Congestive heart failure diet explained

Use Diet to achieve compensated congestive heart failure

A diet to control congestive heart failure is the best home remedy for congestive heart failure. In fact, once you have been diagnosed with congestive heart failure, your internist and cardiologist will help you by optimizing your medicines, and, iIdeally they will also explain the remedial diet that you should use and may even suggest cardiac rehab for you. The goal is to achieve a state of “compensated” congestive heart failure using primarily diet. This means that you can use diet to achieve a state where you can go about your life without significant congestive heart failure symptoms. While you may need to adjust your lifestyle (and likely will), compensated congestive heart failure is a good place to be. The alternative is “decompensated” congestive heart failure, which means a trip to the hospital or doctor’s office to bring you back into the compensated state.

Life-style and congestive heart failure

Lifestyle choices including diet can spell the difference for thousands of patients each year. The Veterans Administration Hospitals in the United States, an organization that has a fully electronic medical record for their patients, use diagnoses such as “Inappropriate lifestyle” and “Dietary indiscretion” when documenting why a patient has returned to the hospital for congestive heart failure exacerbation or decompensation. That means that patients have a good deal of control over their own destiny when it comes to congestive heart failure because lifestyle choices play such an important role.

The role of diet to control congestive heart failure

The first step in controlling congestive heart failure is to understand the diet that can keep patients on the right track.

Dietary salt is bad for those with congestive heart failure

Patients with congestive heart failure must monitor their salt intake and keep it low. Table salt, or the sodium within table salt, acts like a sponge for fluid in the body. Sodium holds water in the body. Patients with congestive heart failure do not need more fluid. This extra fluid from salt raises blood pressure. Increased blood pressure makes it more difficult for the weakened heart to pump blood around the body. Also, the excess fluid being pumped round in the blood (diluted blood in other words), makes it more difficult for the failing heart to pump enough blood to keep the body going.

The salt in the blood vessels pulls water into the blood vessels, but it does not hold onto the blood everywhere in the body. Sadly the cardiovascular system cannot hold onto this excess fluid and it collects in the tissues and in the lungs. This causes swelling (edema) in the skin and breathing problems. Excess salt intake can lead directly to a trip to the hospital for decompensated congestive heart failure.

Dietary fluid intake needs to be controlled by those with congestive heart failure

Excess fluid intake can be just as bad as excess salt intake. Before a patient is diagnosed with congestive heart failure, drinking plenty of water is a healthy behavior. Water gives the body what it needs to function; it replenishes cells and flushes wastes from the body. In congestive heart failure, however, too much water or fluid can overload the blood vessels and heart in the same way too much salt can. Excess fluid collects in the tissues and lungs.

No big deal, right? Simply limit salt and water from the diet.

This is so much easier said than done. Salt is the spice of life. We add it to our food without thinking. Salt shakers show up on dinner tables and restaurants as commonly as silverware and plates. Free refills of water are considered a standard luxury in most places as well. We have a taste for salt, salty snacks, and salty foods. It is a tough flavor to avoid. Our bodies crave salt and, once we eat it, our bodies crave water to expel the salt through the kidneys. Salt and fluid are a one-two punch to the circulatory system.

Despite the ubiquitous presence of salt and water at meals, most congestive heart failure patients realize after a few trips to the hospital that reducing these two dietary staples will keep them out of the emergency department. What is more difficult to overcome is the presence of sodium in just about every food that we eat. The human taste for salt is not lost on food manufacturers and sellers. The amount of sodium that is added to foods is overwhelming (literally for the hearts of people with congestive heart failure). While people can stop adding salt at the table, they forget that a trip to the hospital is waiting for them in the pantry.

A notorious location for hidden salt is in sauces and seasonings. Bouillon cubes, soy and Worcestershire sauces, and spice combinations have tremendous amounts of sodium in them. These things should be cut out of the diet just like table salt.

Packaged, prepared, and fast foods are infamous for exacerbating congestive heart failure. These foods are so easy and quick that a generation of people has forgotten how to cook any other way. This can be hard to unlearn, especially for patients that are set in their ways. What is worse, most people recovering from congestive heart failure need the convenience of easy-to-prepare meals, especially at first. It is so much easier to grab a prepackaged meal than cook a healthy one. This can have serious health consequences.

Anyone with congestive heart failure or those that care for someone with the illness must become skilled at reading food labels. Packaged foods have considerable amounts of sodium, but all of these foods must put the amount of sodium per serving on the package. Remember that most people have moved away from a single serving of almost everything that we eat, so if a patient is eating two servings of packaged food, then you must multiply the sodium amount listed on the label by two. If consuming three servings, multiply by three and so on.

Patients with congestive heart failure are encouraged to keep a sodium diary to make sure they are staying under the predetermined sodium level on a given day. It may seem tedious, but a week in the hospital is no easier.

People with congestive heart failure should limit their sodium intake to less than 2,000 milligrams per day. In fact, the best bet is to shoot for 1,500 milligrams of sodium per day or less. This can be a big change the average person in the Western world who eats about 3,500 milligrams of sodium in a normal day.

Be wary of “reduced sodium” and “reduced salt” labels. In order for manufacturers to put this label on their food, the sodium content needs only to be 25% less than the content of the original food. If the original food has 1,000 milligrams of sodium per serving, the “reduced sodium” food can have up to 750 milligrams per serving. Seven-hundred fifty milligrams of sodium is certainly not a low sodium food!

In the USA, the “low sodium” and “very low sodium” labels can be believed and trusted. A low sodium label means 140 milligrams of sodium or less and a very low sodium label means 35 milligrams of sodium or less per serving. Neither of these amounts is too bad in moderation.

