Lifestyle with Heart Failure

General Heart Failure Management Guides

There are a few things you should be keeping track of when you have heart failure:

  1. Weight tracking: You should keep a record of your weight. Log your weight daily after waking up, first thing in the morning, after urination, and before eating. Make sure to take consistent measurements (same time, wearing similar clothing each day).
    These records can be very important so make sure to bring them to your visits with your heart failure team. Note: weight gain of 3 pounds in 2 days, or 5 pounds or more in a week may indicate fluid retention. One good place to store these records is a calendar.
  2. Symptom monitoring: You should watch out a few things because they might indicate disease progression and call your doctor if necessary
    1. Worsening shortness of breath or a persistent cough
    2. Difficulty breathing, lying down or needing to sleep in a chair due to difficulty breathing
    3. Increased swelling or abdominal girth
    4. Worsening fatigue/weakness
    5. Pain or feeling of ‘fullness’ in stomach area

Lifestyle management of CHF

Nutritional Guide for Heart Failure

There are a few dietary guidelines to follow when you have heart failure.

Firstly, if you have diabetes you should always be following the STEP 2 diet.

Secondly, patients with heart failure should be limiting the amount of fluid intake to 1.5L (6 cups) to 2.0L (8 cups). In this count include everything from water, coffee/tea, soft drinks, alcoholic beverages, etc.

It may seem difficult to limit your fluid, but there are some simple things that patients often find help tremendously. Using smaller cups and sipping fluid slowly are often effective at limiting excess intake. If you are thirsty try brushing your teeth, chewing gum or eating small pieces of cold fruit.

Table salt spilt on a table, with 'eat less SALT!' written into the salt

Finally, something that all heart failure patients should be doing is reducing sodium/salt in their diet. Following a low-salt diet strictly can help to reduce high blood pressure, keep swelling or edema under control, and can make breathing easier.

This is because high amounts of salt cause the body to retain fluid, acting almost like a sponge. This can cause fluid build-up in throughout your body, from your legs to your lungs. Patients often find that their symptoms are reduced when they switch to a low-salt diet.

Experts recommend you should limit your salt-intake to at least below 2000 mg per day and less than 1500 mg of salt is ideal. This means keeping your salt content for each meal below around 600 mg.

At first glance, you may be wondering how to cut the sodium in your diet. Salt is in almost every food, even in sweet foods like breakfast cereals.

Here are some practical tips for keeping the salt in your diet under control!

Nutrition facts are mandatory on all food products you buy. Make sure to check the nutrition facts and eliminate/find replacements for high-sodium foods!

Nutrition facts label: Portion size and sodium content are highlighted

Tips for Reading the Nutrition Facts

Make sure you read the serving size and compare it with how much you are actually eating! In other words, if the serving size is for one cup and you have two, then you need to double the sodium it says.

Make sure to check the nutritional facts on all food you eat; you may find even foods that don’t taste salty actually have high amounts of sodium. For items that do not have a label, you can use this guide that lists sodium content in many foods.

Eat only 75% of the daily value! The daily value percentage is based on a diet with 2400 mg of sodium, which is far more than the 2000 mg heart failure patients should be having! When using the % daily value, try to keep your total for the day under 75% - or under 25% per meal.

In general, there are certain types of foods you should avoid:

Fast/Processed food, Canned food and soubs, soft drinks, salted snacks, sauces & seasonings, adding salt

Instead, eat fresh food that you prepare yourself! You will be more mindful of how much salt goes in to your food when you have to measure it out and add it in! Use this Sodium Calculator to determine how much salt you are consuming

There are some great resources to help you find low salt meals and the American Heart Association Low-Salt Cookbook.

Here are some great tips from the Ottawa Heart Institute about following a low-sodium diet at home and when you are eating out:

When you eat at home
  • Reduce your salt gradually to give your taste buds time to adjust.
  • Instead of adding salt to food when you cook or eat, season foods with herbs and seasonings that do not have salt.
  • Avoid “instant” foods that come in a bag or a box.
  • If you must eat canned goods, rinse the foods before cooking and eating them.
  • When grocery shopping, choose items from the outer aisles, where most of the fresh foods are found.
  • Plan your meals ahead of time (e.g., grill an extra chicken breast to use in sandwiches the next day).
  • Make your own or choose low-sodium sauces.
  • Make salad dressing with fresh garlic, herbs, olive oil and flavoured vinegar.
  • Add seasonings to soups during the last hour of cooking for maximum flavour.
  • At the grocery store, choose items labelled "no salt added" or "low sodium."
When you eat out
  • Ask for food cooked with no salt.
  • Do not use the salt shaker.
  • Avoid cheese or sauces.
  • Avoid fried foods—choose grilled, baked or steamed items.
  • Choose oil and vinegar salad dressing.
  • Avoid bacon, sausage and ham.
  • Request that foods be served without the high-salt condiments or sides (e.g., avoid relish, mustard, ketchup, pickles, potato chips, sauces and dressings). Ask for low-salt substitutions, such as tomatoes, cucumbers, lettuce, horseradish, oil and vinegar, and lemon.
  • Eat foods in their fresh states because fresh foods are naturally low in sodium. Try grilled vegetables or fish rather than battered and deep fried.
  • Ask for dressings and sauces on the side so you can control how much you add.
  • A quick rule of thumb for fast food dining is to limit your sodium intake at one meal to ¼ of your total salt/sodium for the day (about 600 mg of sodium per meal). Most restaurants have a guide listing the sodium content of their food items.
  • Bring half of your dish back home with you.
  • If you can’t avoid eating a high-sodium meal occasionally, cut down on the portion size and make low-sodium choices for the other meals of the day. For example, if you are celebrating a holiday and you know your dinner will be higher in sodium than usual, make sure to choose low-sodium options for your other meals.
Example of what to order when dining out
  • Grilled steak or chicken
  • Salad with balsamic vinegar and oil on the side so you can keep the portion to a small amount
  • Steamed or roasted vegetables
  • Angel food cake, fruit salad or sorbet
  • Roll or bread stick
  • 4 oz. white wine

Visit the Ottawa Heart Institue for more information.

Cambridge Cardiac Care
150 Hespeler Rd.
Cambridge, Ontario N1R 6V6
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Apr 22, 2017 Healthy Heart Day

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