Impact of Inadequate Calorie Intake on Mortality and Hospitalization in Stable Patients with Chronic Heart Failure

Abstract

Malnutrition is highly prevalent in patients with heart failure (HF), but the precise impact of dietary energy deficiency on HF patients’ clinical outcomes is not known. We investigated the associations between inadequate calorie intake and adverse clinical events in 145 stable outpatients with chronic HF who had a history of hospitalization due to worsening HF. To assess the patients’ dietary pattern, we used a brief self-administered diet-history questionnaire (BDHQ). Inadequate calorie intake was defined as <60% of the estimated energy requirement. In the total chronic HF cohort, the median calorie intake was 1628 kcal/day. Forty-four patients (30%) were identified as having an inadequate calorie intake. A Kaplan–Meier analysis revealed that the patients with inadequate calorie intake had significantly worse clinical outcomes including all-cause death and HF-related hospitalization during the 1-year follow-up period versus those with adequate calorie intake (20% vs. 5%, p < 0.01). A multivariate logistic regression analysis showed that inadequate calorie intake was an independent predictor of adverse clinical events after adjustment for various factors that may influence patients’ calorie intake. Among patients with chronic HF, inadequate calorie intake was associated with an increased risk of all-cause mortality and rehospitalization due to worsening HF. However, our results are preliminary and larger studies with direct measurements of dietary calorie intake and total energy expenditure are needed to clarify the intrinsic nature of this relationship.

Home‐based cardiac rehabilitation using information and communication technology for heart failure patients with frailty

“…In general, nutritional guidance in HF is focused on limiting salt intake and teaching a balanced diet. However, for patients with HF and physical frailty, it is considered necessary to prioritize the guidance for energy and protein intake over the guidance for salt intake 36 . In addition, because the distribution of protein intake over the three daily meals (breakfast, lunch, and dinner) is known to affect protein synthesis, a photographic evaluation of the actual dietary habits of patients and appropriate individual advice with specific examples by nutritionists would be useful.…”

Identification of ICU Patients with High Nutritional Risk after Abdominal Surgery Using Modified NUTRIC Score and the Association of Energy Adequacy with 90-Day Mortality

“…The 90-day mortality prediction by energy adequacy showed an AUC of 0.689 (95% CI: 0.525–0.852, p = 0.021), and the best cutoff value was at 50% (sensitivity = 64.4%, specificity = 75.0%). Therefore, the nutritional status and clinical outcomes were compared according to the energy adequacy of 50% and also assessed according to energy adequacies of 60% and 70%, as described in previous reports [ 19 , 20 ]. In the high mNUTRIC group, 33 patients (44%) had energy adequacies of less than 50%.…”

Diagnostic performance of nutritional indicators in patients with heart failure

“…This study was a sub‐analysis of a multicentre, prospective, observational study that assessed the nutritional status and clinical outcomes in chronic HF, as previously reported. 12 A total of 156 stable patients with chronic HF who regularly visited an outpatient ward for >1 month were enrolled between December 2012 and September 2014. These patients had a history of hospitalization because of worsening HF at least once within 5 years before enrolment.…”