Congestive Heart Failure Diet: Benefits and Foods to Try – Verywell Health

Brittany Poulson, MDA, RDN, CDCES, is a registered dietitian and certified diabetes care and education specialist.
Yasmine S. Ali, MD, MSCI, is a board-certified preventive cardiologist and lipidologist. Dr. Ali is also an award-winning writer.
Congestive heart failure (CHF) is a serious medical condition in which the heart doesn’t pump blood as well as it should. Conditions such as high blood pressure and coronary artery disease can lead to CHF. 

What you eat can have a big impact on your heart health, whether you are trying to prevent CHF or live healthier with it. Heart-healthy dietary choices include eating foods that are low in sodium, saturated fat, trans fat, and added sugars. 
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This article will discuss diets for congestive heart failure and tips for shopping, cooking, and eating out, as well as what foods and beverages are included as part of a heart-healthy diet.
Some definitions will help:
A common theme among dietary patterns that have proven to be most beneficial in reducing the risk of heart failure or improving outcomes after heart failure is a plant-forward, low-sodium eating pattern.
The Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet are two eating patterns that have been frequently studied in the prevention and treatment of CHF.
A 2018 review of studies found that both the Mediterranean and DASH diets helped protect against heart failure and/or worsening of heart function compared with people who did not follow these dietary patterns.
Another 2018 review found similar results, concluding that healthful eating patterns, particularly those focusing on plant foods, such as the Mediterranean and DASH diets, may offer some protection against the development of heart failure.
In addition to a plant-forward diet, the study found that decreased sodium intake helped prevent high blood pressure, stroke, and cardiovascular disease. With the strong link between high blood pressure and risk for CHF, it is safe to assume that decreased sodium intake is also protective against CHF.
Nevertheless, the researchers of this study noted that the role of sodium restriction in people with established CHF is not well defined.
Addressing this same concern, a 2020 review looking at the role of diet and nutrition in heart failure also found mixed results on sodium restriction in people with current CHF. Some studies they reviewed found a beneficial effect of decreased sodium intake, while others resulted in worsening symptoms.

However, it is important to note that there may be confounding variables that affect the results. Factors such as the extent of sodium restriction, the stage of heart failure, fluid restrictions, medications, and other comorbidities (conditions the person has) may all play a role in whether sodium restriction is beneficial or not.
Looking at overall dietary patterns' effect on outcomes in people with existing CHF, the same review study found that both the Mediterranean and DASH diets show great promise in their ability to improve secondary outcomes in heart failure.
Heart-healthy diets like the Mediterranean diet and DASH diet share many similar characteristics. Both eating patterns emphasize fruits, vegetables, whole grains, and legumes while limiting saturated fats. 
The DASH diet also emphasizes decreased sodium and total fat intake, while at the same time promoting high potassium intake. The Mediterranean diet puts an emphasis on unsaturated fats from foods such as fatty fish, extra virgin olive oil, canola oil, and nuts.
Diets for congestive heart failure, including the Mediterranean diet and DASH diet, are not meant to be a temporary diet but rather a lifestyle.
Eating to prevent or treat CHF may require some changes to habits at first, but the goal is to make them a permanent change to help your heart perform and function at its best for the rest of your life.

Vegetables

Fruits
Whole grains
Legumes
Fish
Lean cuts of poultry
Nuts
Seeds
Eggs
Dairy (small to moderate amounts)
Vegetable oils (small to moderate amounts)
Herbs and spices
Red meats

Processed meats
Added sugars
Salt and high-sodium foods
Highly processed foods
Foods high in saturated fat
Foods with trans fat
Alcohol
Large amounts of fluid (with current CHF, depending on doctor recommendations)
Foods you should focus on enjoying include:
Look for ways to reduce these foods in your diet:
There is no specific recommended amount of meals per day or timing of meals for a heart-healthy diet. Nevertheless, in general, meals should be spread evenly throughout the day.
This could look like three meals a day with a snack or two in between, or five to six smaller meals daily. Find an eating pattern that works best for you and be consistent with it.
To get started, these tips may help.

