title: Quality and adequacy of dietary intake in a southern urban heart failure population.
abstract: BACKGROUND
  Few studies have examined the quality and adequacy of dietary intake in patients attempting to limit sodium.
  
  
  OBJECTIVE
  The aim of this study was to provide a comprehensive analysis of the dietary intake of persons with heart failure (HF) in the Southern United States who have been advised to limit their sodium intake.
  
  
  METHODS
  Three-day food diaries were completed by 114 New York Heart Association class II and III persons with HF enrolled in a family partnership intervention study, which were reviewed by a dietitian and analyzed using validated nutritional software. The Harris-Benedict equation for sedentary adults was used to determine macronutrient intake adequacy. Demographic information and clinical data were obtained through patient report and medical record review.
  
  
  RESULTS
  Dietary sodium ingestion ranged from 522 to 9251 mg/d (mean [SD], 2671 [1432] mg/d), with 38 (33.3%) individuals consuming the recommended 2000 mg/d or less in this sample (age, 28-78 years; 64.0% men; 57.0% African American). Mean (SD) caloric intake for the total sample was 1674 (636) kcal/d, with participants eating 99% of the recommended daily allowance (RDA) of protein, 63% of the RDA of carbohydrates, and 89% of the RDA of fat. Participants eating 2000 mg or less of sodium consumed significantly less calories (P < .001), protein (P < .001), carbohydrates (P = .008), and fat (P < .001), but not fiber (P = .103), compared with those consuming more than 2000 mg of sodium after adjusting for body mass index. When analyzed by amount of sodium consumption, persons ingesting 2000 mg or less of sodium per day ate significantly less grains (P = .001) and meat and beans (P = .004) and had less intake of the micronutrients calcium (P < .001), zinc (P = .002), and thiamine (P = .05).
  
  
  CONCLUSIONS
  Only one-third of participants with HF who have been instructed on a low-sodium diet reported consuming the RDA of 2000 mg or less, indicating the need for further dietary instruction with a particular focus on modifying the Southern US diet.
authors.affiliation: Biological and Biomedical Sciences, Emory University, Atlanta, Georgia, USA.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Frediani
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Reilly
authors.forename: Melinda
authors.initials: M
authors.lastname: Higgins
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Clark
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Gary
authors.forename: Sandra B
authors.initials: SB
authors.lastname: Dunbar
mesh_terms: D000328:Adult; D000368:Aged; D015930:Diet Records; D004039:Diet, Sodium-Restricted; D005247:Feeding Behavior; D005260:Female; D006333:Heart Failure / Q000534:rehabilitation*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D018977:Micronutrients; D008875:Middle Aged; D015999:Multivariate Analysis; D018673:Nutrition Policy; D009752:Nutritional Status; D009753:Nutritive Value; D010349:Patient Compliance; D010353:Patient Education as Topic; D014481:United States; D014505:Urban Population
chemical_list: D018977:Micronutrients