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By Karen Alexander, Oncology Wellness Specialist

07/13/2018

What is heart failure and what can I do about it?

Heart failure is also known as congestive heart failure, and it’s a global pandemic affecting at least 26 million people worldwide, this number continues to increase due to aging as well as improved treatment of acute cardiovascular events. About 5.7 million adults in the United States have experienced heart failure, and it is estimated that by 2030 more than 8 million people will have this condition.

Heart failure can be caused by coronary artery disease, high blood pressure, heart attack, cardiomyopathy (due to infections or alcohol or drug abuse), valve disease, thyroid disease, kidney disease, smoking, drinking alcohol, diabetes, HIV, hyperthyroidism, hypothyroidism, heart defects, and obesity, among other causes.

Heart failure occurs when the heart can no longer pump enough blood to support other organs in the body, and as a result, those organs start failing. Heart failure symptoms may vary, and it depends if heart failure is dominant in the right or left side. When heart failure is primarily left-sided, shortness of breath is predominant and may occur when lying flat, causing the person to have to sleep propped up in bed or sitting in a chair. If right-sided heart failure is stronger, fluid may back up into your abdomen, legs and feet, causing swelling.

Some patients are at risk for nutrient deficiencies due to drug-nutrient interactions (such as B complex, magnesium, and potassium) and may experience difficulty eating due to nausea and early satiety from gut/liver edema, depression, use of multiple medications. This may lead to cardiac cachexia, a complex metabolic state characterized by progressive weight loss, muscle wasting, fatigue, and weakness.

Heart failure diagnoses require a well-documented medical history, blood test, Chest X-rays, echocardiogram, electrocardiogram, and stress test, among other tests. Medical treatment consists of medications and procedures to limit heart damage and reverse some symptoms. Non-pharmacologic therapies include restriction of salt and liquids to control acute symptoms, limit progression and reduce overall work of the heart. Your doctor will let you know the degree of restriction of sodium and fluids. In some cases, physical activity may be indicated, but it must be done with the doctor’s approval and under strict supervision.

Below are some dietetic recommendations that may help you manage heart failure, according to the Academy of Nutrition and Dietetics:

Dietetic recommendations to limit salt intake:
In general, start with a restriction of 2000 milligrams of sodium. However, adjustments must be done according to your individual response to the dietetic restrictions. 

  • Eat fresh or frozen produce and avoid preseason or canned produce.
  • Eat fresh meats and avoid processed/deli meats.
  • Use herbs and spices to season your food and avoid using salt.
  • Read the nutrition labels and choose foods with 140 milligrams of sodium or less per serving.
  • Check serving sizes. If you eat more than 1 serving, you will obtain more sodium than the amount listed.
  • Read the nutrition information on your favorite restaurant's website and choose wisely.
  • When eating out, request salad dressings and sauces on the side to limit the serving size.
  • Let your server know that you want your food to be cooked without salt.

Dietetic recommendations to restrict fluids:
Patients with heart failure are often routinely advised to limit their fluid intake to 1500 milliliters a day (or less). Ask your doctor how much fluid you can have.

  • A fluid is any liquid or anything that would melt if left at room temperature. You will need to count these foods and liquids (including any liquid used to take medication) as part of your daily fluid intake.
  • Record your fluid intake daily. Tip: Every day, each time you eat or drink fluids, pour the same amount of water into an empty container that can hold the amount of fluids you are allowed daily. This will help you keep track of how much fluid you are taking in throughout the day.
  • To accurately keep track of how much liquid you take in, measure the size of the cups, glasses, and bowls you use. If you eat soup, measure how much of it is liquid and how much is solid (such as noodles, vegetables, meat).

 

Tips to reduce your thirst:

  • Chew gum or suck on hard candy.
  • Rinse with mouthwash. Do not swallow.
  • Ice chips or popsicles my help quench thirst, but this too needs to be calculated into the total restriction. Melt ice chips or cubes first to figure out how much fluid they produce (for example, experiment with melting ½ cup ice chips or 2 ice cubes).
  • Add a lemon wedge to your water.
  • Limit how much salt you take in. High salt intake makes you thirstier.
  • Don’t eat or drink all your allowed liquids at once. Space your liquids out through the day.
  • Use small glasses and cups and sip slowly. If allowed, take your medications with fluids you eat or drink during a meal.

Monitor your weight:

  • Weigh yourself each day. Sudden weight gain is a sign that fluid is building up in your body. Follow these guidelines: Weigh yourself every morning. If you gain 3 or more pounds in 1-2 days or 5 or more pounds within 1 week, call your doctor. Your doctor may adjust your medicine to get rid of the extra fluid.

Have a wonderful weekend!

Karen Alexander, BSND, MSCN

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