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Nutritional Interventions in Heart Failure: A Systematic Review of the Literature.

Abstract

BACKGROUND

Heart failure (HF) is a major health care burden and there is a growing need to develop strategies to maintain health and sustain quality of life in persons with HF. The purpose of this review is to critically appraise the components of nutrition interventions and to establish an evidence base for future advances in HF nutrition research and practice.

METHODS AND RESULTS

Cinahl, Pubmed, and Embase were searched to identify articles published from 2005 to 2015. A total of 17 randomized controlled trials were included in this review. Results were divided into 2 categories of nutrition-related interventions: (1) educational and (2) prescriptive. Educational interventions improved patient outcomes such as adherence to dietary restriction in urine sodium levels and self-reported diet recall. Educational and prescriptive interventions resulted in decreased readmission rates and patient deterioration. Adherence measurement was subjective in many studies. Evidence showed that a normal-sodium diet and 1-liter fluid restriction along with high diuretic dosing enhanced B-type natriuretic peptide, aldosterone, tumor necrosis factor α, and interleukin-6 markers.

CONCLUSIONS

Educational nutrition interventions positively affect patient clinical outcomes. Although clinical practice guidelines support a low-sodium diet and fluid restriction, research findings have revealed that a low-sodium diet may be harmful. Future research should examine the role of macronutrients, food quality, and energy balance in HF nutrition.

Links

  • PMC Free PDF
  • Authors+Show Affiliations

    ,

    Johns Hopkins University School of Nursing, Baltimore, Maryland. Electronic address: mabshir1@jhu.edu.

    ,

    Johns Hopkins University School of Nursing, Baltimore, Maryland; College of Nursing, University of Utah, Salt Lake City, Utah.

    ,

    Department of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, Maryland.

    ,

    Heart Failure Bridge Clinic, Johns Hopkins Hospital, Baltimore, Maryland.

    ,

    Johns Hopkins University School of Nursing, Baltimore, Maryland.

    ,

    Heart Failure Bridge Clinic, Johns Hopkins Hospital, Baltimore, Maryland.

    ,

    Academic Affairs, Johns Hopkins University School of Nursing, Baltimore, Maryland.

    Department of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, Maryland.

    Source

    Journal of cardiac failure 21:12 2015 Dec pg 989-99

    MeSH

    Age Factors
    Aged
    Aged, 80 and over
    Diet, Sodium-Restricted
    Evidence-Based Medicine
    Female
    Heart Failure
    Humans
    Male
    Middle Aged
    Nutrition Assessment
    Patient Education as Topic
    Prognosis
    Randomized Controlled Trials as Topic
    Sex Factors

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    26525961

    Citation

    Abshire, Martha, et al. "Nutritional Interventions in Heart Failure: a Systematic Review of the Literature." Journal of Cardiac Failure, vol. 21, no. 12, 2015, pp. 989-99.
    Abshire M, Xu J, Baptiste D, et al. Nutritional Interventions in Heart Failure: A Systematic Review of the Literature. J Card Fail. 2015;21(12):989-99.
    Abshire, M., Xu, J., Baptiste, D., Almansa, J. R., Xu, J., Cummings, A., ... Dennison Himmelfarb, C. (2015). Nutritional Interventions in Heart Failure: A Systematic Review of the Literature. Journal of Cardiac Failure, 21(12), pp. 989-99. doi:10.1016/j.cardfail.2015.10.004.
    Abshire M, et al. Nutritional Interventions in Heart Failure: a Systematic Review of the Literature. J Card Fail. 2015;21(12):989-99. PubMed PMID: 26525961.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Nutritional Interventions in Heart Failure: A Systematic Review of the Literature. AU - Abshire,Martha, AU - Xu,Jiayun, AU - Baptiste,Diana, AU - Almansa,Johana R, AU - Xu,Jingzhi, AU - Cummings,Abby, AU - Andrews,Martha J, AU - Dennison Himmelfarb,Cheryl, Y1 - 2015/10/23/ PY - 2015/08/17/received PY - 2015/10/07/revised PY - 2015/10/14/accepted PY - 2015/11/4/entrez PY - 2015/11/4/pubmed PY - 2016/9/14/medline KW - Diet KW - fluid restriction KW - sodium restriction SP - 989 EP - 99 JF - Journal of cardiac failure JO - J. Card. Fail. VL - 21 IS - 12 N2 - BACKGROUND: Heart failure (HF) is a major health care burden and there is a growing need to develop strategies to maintain health and sustain quality of life in persons with HF. The purpose of this review is to critically appraise the components of nutrition interventions and to establish an evidence base for future advances in HF nutrition research and practice. METHODS AND RESULTS: Cinahl, Pubmed, and Embase were searched to identify articles published from 2005 to 2015. A total of 17 randomized controlled trials were included in this review. Results were divided into 2 categories of nutrition-related interventions: (1) educational and (2) prescriptive. Educational interventions improved patient outcomes such as adherence to dietary restriction in urine sodium levels and self-reported diet recall. Educational and prescriptive interventions resulted in decreased readmission rates and patient deterioration. Adherence measurement was subjective in many studies. Evidence showed that a normal-sodium diet and 1-liter fluid restriction along with high diuretic dosing enhanced B-type natriuretic peptide, aldosterone, tumor necrosis factor α, and interleukin-6 markers. CONCLUSIONS: Educational nutrition interventions positively affect patient clinical outcomes. Although clinical practice guidelines support a low-sodium diet and fluid restriction, research findings have revealed that a low-sodium diet may be harmful. Future research should examine the role of macronutrients, food quality, and energy balance in HF nutrition. SN - 1532-8414 UR - https://www.unboundmedicine.com/medline/citation/26525961/full_citation DB - PRIME DP - Unbound Medicine ER -