Effect of a Sodium-Restricted Diet on Intake of Other Nutrients in Heart Failure: Implications for Research and Clinical Practice.
BACKGROUND
Sodium restriction is the primary dietary therapy for heart failure (HF) patients. Currently, it is unknown if changing diets to reduce dietary sodium in HF causes secondary changes to the intake of other nutrients in this patient population already at nutritional risk.


RESULTS
HF patients (n = 16; 52 ± 12 years old; 78% male) followed a sodium-restricted diet for 1 week. Nutritional changes were documented at baseline and after a <2,000 mg/d sodium-restricted diet, as measured by food records before baseline and each day during the study. After a 49% reduction in dietary sodium (3,626 ± 956 to 1,785 ± 696 mg/d), we observed a significant reduction in calorie (2,467 ± 748 to 1,931 ± 388 kcal/d; P < .016), carbohydrate (293 ± 108 to 232 ± 56 g/d; P = .013), calcium (995 ± 496 to 609 ± 208 mg/d; P < .004), thiamine (2.0 ± 0.8 to 1.5 ± 0.8 mg/d; P = .020), and folate (412 ± 192 to 331 ± 172 μg/d; P = .019) intakes. There was a decrease in saturated fat (32 ± 18 to 21 ± 6 g/d; P = .032) and a trend to lower total fat (89 ± 34 to 68 ± 19 g/d; P = .066) and higher potassium (1,262 ± 328 to 1,405 ± 268 mg/1,000 kcal; P = .055) intakes.


CONCLUSIONS
We found multiple unintentional nutritional consequences with dietary sodium reduction in HF patients. These findings highlight the need to consider the whole diet when counseling HF patients to lower sodium intake.
Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.
Katherine
K
Jefferson
Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Division of Cardiology, Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.
Mavra
M
Ahmed
Division of Cardiology, Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.
Marlene
M
Choleva
Division of Cardiology, Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.
Susanna
S
Mak
Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Division of Gastroenterology, Department of Medicine, University Health Network, Toronto, Ontario, Canada.
Johane P
JP
Allard
Division of Cardiology, Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.
Gary E
GE
Newton
Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Division of Cardiology, Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada. Electronic address: joanne.arcand@uoit.ca.
JoAnne
J
Arcand
D000328:Adult; D035843:Biomedical Research; D015510:Clinical Medicine; D015331:Cohort Studies; D004039:Diet, Sodium-Restricted; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis* / Q000178:diet therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009864:Ontario; D010045:Outpatients / Q000706:statistics & numerical data; D018570:Risk Assessment; D012982:Sodium, Dietary / Q000008:administration & dosage / Q000009:adverse effects*; D062606:Tertiary Care Centers; D016896:Treatment Outcome
D012982:Sodium, Dietary
Heart failure; diet; food; sodium