Heart Failure and Nutrition

When you have CHF (congestive heart failure), what you eat and drink is important in helping you get better. A diet low in sodium and fluid will help keep your heart working its best. You already may be on a special diet for health problems such as coronary artery disease, diabetes, or obesity. You will need to continue following that diet in addition to limiting your sodium and fluids.

It is important to meet with a registered dietitian to develop your own meal plan. He or she can teach you what you need to know about your diet.

The more sodium and fluid you consume, the more fluid you will hold, or retain, in your body. When your body holds fluid, this is called edema (eh-DEE-muh). This can worsen your condition and make it more difficult for your heart to work.

If you are overweight, you may be given a diet to help you lose weight. Losing weight can lessen the work load for your heart.

Limiting Sodium

Limit your sodium to 2,000 mg (milligrams), or 2 grams, per day.

How do you know how many milligrams you are getting?

One good way is to read food labels carefully. Look at the serving size first on the food label. Then look at how many milligrams of sodium each serving has. If you eat 2 servings, you are eating double the amount of sodium on the label.

Tips for Limiting Sodium

If there is 250 mg of sodium or more in a serving of any food, that’s a lot. Avoid it unless you can work it into your daily allowance of 2,000 mg per day.

  • Avoid salt. It has the most sodium of any food. One teaspoon of salt has 2,360 mg of sodium. That is more than you should get in a whole day! Even 1/4 tsp. of salt has 590 mg.
    • Do not add salt to your food while cooking or at the table. Try using fresh or dried herbs or spices to season your food. Do not use a salt substitute, unless your doctor says you may.
  • Avoid snack foods with visible salt on them, such as salted crackers, pretzels, potato chips, and salted nuts.
  • Check ingredient lists. Avoid products that contain the following words: salt, sodium, sodium chloride, monosodium glutamate (MSG), brine, broth, corned, pickled, or smoked. These foods generally are high in sodium.
  • Always think fresh and eat fresh. Jarred, canned, and boxed foods generally are much higher in sodium than fresh foods.

You will get used to eating in a lower sodium way. It may take many weeks, so keep working hard at changing your eating habits.

Limiting Fluids

Your doctor probably will have you limit how much you drink. This sometimes is called a fluid restriction. If you are told to limit fluids to 2,000 cc a day, that equals 2 quarts.

Any item that is liquid at room temperature counts. All drinks count, including:

alcoholic drinks fruit drinks  Kool-Aid  nectar  water
coffee hot chocolate liquid medicine soft drinks (soda pop)
flavored waters juice milk tea

 

Other items that count as fluids

 

Quantity

Count as

Crushed ice 1/2 cup 1/4 cup fluid
Broth 1 cup 1 cup fluid
Soup 1 cup 3/4 cup fluid
Fruit ice 1/2 cup 1/2 cup fluid
Fruit gelatin 1/2 cup 1/3 cup fluid
Gelatin, plain 1/2 cup 1/2 cup fluid
Ice cream 1/2 cup 1/2 cup fluid
Frozen yogurt 1/2 cup 1/2 cup fluid
Sherbet 1/2 cup 1/2 cup fluid
Milkshake 1 cup 1 cup fluid
Popsicle 2 halves 1/3 cup fluid

 

Keeping on Track

For at least one day, keep track of how much you drink. If you are limited to 2,000 cc or 2 quarts, fill a 2-quart container of water. Before you drink anything, measure it. Pour out the same amount of water from the container. You can estimate when you eat out. This will let you see how much fluid you have left for the day.

Try to use your fluid allowance evenly throughout the day. Make sure you save enough fluid to take the medicines you need to take late in the day.

Some tips for when you get thirsty

  • Rinse your mouth with water. Spit it out — don’t swallow.
  • Add lemon juice to ice water or crushed ice.
  • Suck on lemon drops or tart hard candies. Or chew a piece of gum. Use sugar-free candy or gum if you are diabetic.
  • Suck on a lemon slice.
  • Put an ice cube in your mouth to melt. Or eat crushed ice. It takes longer to consume than water. Ice is twice as bulky as water. So you can count 1/2 cup of ice as just ¼ cup of fluid.
  • Eat mandarin oranges, grapefruit sections, or grapes (regular or frozen).

Fluid RestrictionGuide

This chart may help you understand the amount of fluid you are allowed.

 

Ounces Cups CC
1  2 Tbsp 30 cc
4 1/2 cup 120 cc
8 1 cup 240 cc
32 4 cups (1 quart) 960 cc
48 6 cups 1,440 cc
64 8 cups (2 quarts or 1/2 gallon) 1,920 cc

 

Weighing Yourself Daily

Weighing yourself daily can help you better manage your CHF. Because CHF can cause your body to hold onto fluid and salt, you may gain weight.

If you weigh yourself every day at the same time, you will be able to notice slight gains in weight. This may be a sign that your heart failure is getting worse.

If you gain 2 or 3 pounds overnight or more than 1 pound each day for 3 days in a row, call your doctor. Your doctor then will be aware that your symptoms may be getting worse. Your doctor will decide if you should change any medicines or come in to his or her office.

A few tips:

  • Weigh yourself once a day in the morning. Right after you awaken and urinate is the best time.
  • Wear the same clothes each time you weigh yourself.
  • Write down your weight on your diary sheet.
  • Make copies of the chart on the next page. Write down your weight each day. Or use an ordinary calendar, and write your weight in each day.

Weight Chart

Sun. Mon. Tues. Wed. Thur. Fri. Sat.
Week of 9/1 (sample)
150 151 150 150 151 152 151
Week of ______              
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Week of ______              
Week of ______              
Week of ______              
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