Foods that come directly from the earth or from animals have a modest amount of sodium. It is hard to go wrong in congestive heart failure by preparing fresh foods all of the time. Fresh foods can be expensive and hard to come by, but have you seen a hospital bill for six days in the cardiac care unit recently? It rivals the budget for food for an entire year. Use frozen foods rather than canned when possible and use frozen foods that have not had salt added.

Try to replace salt with other flavors that your tongue will appreciate. Often people have a taste for acid but think they want more salt. Try putting a little lemon or lime juice or zest on your food. Experiment with a little bit of vinegar. Fresh or even dried herbs can impart a tremendous amount of flavor to foods. Giving up salt does not mean that you have to give up flavor. It means that you need to trade salt flavor for other flavors. Do not be afraid to experiment with taste. Your congestive heart failure depends on it.

The DASH (Dietary Approaches to Stop Hypertension) diet was developed to treat high blood pressure, but the principles apply to congestive heart failure as well. A copy can be found at http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf.

In addition to salt intake, realize that most beverages are mostly water. Juices, sodas, and milk are still fluid. You should not deprive yourself too much if you are truly thirsty, but you need to realistic about thirst. Reducing sodium from the diet should also reduce thirst.

Beverages with alcohol tend to be particularly bad in congestive heart failure. Hospitalizations have been prompted simply from imbibing a little too much. In addition to extra fluid, alcohol tends to bring on bouts of abnormal cardiac rhythms. A heart that is not in rhythm is not pumping effectively. Patients with congestive heart failure are at increased risk for abnormal heart rhythms because the anatomy of their heart changes during the disease.

If you must drink alcohol, it is strongly recommended that you limit your intake to two or three drinks per week. A “drink” varies from country to country, but a rule of thumb is one 12 ounce beers OR one 4 ounce glass of wine OR one shot glass of spirits constitutes a drink.

Speaking of other vices, smoking and a high fat diet lead to a damaged heart. Most cases of congestive heart failure in Western countries are ischemic. That means that the heart was damaged because of a small non-lethal heart attack or some other interruption of blood flow to the heart. Smoking and abnormal blood cholesterol are two controllable things that can either lead to further heart damage (and failure) or can reduce your chances of more heart disease depending on what you do with them.

Exercise used to be forbidden in congestive heart failure patients but cardiologists have realized that heart conditioning can improve symptoms in most patients. The idea is to start with mild exercise and increase the intensity slowly. Exercise can strengthen the heart in healthy people, but it also works in congestive heart failure patients. The difference, though, is that it can be easily overdone. It is very important to discuss exercise options with your doctor before you begin an exercise regimen. Cardiac rehabilitation is a comprehensive, individualized program that provides supervised exercise in addition to education and coaching.

Is your congestive heart failure diet working?

You may be watching sodium and fluid intake, but how do you really know if you are doing a good job with your congestive heart failure diet?

Watch your weight

One of the easiest and most powerful tools to know if you are doing a good job is to buy an accurate scale and weigh yourself every day. Congestive heart failure decompensation usually begins by fluid retention and fluid retention leads to weight gain.

If you notice that you have gained more than two pounds (one kilogram) in a single day or four pounds (two kilograms) in one week, then you are headed in the wrong direction. Something has changed in your diet or in your management of congestive heart failure and you are headed to decompensation. You either need to adjust your diet or temporarily adjust your medications. Any change in medications obviously should be done under close direction of your internist or cardiologist.

Other symptoms of congestive heart failure to watch for

You should also become aware of the early signs and symptoms of decompensation and look for them. In addition to weight gain, be mindful of other signs and symptoms of congestive heart failure exacerbation. If you develop a cough without fever, it may not be a cold or flu, it could be fluid accumulating in the lungs. Also, if you notice that you are requiring more pillows to sleep on at night, you may be losing your grip on congestive heart failure control. Excess fluid in the body can cause people to lose their appetite or become full rapidly after small meals. Look for signs of nausea, especially around meal time.

Obviously if you notice fluid accumulating in your legs, arms, or abdomen, then the heart is struggling extra hard to do its job. You can test for fluid buildup by pressing your finger against a bone in your arm or leg. If there is fluid in the tissues, it will be pressed out of that area and leave a dimple temporarily in its place. If this dimpling is deeper or you can make a dimple further up the extremity (from ankle to mid calf, for example) then your congestive heart failure is getting worse.

Concluding remarks on diet to control congestive heart failure

Ideally anyone with congestive heart failure has had at least one visit with a registered dietician. This medical professional will explain how to institute a low salt, low fluid diet in practical terms. Diet changes in congestive heart failure require a commitment to health, but when done properly, they translate into fewer hospital trips and a better life.

ABOUT THE AUTHOR: Michael T. Spako is an M.D. who specializes in medical writing. I am pleased to have him as the principal writer for this congestive heart failure site, and look forward to his further contributions. Donald Urquhart, Psychologist, Editor.

If you want to come back to www.HeartFailureCongestive.com again, please add HeartFailureCongestive.com to your bookmarks or favorites now, otherwise you'll forget like everyone does! Please also remember,www.HeartFailureCongestive.com, like all our web sites, is an educational one. HeartFailureCongestive.com is NOT designed to diagnose nor treat but to offer understanding, ideas and options for you to discuss with your doctor. Our Privacy Policy can be found at www.cholesterolcholestrol.com/privacypolicy.htm Copyright © 2000-present Donald Urquhart. All Rights Reserved. Designated trademarks and brands are the property of their respective owners. Use of HeartFailureCongestive.com constitutes acceptance of our legal disclaimer.