Nutrition intervention in heart failure: should consumption of the DASH eating pattern be recommended to improve outcomes?

Abu-Sawwa, Renad; Dunbar, Sandra B.; Quyyumi, Arshed A.; Sattler, Elisabeth Lilian Pia

doi:10.1007/s10741-019-09781-6

Cited by 24 publications

(18 citation statements)

References 58 publications

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“…Studies show that approximately 35% to 78% of HF patients suffer from malnutrition, which has also been independently associated with adverse outcomes [ 72 , 73 , 74 , 75 ]. The aetiology of malnutrition is complex and thought to be multifactorial where fatigue, dyspnoea, swallowing disturbances, nausea, anxiety, food monotony, reduced appetite and early satiety could play a role [ 76 , 77 , 78 ]. The advice to reduce dietary salt intake (albeit controversial [ 79 , 80 ]) could compromise the nutritional status of individual patients with HF [ 81 , 82 ].…”

Section: Causes Of Iron Deficiency In Heart Failurementioning

confidence: 99%

Iron Deficiency in Heart Failure: Mechanisms and Pathophysiology

Alnuwaysir

Hoes

Veldhuisen

et al. 2021

JCM

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Iron is an essential micronutrient for a myriad of physiological processes in the body beyond erythropoiesis. Iron deficiency (ID) is a common comorbidity in patients with heart failure (HF), with a prevalence reaching up to 59% even in non-anaemic patients. ID impairs exercise capacity, reduces the quality of life, increases hospitalisation rate and mortality risk regardless of anaemia. Intravenously correcting ID has emerged as a promising treatment in HF as it has been shown to alleviate symptoms, improve quality of life and exercise capacity and reduce hospitalisations. However, the pathophysiology of ID in HF remains poorly characterised. Recognition of ID in HF triggered more research with the aim to explain how correcting ID improves HF status as well as the underlying causes of ID in the first place. In the past few years, significant progress has been made in understanding iron homeostasis by characterising the role of the iron-regulating hormone hepcidin, the effects of ID on skeletal and cardiac myocytes, kidneys and the immune system. In this review, we summarise the current knowledge and recent advances in the pathophysiology of ID in heart failure, the deleterious systemic and cellular consequences of ID.

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Section: Causes Of Iron Deficiency In Heart Failurementioning

confidence: 99%

Iron Deficiency in Heart Failure: Mechanisms and Pathophysiology

Alnuwaysir

Hoes

Veldhuisen

et al. 2021

JCM

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“…Whereas it is often recommended that patients with chronic cardiovascular conditions follow a sodium-restricted diet, the latter often involves a poorer taste of the foods consumed, which explains the low adherence rates to a great extent [38][39][40][41]. In our study cohort, both CHF as well PAH participants consumed large amounts of sodium daily.…”

Section: Discussionmentioning

confidence: 89%

Diet in Scleroderma: Is There a Need for Intervention?

et al. 2021

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Systemic sclerosis (SSc) patients exhibit a plethora of risk factors for nutritional decline, including the presence of chronic inflammation and the progressive nature of disease-related multisystem involvement. The prevalence and consequences of nutritional decline in scleroderma are frequently underestimated, its management currently remaining a subject of debate. The main objective of the present study was to perform a detailed assessment of scleroderma patients’ diet as well as their eating habits and to describe the relationships with weight loss and malnutrition risk in the absence of professional nutritional counseling. Methods: We used a translated and validated version of the EPIC-Norfolk FFQ (European Prospective Investigation into Cancer and Nutrition Norfolk Food Frequency Questionnaire) to evaluate the patients’ diet and MUST (Malnutrition Universal Screening Tool) to investigate the risk of malnutrition. Disease activity was estimated using the EUSTAR-AI (European Scleroderma Trials and Research group Activity Index). Results: We included 69 patients with SSc, of which 42 underwent a detailed dietary assessment. Dietary factors were connected to body composition and digestive symptoms. We found high sodium intake and frequent suboptimal energy consumption in our study group, including patients with cardiopulmonary involvement. Liver transaminases were inversely correlated with the consumption of nuts and seeds. Malnutrition and weight loss were significantly associated with pulmonary hypertension, heart failure, albumin levels, and the extent of skin fibrosis, but not advanced age. Although the patients with EUSTAR-AI ≥ 2.5 were more frequently included in the moderate and high malnutrition risk categories, these results did not reach statistical significance. Conclusions: Currently, there is an unmet need for longitudinal and interventional research focusing on the long-term significance, ramifications, and management of nutritional impairment in SSc patients with various clinical manifestations. Our results indicate that scleroderma patients could benefit from personalized nutritional counseling in an interdisciplinary setting.

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“…Salt consumption is correlated with higher fluid intake and consumption of saturated fatty acids [27], which can also lead to poor outcomes and worsening of symptoms [45,46]. To ensure a healthy diet rich in nutrients and that limits foods high in sodium, promotion of the DASH diet or a Mediterranean diet for heart failure patients could be helpful [47][48][49][50].…”

Section: Discussionmentioning

confidence: 99%

Psychosocial Risk and Health Behaviors as Predictors of Clinical Events in Patients Wait-Listed for a New Heart: Results from 7 Years of Follow-Up

Gali

Weidner

Smits

et al. 2021

Life

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We examined the long-term relationship of psychosocial risk and health behaviors on clinical events in patients awaiting heart transplantation (HTx). Psychosocial characteristics (e.g., depression), health behaviors (e.g., dietary habits, smoking), medical factors (e.g., creatinine), and demographics (e.g., age, sex) were collected at the time of listing in 318 patients (82% male, mean age = 53 years) enrolled in the Waiting for a New Heart Study. Clinical events were death/delisting due to deterioration, high-urgency status transplantation (HU-HTx), elective transplantation, and delisting due to clinical improvement. Within 7 years of follow-up, 92 patients died or were delisted due to deterioration, 121 received HU-HTx, 43 received elective transplantation, and 39 were delisted due to improvement. Adjusting for demographic and medical characteristics, the results indicated that frequent consumption of healthy foods (i.e., foods high in unsaturated fats) and being physically active increased the likelihood of delisting due improvement, while smoking and depressive symptoms were related to death/delisting due to clinical deterioration while awaiting HTx. In conclusion, psychosocial and behavioral characteristics are clearly associated with clinical outcomes in this population. Interventions that target psychosocial risk, smoking, dietary habits, and physical activity may be beneficial for patients with advanced heart failure waiting for a cardiac transplant.

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Nutrition intervention in heart failure: should consumption of the DASH eating pattern be recommended to improve outcomes?

Cited by 24 publications

References 58 publications

Iron Deficiency in Heart Failure: Mechanisms and Pathophysiology

Iron Deficiency in Heart Failure: Mechanisms and Pathophysiology

Diet in Scleroderma: Is There a Need for Intervention?

Psychosocial Risk and Health Behaviors as Predictors of Clinical Events in Patients Wait-Listed for a New Heart: Results from 7 Years of Follow-Up

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