The Best Diet for Heart Failure Patients 

A Dietitian’s Expert Guide to Heart Failure Nutrition

A low sodium diet is what comes to mind with a heart failure diagnosis. And that’s an important part of a heart failure diet. However, to truly improve your health and keep your body strong, you must eat a truly heart healthy diet.

A heart healthy diet is just as much about adding in the good stuff as it is about avoiding the bad stuff. I use these words deliberately. In general, I try not to label foods good or bad. But when you have heart failure, it is so important to know that some foods are bad for you and can worsen your disease.

For my first nutrition post, I want to provide you with clear-cut guidance and a deeper understanding of the best diet for people diagnosed with heart failure (CHF).   

Be sure to read all the way to the end for a sample one -day menu! 

Heart Failure Diet Overview 

Heart failure is a disease of the heart.  Years of research have shown that eating a heart-healthy, low fat and low sodium diet will help prevent complications and decrease symptoms.  And that’s a really big deal. 

In addition to limiting sodium, we will create an eating plan that is: 

  • Low in saturated fat and low in animal fats 
  • Higher in plant based fats like nuts, plant oil, and avocado 
  • High in fruits and vegetables and therefore high in fiber  
  • High in plant protein and lean protein 
  • High in the micronutrients that lower blood pressure and keep your arteries healthy 

Lower Your Saturated Fat and Cholesterol 

Saturated fats are solid at room temperature.  They are found in animal foods like meats, eggs, and dairy.  Plant foods like coconut oil and palm oil contain saturated fat as well.  There isn’t much debate at all in the scientific community.  It is a well-known and well-researched fact that saturated fat intake is correlated with heart disease, coronary artery disease, and high blood pressure(1). The majority of people with heart failure have one or more of these conditions. It is incredibly important for you to remove as much saturated fat from your diet as possible. 

Keep your intake of egg yolks and red meat low–no more than a few times a week.  Do not eat organ meats like liver.  Avoid sausage, bacon, and hot dogs altogether.  They are high in both salt and fat, which you don’t need. 

The following foods are high in saturated fat and cholesterol.  They do not contain any nutrients that cannot be found somewhere else.  It is best to greatly limit them or avoid them altogether: 

  • Ground Beef, Pork, and Turkey 
  • Bacon, Sausage, Hot Dogs 
  • Cheese, Whole Milk, Cream 
  • Organ Meats 
  • Butter, stick margarine, lard, shortening, palm oil, and coconut oil 

Include Plant Sources of Fats 

Plant sources of fats have shown some benefits for heart health.  The research shows that plant-based fats, especially mono-unsaturated fats, reduce the risk of death from heart disease when they are combined with a low saturated fat diet (2).  In other words, adding these foods without removing the saturated fat will not help you at all! 

Here are the plant based fats best for someone with heart failure: 

  • Unsalted nuts and seeds 
  • Olive oil and other plant oils 
  • Avocado 
  • Skip the olives and salty nuts.   

Eat a Variety of Fruits and Vegetables 

I don’t have to tell you that fruits and vegetables are healthy.  We all know that and most of us need to get more fruits and vegetables into our daily meals. 

Here are some big goals:   

  • Aim to eat at least twenty different fruits and vegetables throughout the week.   
  • Get at least one serving of every color of the rainbow!  
  • Try at least one new vegetable or fruit every week.  If you have never had a parsnip or a pomegranate, now is a great time. 

I see different charts and measurements, but I don’t want you measuring out portions of fruits and vegetables.  I just want you to eat a lot of them.  (If you have diabetes, you can still eat fruit.  Just watch the portions and check your blood sugar.) 

Fruits and vegetables contain vitamins, minerals, and electrolytes like potassium.  This is especially important for people with heart failure. These are the micronutrients that help lower blood pressure and improve your heart health.  Fruits and vegetables also contain fiber.  Fiber helps lower cholesterol and keep your digestive system healthy.  And most people get a lot less than the recommended 25-35g of fiber daily. 

