Effects of a nutritional intervention on body composition, clinical status, and quality of life in patients with heart failure

OBJECTIVES: We assessed the effects of a nutritional intervention on clinical and nutritional status and quality of life in patients with heart failure. METHODS: Sixty-five patients with heart failure were assigned to one of two groups: the intervention group (IG; n = 30) received a sodium-restricted diet (2000 to 2400 mg/d) with restriction of total fluids to 1.5 L/d, and the control group (CG; n = 35) received traditional medical treatment and general nutritional recommendations. Anthropometric, body composition, physical activity, dietary, metabolic, clinical, and quality of life assessments were performed in all patients at baseline and 6 mo later. RESULTS: At the end of the study, kilocalories, macronutrients, and fluid intakes were significant lower in the IG than in the CG. Urinary excretion of sodium decreased significantly in the IG and increased in the CG (-7.9% versus 29.4%, P < 0.05). IG patients had significantly less frequent edema (37% versus 7.4%, P = 0.008) and fatigue (59.3% versus 25.9%, P = 0.012) at 6 mo than at baseline; in addition, functional class improved significantly, and no changes were observed in the CG. Extracellular water decreased -1.1 +/- 3.7% in the IG and increased 1.4 +/- 4.5% in the CG (P = 0.03). Physical activity increased 2.5% +/- 7.4% in the IG and decreased -3.1 +/- 12.0 in the CG (P < 0.05). The IG had a greater increase in total quality of life compared with the CG (19.3% versus 3.2%, P = 0.02). CONCLUSIONS: In this study, the beneficial effect of a supervised nutritional intervention was proved as part of a non-pharmacologic treatment of patients with heart failure, with improvements in clinical status and quality of life.