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Diet for the Treatment of Congestive Heart Failure

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DIET FOR THE TREATMENT OF HEART FAILURE. Reason for Diet: To reduce the workload of the heart, To decrease edema of the extremities, To improve breathing in individuals with shortness of breath
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Compliments of Clinical Dietitians, Nutrition Services

DIET FOR THE TREATMENT OF HEART FAILURE



Reason for Diet:


To reduce the workload of the heart


To decrease edema of the extremities


To improve breathing in individuals with shortness of breath



Key Points:

DO NOT add salt at the table or in cooking.

Avoid processed and convenience foods.

Read food labels. Replace products high in sodium
with low-sodium versions when available.

Reduce salt intake to 2000 - 3000 mg per day.

The level of sodium restriction depends on individual
needs and the severity of heart failure.

A fluid restriction may be indicated with severe heart failure.


How long do I need to follow the diet for?


It is recommended that these guidelines be followed and incorporated in daily
dietary behaviors at all times.


Use the following Food List to help guide you







3000 mg Sodium Diet

FOOD GROUP
FOODS ALLOWED
FOODS TO AVOID
Beverages
Milk, buttermilk (limit to 1 cup/day);
Regular vegetable or tomato juices
eggnog; all fruit juices; low-sodium, salt-
free vegetable juices; low-sodium
carbonated beverages
Breads and Cereals
Enriched white, wheat, rye, and
Breads, rolls, and crackers with
6-11 servings
pumpernickel bread, hard rolls and
salted tops; instant hot cereals
dinner rolls; muffins, cornbread; waffles,
pancakes, biscuits; most dry and hot
cereals; unsalted crackers and
breadsticks
Desserts
All None
Fats
Butter or margarine; vegetable oils; low-
Salad dressings containing bacon fat,
Use in moderation
sodium salad dressing, other salad
bacon bits, and salt pork; snack dips
dressings in limited amounts; light, sour, made with instant soup mixes or
and heavy cream
processed cheese
Fruits All
None
Meat or Meat
Any fresh or frozen beef, lamb, pork,
Any smoked, cured, salted,
substitute
poultry, fish, and most shellfish; canned
koshered, or canned meat, fish, or

tuna or salmon, rinsed eggs and egg
poultry including bacon, chipped
substitutes; regular cheese, ricotta, and
beef, cold cuts, ham, hot dogs,
cream cheese (2 oz/day); low-sodium
sausage, sardines, anchovies,
cheese as desired; cottage cheese,
marinated herring, and pickled
drained; regular yogurt; regular peanut
meats; frozen breaded meats;
butter; dried peas and beans; canned,
pickled eggs; processed cheese,
drained/washed legumes; frozen dinners cheese spreads and sauces; salted
(<600 mg sodium/serving)
nuts
Potatoes and
White or sweet potatoes; squash;
Commercially prepared potato, rice,
Substitutes
enriched rice, barley, macaroni,
and pasta mixes; commercial bread
spaghetti, noodles and other pasta;
stuffing
homemade bread stuffing
Soups
Homemade broth, soups without added
Canned or dehydrated regular soups
salt and made with allowed vegetables;
(> once a week)
reduced-sodium canned soups and
broths; commercial canned and
dehydrated soups, broths, and bouillon
(once a week);
Vegetables
All fresh and frozen vegetables; canned, Sauerkraut, pickled vegetables, and
drained vegetables
others prepared in brine; vegetables
seasoned with ham, bacon, or salt
pork
Miscellaneous
Salt substitute with physician’s approval; Any seasoning made with salt
pepper, herbs, spices; vinegar, catsup
including garlic salt, celery salt,
(1tsbp), mustard (1 tbsp), lemon or lime onion salt, and seasoned salt; sea
juice; hot pepper sauce; low-sodium
salt, rock salt, kosher salt; lite salt;
baking powder; unsalted tortilla chips,
meat tenderizers; monosodium
pretzels, potato chips, popcorn, salsa (2
glutamate; regular soy sauce,
tbsp)
teriyaki sauce, most flavored
vinegars; regular snack chips, olives






2000 mg Sodium Diet

FOOD GROUP
FOODS ALLOWED
FOODS TO AVOID
Beverages
Milk (limit to 16 oz/day), buttermilk (limit Malted milk, milkshake, chocolate
to 1 cup per week) eggnog; all fruit
milk; regular vegetable or tomato
juice; low0sodium, salt-free vegetable
juices; commercially softened water
juices; low-sodium carbonated
used for drinking or cooking
beverages

Breads and Cereals
Enriched white, wheat, rye and
Bread, rolls and crackers with salted
pumpernickel bread, hard rolls, and
tops; quick breads; instant hot
dinner rolls; muffins, cornbread, and
cereals; pancakes; commercial bread
waffles; most dry cereals, cooked cereal
stuffing; self-rising flour and biscuit
with out added salt; unsalted crackers
mixes; commercial bread crumbs or
and breadsticks; low-sodium or
cracker crumbs
homemade bread crumbs

Desserts and Sweets All; desserts and sweets made with milk
Instant pudding mixes and cake
should be within allowance
mixes.

