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Nutrition Assessment and Dietary Interventions in Heart Failure JACC Review Topic of the Week

Journal

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 79, Issue 16, Pages 1623-1635

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2022.02.025

Keywords

diet; heart failure; nutrition

Funding

  1. National Institutes of Health [R01HL139671, R21AG058348, K24AG036778, UG3 DK128302-01, P30 DK26687-41, 5T32DK007559-31, R01-HL39813, R01-AG062582, R61-HL155498]
  2. National Institutes of Health National Center for Advancing Translational Sciences [1U24TR002306-01]
  3. American Heart Association [20-SFRN35370008, 19CDA34660318]
  4. Veterans Affairs Clinical Science Research Development [CARA-009-16F9050]
  5. PurFoods, LLC
  6. Pfizer
  7. Novartis
  8. Corvia
  9. Axon Therapeutics
  10. Clinical and Translational Science Awards Program from the National Institutes of Health [UL1TR002649]
  11. Ionis
  12. Eidos
  13. Alnylam

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Despite the high prevalence of nutrition disorders in patients with heart failure (HF), there is a lack of specific nutrition recommendations in major HF guidelines. The lack of standardized definitions and assessment tools to quantify nutritional status often leads to underrecognition of nutrition disorders in HF patients. Various dietary interventions and patterns have been studied in this population, but the evidence of their benefits is conflicting. This article reviews the available nutritional status assessment tools and evaluates the current evidence for dietary interventions in HF, as well as the feasibility and challenges associated with implementing multimodal nutrition interventions.
Despite the high prevalence of nutrition disorders in patients with heart failure (HF), major HF guidelines lack specific nutrition recommendations. Because of the lack of standardized definitions and assessment tools to quantify nutritional status, nutrition disorders are often missed in patients with HF. Additionally, a wide range of dietary interventions and overall dietary patterns have been studied in this population. The resulting evidence of benefit is, however, conflicting, making it challenging to determine which strategies are the most beneficial. In this document, we review the available nutritional status assessment tools for patients with HF. In addition, we appraise the current evidence for dietary interventions in HF, including sodium restriction, obesity, malnutrition, dietary patterns, and specific macronutrient and micronutrient supplementation. Furthermore, we discuss the feasibility and challenges associated with the implementation of multimodal nutrition interventions and delineate potential solutions to facilitate addressing nutrition in patients with HF. (C) 2022 by the American College of Cardiology Foundation.

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