party food: What should be avoided?

“Fried foods are not ideal but if this cannot be avoided, chicken or fish is preferred over red meat.”

Is there a healthier way for AHF patients to cure their cravings?

“Off-limit foods like ice cream can be a treat occasionally, meaning a small portion can be enjoyed once every 1-2 weeks.  Everything in moderation!”

Care for your heart

The Vanderbilt Heart and Vascular Institute knows how to care for each person’s unique heart. The team includes some of the top heart and vascular specialists in the nation, who can personalize a treatment plan for each patient — whether it’s simply a change in diet and exercise, medication, a catheter procedure, surgery or mechanical support.

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