Fats
Butter or margarine; vegetable oils;
Regular salad dressings containing
unsalted salad dressing, regular salad
bacon fat, bacon bits, and salt pork;
dressings limited to 1 tbsp; light, sour
Caesar dressing, snack dips made
and heavy cream
with instant soup mixes or processed

cheese
Fruits
Most fresh, frozen, and canned fruits
Fruits processed with salt or sodium-
containing compounds (ie. Some
dried fruits)
Meat and meat
Any fresh or frozen beef, lamb, pork,
Any smoked, cured, lasted, koshered
substitutes
poultry, fish, and shrimp; canned tuna or or canned meat, fish, or poultry
salmon, rinsed; eggs and egg
including bacon, chipped beef, cold
substitutes; low-sodium cheese including cuts, ham, hot dogs, sausage,
low-sodium ricotta and cream cheese;
sardines, anchovies, crab, lobster,
low-sodium cottage cheese; regular
imitation seafood, marinated herring
yogurt; low-sodium peanut butter; dried
and pickled meats; pickled eggs,
peas and beans; frozen dinners (<500
regular hard and processed cheese,
mg sodium/serving)
cheese spreads and sauces; salted
nuts
Potato and potato
White or sweet potatoes; squash;
Commercially prepared potato, rice,
substitutes
enriched rice, barley, noodles, spaghetti, or pasta mixes; commercial bread
macaroni, and other pastas cooked
stuffing
without salt; homemade bread stuffing
Soups
Low-sodium commercially canned and
Regular canned or dehydrated
dehydrated soups, broths, and bouillons; soups, broths, or bouillon
homemade broth and soups without
added salt and made with allowed
vegetables; cream soups within milk
allowance
Vegetables
Fresh, frozen vegetables and low-sodium Regular canned vegetables,
canned vegetables
sauerkraut, pickled vegetables, and
others prepared in brine; frozen
vegetables in sauces; vegetables
seasoned with ham, bacon, or salt
pork




FOOD GROUP
FOODS ALLOWED
FOODS TO AVOID
Miscellaneous
Salt substitute with physician’s
Any seasoning made with salt
approval; pepper, herbs, spices;
including celery salt, garlic salt,
vinegar, lemon, or lime juice; hot
onion salt, and seasoned salt; sea
pepper sauce; low-sodium soy sauce salt, rock salt, kosher salt; meat
(1 tsp); low-sodium condiments
tenderizers; lite salt; monosodium
(catsup, chili sauce, mustard); fresh
glutamate; regular soy sauce,
ground horseradish; unsalted tortilla barbecue sauce, teriyaki sauce,
chips, pretzels, potato chips,
steak sauce, Worcestershire sauce,
popcorn, salsa (2 tbsp)
and most flavored vinegars;
canned gravy and mixes; regular
condiments; salted snack foods;
olives





SUGGESTED MENU PATTERN

Sodium Restricted Diet

Breakfast
Noon
Evening



½ cup fruit juice
Low-sodium vegetable soup (1 c.)
Green salad
¾ cup whole-grain cereal
Unsalted crackers (4)
Vinegar and oil dressing (1 Tbsp)
2 slices enriched white toast
Lean beef patty (3 oz.)
Broiled skinless chicken breast
2 tsp. margarine
Hamburger bun (1)
(3oz)
1 Tbsp. jelly
Mayonnaise (2 Tbsp)
Herbed brown rice (1/2 c.)
1 cup low-fat milk
Sliced tomato and lettuce
Steamed broccoli (1/2 cup)
1 cup 2% milk
Fresh fruit salad (1/2 c.)
Whole-grain roll
Graham crackers (2)
Margarine (2 Tbsp)
1 cup 2% milk
Fruit sorbet (1/2 cup)
Medium apple

Information adapted from Manual of Clinical Dietetics, American Dietetic Association, 6th Edition, © 2000





FYI:




1 teaspoon of salt


provides

2400 mg of sodium










TRY THESE OTHER SEASONINGS TO ADD FLAVOR


Herbs/Spices
Ways to Use Them
Basil
Egg, fish, tomato sauce, and vegetables

Bay leaves
Soups, stews, and boiled beef or pork

Caraway Seeds
Roast Pork, vegetables of the cabbage family, carrots, onions, and celery

