title: Dietary habits are related to outcomes in patients with advanced heart failure awaiting heart transplantation.
abstract: BACKGROUND
  Empirical evidence supporting the benefits of dietary recommendations for patients with advanced heart failure is scarce. We prospectively evaluated the relation of dietary habits to pre-transplant clinical outcomes in the multisite observational Waiting for a New Heart Study.
  
  
  RESULTS
  A total of 318 heart transplant candidates (82% male, age 53 ± 11 years) completed a Food Frequency Questionnaire (foods high in salt, saturated fats, poly-/monounsaturated fats [PUFA+MUFA], fruit/vegetables/legumes, and fluid intake) at time of waitlisting. Cox proportional hazard models controlling for heart failure severity (eg, Heart Failure Survival Score, creatinine) estimated cause-specific hazard ratios (HRs) associated with each dietary habit individually, and with all dietary habits entered simultaneously. During follow-up (median 338 days, range 13-1,394), 54 patients died, 151 received transplants (110 in high-urgency status, 41 electively), and 45 became delisted (15 deteriorated, 30 improved). Two robust findings emerged: Frequent intake of salty foods, which correlated positively with saturated fat and fluid intake, was associated with transplantation in high-urgency status (HR 2.90, 95% confidence interval [CI] 1.55-5.42); and frequent intake of foods rich in PUFA+MUFA reduced the risk for death/deterioration (HR 0.49, 95% CI 0.26-0.92).
  
  
  CONCLUSIONS
  These results support the importance of dietary habits for the prognosis of patients listed for heart transplantation, independently from heart failure severity.
authors.affiliation: Department of Psychology, Johannes Gutenberg University, Mainz, Germany. spaderna@uni-wuppertal.de
authors.forename: Heike
authors.initials: H
authors.lastname: Spaderna
authors.forename: Daniela
authors.initials: D
authors.lastname: Zahn
authors.forename: Johanna
authors.initials: J
authors.lastname: Pretsch
authors.forename: Sonja L
authors.initials: SL
authors.lastname: Connor
authors.forename: Armin
authors.initials: A
authors.lastname: Zittermann
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schulze Schleithoff
authors.forename: Katrina A
authors.initials: KA
authors.lastname: Bramstedt
authors.forename: Jacqueline M A
authors.initials: JM
authors.lastname: Smits
authors.forename: Gerdi
authors.initials: G
authors.lastname: Weidner
mesh_terms: D000328:Adult; D004041:Dietary Fats / Q000008:administration & dosage / Q000009:adverse effects; D005247:Feeding Behavior / Q000502:physiology; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D016027:Heart Transplantation / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage / Q000009:adverse effects; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014850:Waiting Lists
chemical_list: D004041:Dietary Fats; D017673:Sodium Chloride, Dietary