Micronutrient Deficiencies in Patients With Heart Failure: Relationships With Body Mass Index and Age

Shetty, Paulina M; Hauptman, Paul J.; Landfried, L.; Patel, Karishma; Weiss, Edward P.

doi:10.1016/j.cardfail.2015.10.001

Cited by 9 publications

(1 citation statement)

References 15 publications

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“…This finding is comparable to that of Shetty et al,53 who reported that the number of dietary micronutrient deficiencies was similar in normal weight and overweight/obese patients with heart failure. Many screening tools for malnutrition (eg Geriatric Nutritional Risk Index, Mini Nutrition Assessment, Nutritional Risk Index) include an anthropometric measure, most commonly BMI 54, 55.…”

Section: Discussionsupporting

confidence: 90%

Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure

Lennie

Andreae

Rayens

et al. 2018

JAHA

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BackgroundDietary micronutrient deficiencies have been shown to predict event‐free survival in other countries but have not been examined in patients with heart failure living in the United States. The purpose of this study was to determine whether number of dietary micronutrient deficiencies in patients with heart failure was associated with shorter event‐free survival, defined as a combined end point of all‐cause hospitalization and death.Methods and ResultsFour‐day food diaries were collected from 246 patients with heart failure (age: 61.5±12 years; 67% male; 73% white; 45% New York Heart Association [NYHA] class III/IV) and analyzed using Nutrition Data Systems for Research. Micronutrient deficiencies were determined according to methods recommended by the Institute of Medicine. Patients were followed for 1 year to collect data on all‐cause hospitalization or death. Patients were divided according to number of dietary micronutrient deficiencies at a cut point of ≥7 for the high deficiency category versus <7 for the no to moderate deficiency category. In the full sample, 29.8% of patients experienced hospitalization or death during the year, including 44.3% in the high‐deficiency group and 25.1% in the no/moderate group. The difference in survival distribution was significant (log rank, P=0.0065). In a Cox regression, micronutrient deficiency category predicted time to event with depression, NYHA classification, comorbidity burden, body mass index, calorie and sodium intake, and prescribed angiotensin‐converting enzyme inhibitors, diuretics, or β‐blockers included as covariates.ConclusionsThis study provides additional convincing evidence that diet quality of patients with heart failure plays an important role in heart failure outcomes.

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Section: Discussionsupporting

confidence: 90%

Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure

Lennie

Andreae

Rayens

et al. 2018

JAHA

View full text Add to dashboard Cite

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Nutrition as Treatment Modality in Heart Failure

Ishikawa

Sattler

2021

Curr Atheroscler Rep

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Dietary Self-management in Heart Failure: High Tech or High Touch?

Colin-Ramírez

Arcand

2017

Curr Treat Options Cardio Med

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Dietary management of heart failure (HF) has largely been focused on sodium and fluid restrictions. Although safety and efficacy of these interventions in HF remain unclear, a daily sodium intake between 2000 and 3000 mg/day appears to be safe in these patients. Ongoing clinical research will inform on the safety and efficacy of a more restrictive sodium intake to less than 1500 mg/day. Data shows that routine fluid restriction in HF regardless of symptoms may be unnecessary; however, in patients with signs of congestion, fluid restriction to 2.0 L/day may be advisable. Recently, more attention has been paid to other nutritional aspects of HF beyond sodium and fluid intake, although there is still little evidence available to guide nutritional management of HF. Assuring that patients meet daily requirements for key micronutrients, such as calcium, magnesium, potassium, folate, vitamin E, vitamin D, zinc, and thiamine, is essential in order to prevent deficiencies. More appropriate macronutrient composition of the diet is still to be determined; however, a diet containing 50-55% carbohydrates, 25-30% fat, and 15-20% protein seems acceptable for patients with HF with or without non-end-stage renal disease. Additionally, increased protein intake may be considered in malnourished/cachectic patients. Consulting a registered dietitian is especially helpful for patients with recent HF exacerbations or for patients with multiple comorbidities who may need to follow several dietary restrictions and may benefit of individualized dietary counseling in order to ensure appropriate intake of energy, protein, and micronutrients. Today, there are still several knowledge gaps in guiding the dietary management of HF. In this article, we review current recommendations for the dietary management of HF and the evidence supporting this practice.

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Micronutrient Deficiencies in Patients With Heart Failure: Relationships With Body Mass Index and Age

Cited by 9 publications

References 15 publications

Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure

Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure

Nutrition as Treatment Modality in Heart Failure

Dietary Self-management in Heart Failure: High Tech or High Touch?

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