title: Association between self-reported adherence to a low-sodium diet and dietary habits related to sodium intake in heart failure patients.
abstract: BACKGROUND
  Sodium restriction is the primary dietary therapy in heart failure (HF); however, assessing sodium intake is challenging to clinicians, who commonly rely on patients' self-report of following a low-sodium diet to determine adherence. It is important to further explore the utility of self-reported adherence to a low-sodium diet in patients with HF.
  
  
  OBJECTIVE
  The objective of this study was to evaluate the association between patients' self-reported adherence to a low-sodium diet and dietary habits related to sodium intake in patients with chronic HF.
  
  
  METHODS
  Patients with HF seen in a tertiary care Heart Function Clinic and who have been taught on a low-sodium diet with a target of less than 2300 mg/d were included. Self-perception of compliance and dietary habits related to sodium intake was evaluated by using a dietary questionnaire. Patients were divided into 3 groups according to self-reported adherence to a low-sodium diet: never, sometimes, and always.
  
  
  RESULTS
  Overall, 237 patients (median age, 66 years, 72.6% men) were included. Compared with the other 2 groups, patients who stated always following a low-sodium diet were less likely to use salt in cooking or at the table. However, 4.2% of the patients in the always group reported eating canned or package soups every day. Moreover, the highest proportion of patients eating fast foods 1 to 3 times a week was found among those in the sometimes group (22.9%) compared with the never (9.1%) and always (6.7%) groups (P = .002). Importantly, the rest of the food items did not show any significant differences between self-reported adherence groups.
  
  
  CONCLUSIONS
  Self-report of adherence to a low-sodium diet is not reliable among patients with HF, who associate the idea of following a low-sodium diet mainly with not using salt for cooking or at the table but not with reducing frequency of intake of high-sodium processed foods.
authors.affiliation: Eloisa Colin-Ramirez, PhD Postdoctoral Fellow, Medicine Department, University of Alberta, Edmonton, Canada. Finlay A. McAlister, MSc Professor, Division of General Internal Medicine, University of Alberta, Edmonton, Canada. Elizabeth Woo, RD Clinic Dietitian, Heart Function Clinic, Division of Cardiology, University of Alberta Hospital, Edmonton, Canada. Nellie Wong, RD Clinical Dietitian for Heart Function and EASE Clinic and Outpatient Cardiology Dietitian at the Mazankowski Alberta Heart Institute. University of Alberta Hospital, Edmonton, Canada. Justin A. Ezekowitz, MBBCh, MSc Director, Heart Function Clinic, Division of Cardiology, University of Alberta, Edmonton, Canada.
authors.forename: Eloisa
authors.initials: E
authors.lastname: Colin-Ramirez
authors.forename: Finlay A
authors.initials: FA
authors.lastname: McAlister
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Woo
authors.forename: Nellie
authors.initials: N
authors.lastname: Wong
authors.forename: Justin A
authors.initials: JA
authors.lastname: Ezekowitz
mesh_terms: D000368:Aged; D004039:Diet, Sodium-Restricted; D005247:Feeding Behavior; D005260:Female; D006333:Heart Failure / Q000178:diet therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D057566:Self Report; D011795:Surveys and Questionnaires