Nutrition Assessment and Dietary Interventions in Heart Failure

Highlights

• Nutritional disorders are often overlooked in patients with heart failure because of a paucity of standardized definitions and accurate tools to assess nutritional status in this population.

• Evidence is controversial for interventions targeting nutrition issues pertinent to patients with heart failure, including sodium restriction, obesity, malnutrition, dietary patterns, and micronutrient supplementation.

• There are several patient, provider, and societal barriers to the implementation of effective nutrition interventions in the management of heart failure.

Abstract

Despite the high prevalence of nutrition disorders in patients with heart failure (HF), major HF guidelines lack specific nutrition recommendations. Because of the lack of standardized definitions and assessment tools to quantify nutritional status, nutrition disorders are often missed in patients with HF. Additionally, a wide range of dietary interventions and overall dietary patterns have been studied in this population. The resulting evidence of benefit is, however, conflicting, making it challenging to determine which strategies are the most beneficial. In this document, we review the available nutritional status assessment tools for patients with HF. In addition, we appraise the current evidence for dietary interventions in HF, including sodium restriction, obesity, malnutrition, dietary patterns, and specific macronutrient and micronutrient supplementation. Furthermore, we discuss the feasibility and challenges associated with the implementation of multimodal nutrition interventions and delineate potential solutions to facilitate addressing nutrition in patients with HF.