When you are dining away from home:
When you shop for food:
There are many terms on food labels that can be confusing. Below are some nutrient content claims you may come across when looking to eat in a more heart-healthy way, along with what they mean:
When preparing food and eating at home:
The Mediterranean diet and DASH diet are considered healthy for most populations. However, some modifications may need to be made for people with certain health conditions, such as celiac disease, or who choose to follow a vegetarian or vegan diet. 
One study looked at the DASH diet in relation to special populations. The study authors recognized that the DASH diet is a healthy eating pattern for most people.
However, they recommended that people with chronic liver or kidney disease and those who are prescribed renin-angiotensin-aldosterone system (RAAS) antagonist medication talk with their healthcare professional before starting the diet. RAAS antagonists include Vasotec (enalapril), Prinivil (lisinopril), Altace (ramipril), captopril, and Lotensin (benazepril).
In addition, the researchers also noted that people with uncontrolled type 2 diabetes, lactose intolerance, and celiac disease may need to make modifications when following the DASH diet. 
It’s important to work with your healthcare professional before making any big changes to your diet. They will help you look at individual potential health benefits of the diet, as well as possible side effects.
They may also be able to refer you to a registered dietitian or another professional who can provide education, guidance, and support if you require additional dietary restrictions or modifications.
The Mediterranean diet is a plant-forward diet and is considered safe for most people. If you have any medical conditions, you should talk with your healthcare professional before making major dietary changes, including the Mediterranean diet.  
With numerous studies investigating the health effects of the Mediterranean diet, it has been generally regarded as a heart-healthy eating pattern.
The keto diet is a high-fat, very-low-carbohydrate diet. Diets high in fat may pose risks for heart health. If you have certain medical conditions, such as liver or kidney disease, the keto diet may not be safe. Whether or not people with diabetes, especially those taking insulin, should follow a keto diet remains controversial.
How the keto diet affects HDL and LDL cholesterol, triglycerides, and overall heart health is still being researched. Most studies on the connection have been short-term and have reached a variety of conclusions. The long-term effects of the keto diet on heart health remain unclear.
One major factor that affects cholesterol and, therefore, heart health outcomes is the type of fats consumed, with unsaturated fats being preferred over saturated and trans fats. If you are choosing to follow a keto diet, your healthcare professional may recommend regularly checking your cholesterol levels to ensure LDL (or "bad" cholesterol) levels do not become too high.

Congestive heart failure (CHF) is a serious medical condition in which the heart doesn't pump blood as well as it should. Whether you are trying to prevent CHF or live healthier with it, you may benefit from changing your diet to follow a more heart-healthy eating pattern. 
Popular science-based diets for CHF include the Mediterranean diet and the DASH diet, with many studies supporting their benefits for heart health. The keto diet remains controversial. Choosing foods and beverages that are low in sodium, saturated fat, trans fat, and added sugars is recommended as part of an overall heart-healthy diet. 
Preventing or managing CHF may involve many dietary and lifestyle changes. Making a heart-healthy diet a lifelong way of eating requires commitment and discipline, though the benefits that come from following it are many. 
Having a support person or partner who is also following a heart-healthy diet may make it easier for you. Choose one or two habits to work on at a time, as small changes over time can add up to big results in the long run.

Good food choices for congestive heart failure include vegetables, fruits, whole grains, legumes, nuts, seeds, fatty fish, poultry, lean meats, and healthy (unsaturated) fats. In addition, it’s recommended to choose foods and beverages that are low in sodium, saturated fat, trans fat, and added sugars.
Popular science-based diets for congestive heart failure include the Mediterranean diet and the DASH diet. Due to its high fat content, the keto diet may pose risks for heart health and isn’t generally recommended for people with CHF.
In a low-sodium meal plan, salt substitutes might include a variety of herbs and spices, garlic, onions, and citrus zest and juices. You can purchase pre-made salt-free seasonings or make your own at home. For example, combine chili, garlic, and onion powders, paprika, cumin, cayenne pepper, and black pepper for your own salt-free taco seasoning. 
Did you know the most common forms of heart disease are largely preventable? Our guide will show you what puts you at risk, and how to take control of your heart health.
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