Estado nutricional e adequação da ingestão de energia e nutrientes em pacientes com insuficiência cardíaca

Abstract

SummarySummary: Increased knowledge about nutritional status and energy and nutrient intakes is required to improve the treatment of patients with heart failure (HF).Objectives: To verify the nutritional status and evaluate the adequacy of energy, macronutrient and micronutrient intakes in patients with HF in outpatient clinical settings.Methods: We collected anthropometric and habitual dietary intake data of 125 patients (72% men, 52.1 ± 9.8 years, BMI 26.9 ± 4.4 kg/m2). Anthropometric variables were compared between genders, and the adequacy of energy and nutrient intakes was analyzed according to current recommendations.Results: Muscle depletion or risk of depletion was present in 38.4% of patients (association with male gender, p <0.0001). In 69.6% of cases the mean energy intake was lower than the one required (p <0.0001). Among the micronutrients evaluated in this study, there was an important prevalence of inadequacy in magnesium, zinc, iron and thiamine intakes, and most patients had calcium and potassium intakes below the adequate levels, and sodium intake above the adequate levels. Conclusions

Iron deficiency and heart failure: diagnostic dilemmas and therapeutic perspectives

“…The following mechanisms are presumed to be involved in the development of absolute ID in HF: (i) insufficient dietary iron supply, 94,95 (ii) poor GI absorption, impaired duodenal iron transport, 96 drug interactions (e.g. omeprazole), or food reducing absorption, and (iii) GI blood loss ( Figure 3 ).…”

Iron Therapy in Patients with Heart Failure and Iron Deficiency: Review of Iron Preparations for Practitioners

“…It is considered that ID in HF partially results from inadequate iron intake in the diet [19, 20], low bioavailability of iron in the diet (more frequent in developing countries), and handicapped gastrointestinal absorption. The latter results from intestinal interstitial oedema, the use of medications increasing gastric pH (such as proton pump inhibitors or H 2 receptor antagonists), and the ingestion of food reducing iron absorption (calcium, tannins, oxalates, phytate, phosphates, antiacids) [21, 22].…”

Prescrição de dieta na insuficiência cardíaca crônica: por que não fazemos?

“…Calcium, potassium and magnesium intakes were described as below the recommended levels in almost all the patients, unlike sodium, whose intake was above the level considered appropriate in 84% of the study patients 5 .…”

“…An inadequate intake of micronutrients (minerals and thiamine) also occurred in a significant percentage of patients in the study of Lourenço et al 5 Micronutrient deficiencies are common in chronic heart failure patients, and their origin appears to be multifactorial 4 . Calcium, potassium and magnesium intakes were described as below the recommended levels in almost all the patients, unlike sodium, whose intake was above the level considered appropriate in 84% of the study patients 5 .…”

“…The study of Lourenço et al 5 raises again the issue of nutritional disorders presented by patients with stable chronic heart failure in a sample of patients seen in a specialized clinic. The authors demonstrated the occurrence of depletion of muscle reserves and inadequate dietary intake of various nutrients, such as magnesium, zinc, iron, thiamine, calcium, potassium and sodium.…”