Celery powder
Soups, salads, and deviled eggs

Curry Powder
Chicken, lamb, eggs, and rice

Dill
Salads, deviled eggs, chicken, and fish

Fennel
Pork, poultry, and seafood dishes

Garlic
Meats, stews, soups, and salads

Nutmeg
Apple dishes and vegetables

Onion powder
Meat, soups, stews and casseroles

Oregano
Italian dishes, stews, and soups

Paprika
For color; also aids in browning of roast chicken and turkey

Parsley
Eggs, soups, stews, and vegetables

Pepper, black
Salads, fish, meat, eggs, and vegetables

Pepper, red
Meats, sauces, gravies, eggs, fish, vegetable dishes, and stews

Rosemary
Potatoes, peas, squash, lamb, veal, duck, pork stews, and salmon

Sage
Stuffing, poultry, pork, lamb and veal

Thyme
Italian dishes, meat, and vegetables




FYI:


Certain over-the-


counter medications
can contain significant
amounts of sodium.
Make sure you check
the label!






FOOD LABEL

The first place to start reading the food
label is at the top. All the information
Nutrition Facts
on the label will be based on the
serving size
.
Serving Size 8 wafers

Servings per Container 8
Ask yourself a few questions….Is this a serving
Amount Per Serving

that I will eat? Do I usually eat more than this or
Calories 130
Calories from fat 25
less?



% Daily Value

Total Fat 3g
5%

Sodium is listed in milligrams. This
Sodium 180mg
7%
number tells you how many mg of
Total Carb. 34g
8%
sodium are in this serving.
Dietary Fiber 4g
0%

Sugars 0g

If you are following a 2000 mg sodium diet, one
Protein 3g


serving of this food will provide you with 180 mg
of sodium.
Vitamin A 0%
Calcium 0%

Iron 10%

Vitamin C 0%





* Percent Daily Values are based on a 2,000
Also look in the ingredient list for hidden
calorie diet. Your daily values may be higher or
terms for sodium such as, brine,
lower depending on your calorie needs.
monosodium glutamate, sodium




Calories 2,000 2,500
bicarbonate, sodium nitrate and any
Total Fat
Less than 65g 80g
ingredients with sodium in its name.
Sat. Fat
Less than 20g 25g
Salt and other sodium ingredients are
Cholesterol
Less than 300mg 300mg
often added to foods during processing.
Sodium
Less than 2,400mg 2,400mg

Total Carbohydrate
300g 375g
Dietary Fiber
25g 30g
Don’t be mislead by sodium claims on
Protein

50g 60g
food labels. Make sure you read the
Calories per gram:

food label!
Fat 9 * Carbohydrate 4 * Protein 4








Sodium Claims on Labels:
What is really means
Sodium Free
Less than 5 mg of sodium per serving
Salt free
Meets requirements for sodium free
Low Sodium
140 mg sodium or less per serving
Very low sodium
35 mg or less sodium per serving
Reduced Sodium
At least 25% less sodium when compared with a reference food (regular
version of that food)
Light in Sodium
50% less sodium per serving, restricted to foods with more than 40
calories per serving or more than 3 g of fat per serving
Unsalted, without added
No salt is added during processing.
salt, No salt added
The product it resembles and substitutes for is normally processed with
salt.
The label bears the statement “not a sodium free food” or “not for control
of sodium on the diet” if the food is not sodium free.


HELPFUL HINTS FOR FLUID CONTROL


Your fluids are restricted to: _____ ml = _____ cups = ____ ounces per day


All foods contain some fluids; however, only those that are liquid at room temperature
need to be counted. The following foods should be measured and counted as fluids:



Water (including that taken with
pills)
Coffee,
Tea
Milk, Cream, Non-Dairy creamer


Fruit Juice
Vegetable
juice
Soda
Alcohol






Soups
Ice
cream,
sherbet,
frozen
yogurt
Gelatin
Popsicles (1 double = 1/3 cup)


Ice cubes



FLUID TABLE

1 quart
=
4 cups
=
32 ounces =
980 ml
1 pint
=
2 cups
=
16 ounces =
480 ml
1
cup
=


8
ounces
=
240
ml
½
cup
=


4
ounces
=
120
ml



1/3 cup
=
3 ounces =
80 ml



¼ cup
=
2 ounces =
60 ml
2 tbsp
=
1/8 cup
=
1 ounce
=
30 ml
1 tbsp
=


=
½ ounce =
15 ml






If you have any questions or concerns, please feel free to call Outpatient Nutrition Counseling at 577-
2396 to speak with a Dietitian. We may recommend that you contact your physician for a referral to
make an appointment with a Registered Dietitian who can personalize your meal plan.

To make an appointment with Outpatient Nutrition Counseling, please call
Central Scheduling at 577-2665.





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Our people make it happen everyday.

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