Protein Sources for a Healthy Heart 

Americans spend a lot of time worrying about protein.  And protein is important.  Protein will help you preserve muscle as you get older.  Protein is needed in many metabolic processes such as immunity and blood cell creation.  The problem I see is that this focus on protein leads them to unhealthy animal foods with too much saturated fat and actually harms their health instead of helping. 

Eat plant sources of protein.  You don’t have to eat tofu to be plant based, although I love it.  Beans, peas, and legumes are great protein sources, and you should eat them daily.  Grains like oats, wheat, and quinoa are good sources of protein. Vegetables have protein. Nuts have protein.  All plant foods have some protein in them and eating a nice variety will ensure you meet your needs. 

Eating plant based has been shown to improve heart failure in a recent review published in the Journal of Geriatric Cardiology (3).  For this reason, I do recommend a plant based or plant forward diet. That being said, I know that many people choose to eat both plant and animal foods.  It’s important to understand that each step you take toward increasing the plants in your diet while decreasing the animal foods will improve your health 

If you do eat animal foods, be sure that they are very lean, and prepared healthily without adding fats and salt.  Leaner sources of animal protein are grilled or broiled white meat chicken, Grilled or broiled fish, non-fat dairy products, and egg whites.   

Eat Foods that Promote Blood Vessel Health  

This part of a heart failure diet is super exciting to me. Research has shown that certain vegetables lower blood pressure (3). 

That is because they contain nitrates.  You can’t just take a nitrate pill and get these benefits.  When you chew nitrate-containing foods, it is changed to nitric oxide. Nitric oxide relaxes blood vessels and increases blood flow in your body.  It also decreases blood pressure.   

The top sources of these foods are 

  • Beets 
  • Dark Green Leafy Vegetables and Lettuces 
  • Carrots 
  • Cabbage 
  • Celery 
  • Radishes 
  • Parsley 

As promised here is a heart failure one-day meal plan. It has nitrate-containing veggies, lots of fiber, whole-food carbs, protein, and healthy fats. 

Breakfast Oatmeal topped with cinnamon, ⅛ cup almonds, 1 tsp maple syrup 1 cup berries 
Lunch Large salad with cucumbers, carrots, tomatoes, radishes, celery, and chickpeas Low Sodium dressing or olive oil and vinegar Two Slices Whole Grain Bread Apple 
Snack Sweet potato topped with ⅛ cup walnuts 
Dinner Lean Protein of Choice Black eye peas (Low Sodium) Broccoli with Olive Oil, Garlic, Lemon Tangerine 

This one day of eating has at least twelve different fruits and vegetables, so you are well on your way to your goal of 20 in one week.   

Keep an eye out for a future blog post 100% devoted to meal planning! 

References 

1 Circulation Volume 144, No. 23, Guidelines to Improve Cardiovascular Health: A Scientific Statement from the American Heart Association Originally published2 Nov 2021https://doi.org/10.1161/CIR.0000000000001031Circulation. 2021;144:e472–e487 

2.. Monounsaturated Fat. American Heart Association https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/monounsaturated-fats 

3.. Choi, E. Y., Allen, K., McDonnough, M., Massera, D., & Ostfeld, R. J. (2017). A plant-based diet and heart failure: case report and literature review. Journal of Geriatric Cardiology: JGC, 14(5), 375-378. https://doi.org/10.11909/j.issn.1671-5411.2017.05.003 

4.  Sweazea, K. L., Johnston, C. S., Miller, B., & Gumpricht, E. (2017). Nitrate-Rich Fruit and Vegetable Supplement Reduces Blood Pressure in Normotensive Healthy Young Males without Significantly Altering Flow-Mediated Vasodilation: A Randomized, Double-Blinded, Controlled Trial. Journal of Nutrition and Metabolism, 2018.  

https://doi.org/10.1155/2018/1729653 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165613/ 

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