Running head: NUTRITION AND CONGESTIVE HEART FAILURE

Nutrition and Congestive Heart Failure

Patricia Korovich
University of South Florida

NUTRITION AND CONGESTIVE HEART FAILURE

Nutrition and Congestive Heart Failure

Like many diseases, congestive heart failure (CHF) is a condition that is heavily affected
by nutrition, activity and lifestyle habits. CHF is characterized by inadequate tissue perfusion
due to insufficient cardiac output, as well as excess sodium and water retention; signs can
include dyspnea, edema and/or hypertension due to fluid overload (Huether & McCance, 2012).
For patients like Mrs. Johnson, who are newly diagnosed with CHF, adherence to specific
nutritional guidelines and administration of diuretics can help alleviate symptoms and slow the
progression of the disease.
According to the American Heart Association (AHA), recommendations for a patient
diagnosed with CHF include avoidance of alcohol and caffeine, healthy weight loss and
adherence to a heart-healthy diet (2015). The AHA indicates that a heart-healthy diet ideally
includes high-fiber whole grains (6-8 servings per day), fresh fruits and vegetables (4-5 servings
per day, each), lean meats (up to 6 cooked ounces per day), nuts and legumes (4-5 servings per
week), low-fat milk products (2-3 servings per day), healthy fats (2-3 servings per day) and low
consumption of cholesterol and saturated fats (2012a). However, two of the most important
elements of dietary education for a patient with CHF concern sodium and fluid intake.
Excess sodium in the body prompts water retention, which can be detrimental to a patient
with CHF due to increased blood pressure and workload of a heart that is already
malfunctioning. Excessive fluid intake can similarly exacerbate CHF and because of this,
reduction of salt and limiting fluids can help patients, like Mrs. Johnson, if she begins
experiencing symptoms related to fluid overload (Cleveland Clinic, 2015). Depending on the
severity of Mrs. Johnsons CHF, as well as the source of information one references, sodium and
fluid guidelines may vary. According to the AHA, dietary sodium should be limited to 1,500 mg

NUTRITION AND CONGESTIVE HEART FAILURE

per day and may be eliminated altogether in extreme cases (2012b), and the Cleveland Clinic
suggests that sodium should be limited to 2,000 mg per day (2015). Similarly, the Cleveland
Clinic suggests that daily fluid intake be limited to 2 liters, and may be decreased further in the
presence of exacerbated symptoms such as shortness of breath or edema (2015). It is important to
educate patients how to read nutrition labels on packages, to avoid processed foods (like canned
vegetables or deli meats), to exclude salt in cooking, and to use other herbs and spices in its
place. Since there can be a great deal of sodium in some unexpected places like condiments,
dressings and even some over-the-counter medications, it would be important to instruct Mrs.
Johnson to be cognizant of these sources, as well (American Heart Association, 2012b).
In order to combat fluid excess, diuretics can be prescribed to CHF patients to increase
urination, reduce blood volume, cardiac workload, edema and pulmonary congestion (Kee et al.,
2015). A patient being prescribed diuretics would need to be taught to closely watch fluid intake
and output, to take daily weights, and to understand that a doctor should be called if there is a
weight gain of more than two pounds in one day or five in one week (Cleveland Clinic, 2015).
Mrs. Johnson may have to increase her potassium intake with foods like bananas, dried fruit or
potatoes if she is prescribed a potassium-wasting diuretic; conversely, she may have to lower her
potassium levels, avoiding those high-potassium foods and also salt substitutes if she is
prescribed a potassium-sparing diuretic (Kee et al., 2015). The most important thing to consider
in Mrs. Johnsons dietary education, though, is her ability and willingness to comply with these
goals. Making such drastic changes can be difficult, especially in times of ill health. However,
addressing concerns, encouraging beneficial practices and teaching the potential risks if they are
not followed could go a long way in helping Mrs. Johnson maintain a comfortable quality of life,
even with CHF.

NUTRITION AND CONGESTIVE HEART FAILURE

References
American Heart Association. (2012a). How do I follow a healthy diet? Retrieved July 15th, 2015
from http://www.heart.org/idc/groups/heartpublic/@wcm/@hcm/documents/downloadable/ucm_300467.pdf
American Heart Association. (2012b). Why should I limit sodium? Retrieved July 15th, 2015 from
http://www.heart.org/idc/groups/heartpublic/@wcm/@hcm/documents/downloadable/ucm_300625.pdf
American Heart Association. (2015). Lifestyle changes for heart failure. Retrieved July 15th,
2015 from
http://www.heart.org/HEARTORG/Conditions/HeartFailure/PreventionTreatmentofHeart
Failure/Lifestyle-Changes-for-Heart-Failure_UCM_306341_Article.jsp
Cleveland Clinic. (2015). What is heart failure? Retrieved July 15th, 2015, from
http://my.clevelandclinic.org/services/heart/disorders/heart-failure-what-is
Huether, S. E. & McCance, K. L. (2012). Understanding pathophysiology (5th ed.). St. Louis,
MO: Mosby Elsevier.
Kee, J. L., Hayes, E. R. & McCuistion, L. E. (2015). Pharmacology: a Patient-centered nursing
process approach (8th ed.). St. Louis, MO: Mosby Elsevier.