- People with heart failure are often advised to follow a low-salt diet.
- A new study indicates that it can help improve people’s quality of life.
- However, it did not appear to improve rates of death, hospitalization or emergency room visits.
- Patients are advised to keep their sodium intake below 1500 mg per day.
The reasoning behind this recommendation is that salt contains sodium and too much sodium can cause fluid retention.
Limiting dietary sodium can help minimize extra fluid buildup around the heart and lungs and in the legs of patients with heart failure.
It is believed that it can ease the burden of an already overworked heart and reduce some of the negative symptoms associated with the disease, such as swelling, fatigue and coughing.
Until now, however, there has been little scientific evidence to support this claim.
However, a new study published in
To conduct the study, the lead author justin ezekowitzprofessor in the Faculty of Medicine and Dentistry at the University of Alberta and co-director of the Canadian VIGOR Centre, and his team followed 806 patients with heart failure at 26 medical centers in Canada, the United States, Colombia, Chile, Mexico and New Zealand.
Half were randomly assigned to receive usual care. The others received advice on how to reduce their salt intake.
Those who received nutritional counseling received menu suggestions designed by dietitians.
They were also encouraged to do their own cooking, avoiding salt and high salt ingredients.
Their sodium goal was to consume less than 1,500 mg per day, or about two-thirds of a teaspoon of salt.
People who received dietary advice reduced their sodium intake more than the group who did not.
Before the study, patients took an average of 2,217 mg per day.
At the end of the one-year study, patients receiving usual care were still consuming an average of about 2,073 mg of sodium per day.
In contrast, patients who received counseling consumed significantly less at an average of 1,658 mg per day.
The results, however, have been mixed.
For all-cause mortality rates, cardiovascular hospitalizations, and cardiovascular emergency room visits, there was no real difference between the two groups.
Where sodium restriction made a difference, however, was in people’s quality of life.
When researchers assessed patients’ quality of life using three different tools, they found significant improvements.
They also found improvements in a heart failure severity rating called the New York Heart Association functional classification.
What should the average person know about sodium? In a nutshell, we should probably all eat less, especially those at risk for cardiovascular disease.
“When it comes to salt, most Americans get way more of it than we need in our diets,” said Molly KimballRD, CSSD, Registered Dietitian at Ochsner Health and Founder of Ochsner Eat Fit.
For healthy people, the recommendation is around 2,300 mg per day.
For people over 51 or at risk for cardiovascular disease, the goal is to further reduce salt intake, to less than 1,500 mg of sodium per day.
“Most of us get more than double that,” Kimball noted.
She further explained that only about 10% of the sodium in our diet comes from a shaker.
More than 75% comes from processed foods, food services and restaurants.
To keep your sodium intake in check, Kimball suggests keeping an eye out for what the American Heart Association calls “the Salty Six”: bread and rolls, pizza, sandwiches, meats and deli meats, canned soup, burritos and tacos. .
Additionally, you should be sure to read labels and make product swaps for lower sodium items.
Dr Ragavendra Baligawho specializes in heart disease and heart failure at Ohio State University Wexner Medical Center, said that in addition to a low-salt diet, another dietary change that can be made under being supervised by a doctor is to restrict fluid intake, which will also reduce fluid buildup around your heart and lungs.
He recommends patients consume about 2 L of water per day (about 64 ounces).
He further pointed out four particular types of drugs that are useful for heart failure, which he called “the new four horsemen”.
These drugs include:
- The angiotensin inhibitor neprilysin (RNAi) Entrestowhich is a combination of two drugs that reduce blood pressure, sacubitril and valsartan.
- Sodium-glucose co-transporter (SGLT2is) inhibitors like dapagliflozin and empagliflozin, which can help lower blood sugar and reduce hospitalizations diabetic heart failure.
- Beta-blockers like carvedilol, metoprolol XL and bisoprolol, which slow the heart rate and reduce blood pressure.
- Mineralocorticoid receptor antagonists (MRAs) such as eplerenone and spironolactone which can reduce fluid accumulation and blood pressure.
Your doctor may use these and other medicines to help your heart work more efficiently or to reduce pressure on it.
Surgical procedures or implantation of certain devices may also be appropriate for some patients.