Nutritional Interventions in Heart Failure: A Systematic Review of the Literature

Martha Abshire, Jiayun Xu, Diana Baptiste, Johana R. Almansa, Jingzhi Xu, Abby Cummings, Martha J. Andrews, Cheryl Dennison Himmelfarb

Research output: Contribution to journalReview articlepeer-review


Background Heart failure (HF) is a major health care burden and there is a growing need to develop strategies to maintain health and sustain quality of life in persons with HF. The purpose of this review is to critically appraise the components of nutrition interventions and to establish an evidence base for future advances in HF nutrition research and practice. Methods and Results Cinahl, Pubmed, and Embase were searched to identify articles published from 2005 to 2015. A total of 17 randomized controlled trials were included in this review. Results were divided into 2 categories of nutrition-related interventions: (1) educational and (2) prescriptive. Educational interventions improved patient outcomes such as adherence to dietary restriction in urine sodium levels and self-reported diet recall. Educational and prescriptive interventions resulted in decreased readmission rates and patient deterioration. Adherence measurement was subjective in many studies. Evidence showed that a normal-sodium diet and 1-liter fluid restriction along with high diuretic dosing enhanced B-type natriuretic peptide, aldosterone, tumor necrosis factor α, and interleukin-6 markers. Conclusions Educational nutrition interventions positively affect patient clinical outcomes. Although clinical practice guidelines support a low-sodium diet and fluid restriction, research findings have revealed that a low-sodium diet may be harmful. Future research should examine the role of macronutrients, food quality, and energy balance in HF nutrition.

Original languageEnglish (US)
Pages (from-to)989-999
Number of pages11
JournalJournal of cardiac failure
Issue number12
StatePublished - Dec 1 2015


  • Diet
  • fluid restriction
  • sodium restriction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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