For advanced heart failure patients, a healthy diet is imperative.
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, Dr. Dawn Pedrotty, 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.
Why is a healthy diet important for AHF patients?
“The goal of optimizing your diet when you have heart failure is to reduce the amount of work the heart needs to do. We often call poor dietary choices ‘dietary indiscretions’ — drinking too much fluid or eating foods high in salt can both cause water retention, which manifests as rapid weight gain,” said Pedrotty. “This retention will cause swelling or edema, often in the legs, that can eventually affect your gut and can lead to your oral medications not being absorbed well. Your oral diuretic (fluid pill) might not be absorbed in the gut thus resulting in more fluid retention and weight gain. Eventually this requires the patient to be admitted to the hospital for IV medications to finally get the fluid off.”
What is the recommended salt and fluid intake for AHF patients?
“The consensus statement from April 2024 now recommends limiting salt intake to no more than 5 grams day and a fluid restriction of 1.5-2 liters a day in select patients,” Pedrotty said.
What foods and drinks are off-limits?
“Foods high in salt should always be off-limits,” Pedrotty said. “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 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,” she added, “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,” Pedrotty said. “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. Fried foods are not ideal, and chicken or fish is preferred over red meat.”
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,” Pedrotty said. “If you are struggling with cholesterol or are concerned you can always just eat the egg whites, which still have protein and no cholesterol.”
Is there a healthier way for AHF patients to cure their cravings?
“You have treats, just not daily. For example, 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.
