Diet Tips for Congestive Heart Failure

Congestive heart failure occurs when the heart becomes unable to pump oxygen- and nutrient-rich blood as efficiently as it should, leading to excess fluid buildup in the lungs and extremities (arms and legs).

Your healthcare provider may prescribe medications to help you manage your condition, but they likely will also urge you to make some lifestyle changes, including to your diet, to prevent your congestive heart failure from getting worse.

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Reduce Sodium

The salt we use to flavor and enhance many of our meals consists of 40% sodium and 60% chloride. Our cells require about 0.5 grams (g) daily for our bodies to function optimally. On average, most Americans consume 3.4 g, or 1.5 teaspoons, of sodium daily.

Consuming too much sodium may lead to health conditions like: 

Restricting dietary sodium is generally recommended for people with heart failure. The American College of Cardiology (ACC) and the American Heart Association (AHA) guidelines recommend that these individuals restrict their sodium to less than 3,000 milligrams (mg) per day. This recommendation is actually in line with the Dietary Guidelines for Americans, which recommends no more than 2,300 mg of sodium, or 1 teaspoon of salt, per day for all Americans.

To lower sodium consumption:

  • Read nutritional labels on packaging and choose foods that are low in sodium.
  • Refrain from using the salt shaker.
  • Eat fresh fruits and vegetables, and avoid processed foods when possible.
  • Prepare your own meals, which allows you to control how much sodium you use when cooking or consuming food.
  • At restaurants, ask to have the meal prepared without salt or select a low-sodium option.

You may also want to eat high-fiber foods, which are considered heart-healthy. These include legumes and whole grains, which also aid in digestion and control glucose levels.

If you’re unable to get fresh fruits and vegetables, select no-sodium-added or low-sodium canned vegetables. Make sure to rinse canned vegetables before you use them. Experiment with spices, lemon and lime juice, apple vinegar, or herb blends to add more flavor to your food. 

Lower Fat and Cholesterol

Studies have shown that the rate of heart failure is lower in people who follow a DASH diet (Dietary Approaches to Stop Hypertension), which centers on consuming polyunsaturated fats, complex carbohydrates like brown rice, low amounts of saturated fats, and fruits and vegetables.

Saturated fat and cholesterol can lead to other cardiovascular issues like atherosclerosis, which is the buildup of plaque on the walls of the arteries. To reduce that risk, eliminate butter, shortening, and margarine, and consume limited amounts of olive, peanut, and canola oils.

To lower your fat intake, avoid fatty cuts of meat, remove the skin from poultry, and consume more fish. Replace high-fat dairy with low-fat or nonfat options, eat whole grains for their high fiber content, and limit condiments and salad dressings that are high in fat and sodium. When preparing your food, avoid frying, and choose to bake, broil, poach, boil, or steam instead.  

Avoid Alcohol

Excessive alcohol consumption is associated with several conditions that can affect your liver, kidneys, and heart. Heavy drinking can lead to high blood pressure, stroke, and heart failure as well as cardiomyopathy, which affects the heart muscle and can lead to heart failure. 

According the American Heart Association, drinking too many alcoholic beverages increases triglycerides levels and leads to high LDL cholesterol ("bad" cholesterol) or low HDL cholesterol ("good" cholesterol), which is linked to fatty deposits in the artery walls and increases the risk of a heart attack or stroke. 

Having five or more drinks in two hours for men or four or more drinks for women leads to a higher risk of atrial fibrillation (fast and irregular heart rhythm), which can lead to blood clots, stroke, and heart failure.

The best approach is to drink in moderation, but if your heart failure is linked to heavy drinking, it is best not to consume any alcoholic beverages at all.

What About Caffeine?

In one study, researchers found no significant changes in heart rhythms from those who consumed caffeine or no caffeine. However, researchers noted that the trial tested only the effects of 500 mg of caffeine and that it may not be safe to consume unlimited cups of coffee on a daily basis. For most people with heart failure, drinking modest amounts of caffeinated beverages should not be a problem. However, this is something you should discuss with your doctor.

Manage Fluids

When your heart is unable to pump blood to the rest of your body, fluids build up. If you have heart failure, drinking too many fluids may lead to swelling, weight gain, and shortness of breath. To prevent these symptoms, some people with heart failure may need to limit the amount of liquid in their diet.

Your healthcare provider will discuss with you whether fluid restriction is necessary in your case and to what extent. If you are fluid-limited, keep in mind that this restriction will include coffee, juice, milk, tea, soda, and water. Also limit yogurt, pudding, ice cream, and the juice in fruits. When eating soup, eat chunkier types that have high-fiber vegetables and leave the broth.

To keep track of how much fluid you consume throughout the day, keep a pitcher nearby that holds the amount of fluid permitted on a daily basis. Each time you drink any fluid, empty that amount of fluid from the pitcher. Once you've emptied the pitcher, you know that you've reached your fluid allotment for the day.

Heart Failure Doctor Discussion Guide

Doctor Discussion Guide Old Man

A Word From Verywell

To reduce the risk of heart disease and heart failure, modifying your diet is key. If you have questions about what changes you need to make, speak with your healthcare provider and a nutritionist specializing in heart health. They’ll be able to provide more guidance to help you transition to a healthier way of eating that can help manage your condition as well.

Frequently Asked Questions

What is the best diet for congestive heart failure?

Once you are diagnosed with congestive heart failure, you will meet with your medical team, which includes a nutritionist. They will provide you with guidelines on what activities you can do, along with an eating plan that helps manage your condition. Your diet should be low in sodium, cholesterol, and saturated fat. You can still eat lean protein like chicken, certain types of fish, seafood, legumes, whole grains, fresh fruit, and vegetables.

What foods should be avoided with congestive heart failure? 

You should avoid foods that are high in sodium, including many cheeses, deli meats, smoked meats and fish. You should also avoid foods that are high in fat and cholesterol, such as rich desserts and processed foods. Also, avoid alcoholic beverages if your heart condition is associated with heavy drinking.

Can you reverse congestive heart failure with diet?

No. However, a low-sodium and low-fat diet will help lower the risk of a cardiac episode.

Can you drink coffee if you have congestive heart failure?

According to recent studies, as noted by the American Heart Association, drinking one or more cups of caffeinated coffee may reduce the risk of heart failure. But other studies noted that drinking several cups throughout the day may not be safe. When in doubt, talk to your cardiologist and nutritionist about the amount of coffee you can drink.

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