Nutrition Self-care in Heart Failure

Abstract

The purposes of this article were to describe the state of science in nutrition self-care in heart failure and make recommendations for future research. Four areas of nutrition self-care were reviewed: sodium restriction recommendations, nutrition recommendations, body weight recommendations, and self-care strategies. A review of the available evidence demonstrated that the current state of knowledge in each of these 4 areas is insufficient for clinicians to provide evidence-based interventions to improve nutrition self-care. Subsequently, research priorities in each area were identified. Although there is a growing recognition of the important role that nutrition may play in heart failure outcomes, advancements in our knowledge base are needed before nutrition self-care can evolve into an essential component of heart failure self-care.

The Body of Knowledge on Compliance in Heart Failure Patients

“…Following a diet might be more challenging than following a pharmacological treatment because it involves changes in habitual behaviors that are frequently embedded in culture or have social consequences. 34 Regarding fluid restriction, a higher percentage of noncompliant patients in our study also perceived more difficulty with the restriction, compared with compliant patients, although this difference was not statistically significant. Thirst was the most reported problem by both compliant and noncompliant patients.…”

Health Status and Self-care Outcomes After an Education-Support Intervention for People With Chronic Heart Failure

“…Nutrition self-care behaviors are unique from most other activities in that they necessitate modifying existing behaviors and habits. 67 Teaching diet skills, as label reading for sodium content was incorporated, as was an interactive “pantry analysis” to specifically evaluate foods and sodium content actually present in the home. We recommended a 2000–2400 mg sodium diet, consistent with the teaching in HF Clinics in the city and the Nutrition Committee of the AHA.…”

“…We recommended a 2000–2400 mg sodium diet, consistent with the teaching in HF Clinics in the city and the Nutrition Committee of the AHA. 67–68 …”

State of the Science

“…42 In addition, an inherent bias in these studies was the inclusion of only those patients who were hospitalized for an acute exacerbation of HF. A newly published study evaluated the effect of a normal-sodium diet compared with a low-sodium diet on rehospitalization for HF.…”