Design and Region-Specific Adaptation of the Dietary Intervention Used in the SODIUM-HF Trial: A Multicentre Study

Colin-Ramírez, Eloisa; Arcand, JoAnne; Woo, Elizabeth; Brum, Margaret; Morgan, Kate; Christopher, W. Habeck; Velázquez, Lubia; Sharifzad, Amirhossein; Feeney, Sinead

doi:10.1016/j.cjco.2019.11.006

Cited by 5 publications

(7 citation statements)

References 27 publications

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“…There are multiple clinical trials that aim to examine if sodium restriction in HF patients is associated with improved clinical outcomes. The Study of Dietary Intervention under 100 MMOL in Heart Failure (SODIUM-HF) is an open-label, multicenter, international, randomized controlled trial in ambulatory patients with chronic HF and aims to assess the effects of dietary sodium restriction on clinical outcomes [ 76 ]. The Geriatric out of Hospital Randomized Meal Trial in Heart Failure (GOURMET-HF) is a multicenter, randomized, single-blind, controlled trial of 3-months duration to see the effect of sodium restriction/DASH diet in older patients after discharge from acute decompensated HF admission [ 59 ].…”

Section: Future Directionsmentioning

confidence: 99%

Sodium Intake and Heart Failure

Patel

Joseph

2020

IJMS

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Sodium is an essential mineral and nutrient used in dietary practices across the world and is important to maintain proper blood volume and blood pressure. A high sodium diet is associated with increased expression of β—myosin heavy chain, decreased expression of α/β—myosin heavy chain, increased myocyte enhancer factor 2/nuclear factor of activated T cell transcriptional activity, and increased salt-inducible kinase 1 expression, which leads to alteration in myocardial mechanical performance. A high sodium diet is also associated with alterations in various proteins responsible for calcium homeostasis and myocardial contractility. Excessive sodium intake is associated with the development of a variety of comorbidities including hypertension, chronic kidney disease, stroke, and cardiovascular diseases. While the American College of Cardiology/American Heart Association/Heart Failure Society of America guidelines recommend limiting sodium intake to both prevent and manage heart failure, the evidence behind such recommendations is unclear. Our review article highlights evidence and underlying mechanisms favoring and contradicting limiting sodium intake in heart failure.

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Section: Future Directionsmentioning

confidence: 99%

Sodium Intake and Heart Failure

Patel

Joseph

2020

IJMS

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“…The lower 90-day hospitalization risk for heart failure observed with MTMs in adults with known heart failure is consistent with prior observational studies suggesting potential benefits of MTMs in this population,38,39 but these results should also be considered exploratory. Of note, a recently published international, open-label, RCT enrolling 806 adults with chronic heart failure found no difference in a composite endpoint of all-cause death or cardiovascular-related hospitalizations or ED visits between a low sodium diet (ie, <1500 mg/d) compared with usual care 22–26. In contrast, the KP NOURISH study enrolled a higher acuity population (ie, after an index hospitalization) and incorporated a more comprehensive nutritional intervention permitting a higher average sodium intake (ie, 2000–3000 mg/d).…”

Section: Discussionmentioning

confidence: 99%

“…Although sodium restriction has been a key focus in patients with heart failure, there remains controversy about the optimal daily limit given the limited RCT data in the context of different types of heart failure, concomitant use of diuretics, and other factors. [21][22][23][24][25][26] Our MTMs targeted an average sodium intake of 2000-3000 mg/d that was further adjusted toward <2300 mg/ d if diabetes or chronic kidney disease was present. In general, the remaining components (eg, percentage of total calories from saturated fat and daily protein, cholesterol, and fiber intake) of the MTMs followed the DASH diet, which emphasizes vegetables, whole grains, lower fat and saturated fat, and lean proteins.…”

Section: Interventionmentioning

confidence: 99%

Effect of Medically Tailored Meals on Clinical Outcomes in Recently Hospitalized High-Risk Adults

