How low-salt diets can help those living with heart failure

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New research found that low-salt diets may help improve quality of life for people living with heart failure. Bruce and Rebecca Meissner/Stocksy United
  • People living with heart failure are often advised to follow a low-salt diet.
  • A new study indicates that this can help improve people’s quality of life.
  • However, it did not appear to improve rates of death, hospitalization or emergency room visits.
  • Patients are advised to keep their sodium intake below 1,500 mg per day.

people living with heart failure – a chronic condition in which the heart muscle cannot pump enough blood to meet the body’s needs – they are often advised to continue low salt diets.

The reasoning behind this recommendation is that salt contains sodium and too much sodium can cause fluid retention.

Limiting sodium in the diet can help minimize the buildup of excess fluid around the heart and lungs and in the legs of heart failure patients.

This is thought to ease the burden on an already overworked heart and reduce some of the negative symptoms associated with the condition, such as swelling, fatigue and cough.

However, until now there was little scientific evidence to support this claim.

However, a new study published in the lancet indicates that low-salt diets can reduce these unpleasant symptoms and improve people’s overall quality of life.

To carry out the study, the main author Justin Ezekowitza professor at the University of Alberta School of Medicine and Dentistry and co-director of Canada’s VIGOR Center, and his team followed 806 heart failure patients at 26 medical centers in Canada, the United States, Colombia, Chile, Mexico, and New Zealand.

Half were randomized to receive usual care. The rest received advice on how to reduce their salt intake.

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Those who received nutritional advice received menu suggestions designed by dieticians.

They were also encouraged to cook for themselves, avoiding salt and high-salt ingredients.

His sodium goal was to consume less than 1,500 mg per day, or about two-thirds of a teaspoon of salt.

People who received dietary advice reduced their sodium intake more than the group that did not.

Before the study, the patients consumed an average of 2,217 mg per day.

At the end of the one-year study, patients who received usual care still had an average of 2,073 mg of sodium per day.

On the other hand, the patients who received advice consumed much less with an average of 1,658 mg per day.

However, the results were mixed.

When it came to rates of all-cause mortality, cardiovascular hospitalizations, and cardiovascular emergency room visits, there was no real difference between the two groups.

Where sodium restriction made a difference, however, was in people’s quality of life.

When the researchers assessed the patients’ quality of life using three different tools, they found significant improvements.

They also found improvements in a classification of heart failure severity called the New York Heart Association Functional Classification.

What should the average person know about sodium? Bottom line, we should probably all be eating less, especially those at risk for cardiovascular disease.

“When it comes to salt, most Americans get much more than we need in our diets,” he said. Molly KimballRD, CSSD, registered dietitian at Ochsner Health and founder of Ochsner Eat Fit.

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For healthy people, the recommendation is around 2,300 mg per day.

For people over the age of 51 or at risk for cardiovascular disease, the goal is to further reduce salt intake, to less than 1,500 mg of sodium per day.

“Most of us get more than double that,” Kimball noted.

He further explained that only about 10 percent of the sodium in our diet comes from a cocktail shaker.

More than 75 percent comes from processed foods, food services, and restaurants.

To keep your sodium intake in check, Kimball suggests keeping an eye on what the American Heart Association calls “the salty six”: bread and rolls, pizza, sandwiches, cold cuts and cured meats, canned soup, and burritos and tacos.

Also, be sure to read labels and switch to low-sodium items.

Dr Ragavendra Baliwho specializes in heart disease and heart failure at The Ohio State University Wexner Medical Center, said that in addition to a low-salt diet, another dietary change that can be made under a doctor’s supervision is to restrict intake of fluids, which will also reduce fluid buildup around the heart and lungs.

He recommends that patients consume about 2 L of water per day (about 64 ounces).

In addition, he pointed out four particular types of drugs that are useful for heart failure, which he called “the new four horsemen.”

These medications include:

  • The angiotensin neprilysin inhibitor (RNAi) starterwhich is a combination of two blood pressure-lowering drugs, sacubitril and valsartan.
  • Sodium-glucose cotransporter inhibitors (SGLT2is) such as dapagliflozin and empagliflozin, which can help lower blood sugar and reduce hospitalizations of patients with heart failure and diabetes.
  • Beta-blockers such as carvedilol, metoprolol XL, and bisoprolol, which slow the heart rate and lower blood pressure.
  • Mineralocorticoid receptor antagonists (MRAs) such as eplerenone and spironolactone, which can reduce fluid buildup and blood pressure.
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Your doctor may use these medications, as well as others, to help your heart work more effectively or to reduce stress on it.

Surgical procedures or the implantation of certain devices may also be appropriate for some patients.