Tan

Horiuchi

et al. 2022

Medical Care

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Background: Inability to adhere to nutritional recommendations is common and linked to worse outcomes in patients with nutrition-sensitive conditions. Objectives: The purpose of this study is to evaluate whether medically tailored meals (MTMs) improve outcomes in recently discharged adults with nutrition-sensitive conditions compared with usual care. Research Design: Remote pragmatic randomized trial. Subjects: Adults with heart failure, diabetes, or chronic kidney disease being discharged home between April 27, 2020, and June 9, 2021, from 5 hospitals within an integrated health care delivery system. Measures: Participants were prerandomized to 10 weeks of MTMs (with or without virtual nutritional counseling) compared with usual care. The primary outcome was all-cause hospitalization within 90 days after discharge. Exploratory outcomes included all-cause and cause-specific health care utilization and all-cause death within 90 days after discharge. Results: A total of 1977 participants (MTMs: n=993, with 497 assigned to also receive virtual nutritional counseling; usual care: n=984) were enrolled. Compared with usual care, MTMs did not reduce all-cause hospitalization at 90 days after discharge [adjusted hazard ratio, aHR: 1.02, 95% confidence interval (CI), 0.86–1.21]. In exploratory analyses, MTMs were associated with lower mortality (aHR: 0.65, 95% CI, 0.43–0.98) and fewer hospitalizations for heart failure (aHR: 0.53, 95% CI, 0.33–0.88), but not for any emergency department visits (aHR: 0.95, 95% CI, 0.78–1.15) or diabetes-related hospitalizations (aHR: 0.75, 95% CI, 0.31–1.82). No additional benefit was observed with virtual nutritional counseling. Conclusions: Provision of MTMs after discharge did not reduce risk of all-cause hospitalization in adults with nutrition-sensitive conditions. Additional large-scale randomized controlled trials are needed to definitively determine the impact of MTMs on survival and cause-specific health care utilization in at-risk individuals.

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“…Due to the sodium retention observed, reducing the intake of sodium, through a low-salt diet, plays an essential part in HF management [6]. The main source of dietary sodium is table salt (sodium chloride).…”

Section: Introductionmentioning

confidence: 99%

“…However, the benefit of restricting dietary sodium in patients with HF remains controversial [6][7][8][9]. There is evidence that high-salt intake results in fluid retention, increased blood pressure, and increased cardiovascular risk [8].…”

Section: Introductionmentioning

confidence: 99%

Prescription, Compliance, and Burden Associated with Salt-Restricted Diets in Heart Failure Patients: Results from the French National OFICSel Observatory

et al. 2022

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(1) Background: There is much debate about the use of salt-restricted diet for managing heart failure (HF). Dietary guidelines are inconsistent and lack evidence. (2) Method: The OFICSel observatory collected data about adults hospitalised for HF. The data, collected using study-specific surveys, were used to describe HF management, including diets, from the cardiologists’ and patients’ perspectives. Cardiologists provided the patients’ clinical, biological, echocardiography, and treatment data, while the patients provided dietary, medical history, sociodemographic, morphometric, quality of life, and burden data (burden scale in restricted diets (BIRD) questionnaire). The differences between the diet recommended by the cardiologist, understood by the patient, and the estimated salt intake (by the patient) and diet burden were assessed. (3) Results: Between March and June 2017, 300 cardiologists enrolled 2822 patients. Most patients (90%) were recommended diets with <6 g of salt/day. Mean daily salt consumption was 4.7 g (standard deviation (SD): 2.4). Only 33% of patients complied with their recommended diet, 34% over-complied, and 19% under-complied (14% unknown). Dietary restrictions in HF patients were associated with increased burden (mean BIRD score of 8.1/48 [SD: 8.8]). (4) Conclusion: Healthcare professionals do not always follow dietary recommendations, and their patients do not always understand and comply with diets recommended. Restrictive diets in HF patients are associated with increased burden. An evidence-based approach to developing and recommending HF-specific diets is required.

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Design and Region-Specific Adaptation of the Dietary Intervention Used in the SODIUM-HF Trial: A Multicentre Study

Cited by 5 publications

References 27 publications

Sodium Intake and Heart Failure

Sodium Intake and Heart Failure

Effect of Medically Tailored Meals on Clinical Outcomes in Recently Hospitalized High-Risk Adults

Prescription, Compliance, and Burden Associated with Salt-Restricted Diets in Heart Failure Patients: Results from the French National OFICSel Observatory

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