Heart Failure

Publication Date: May 11, 2018

Screening and Referral

Screening and Referral

The registered dietitian nutritionist (RDN) plays an integral role in the interdisciplinary healthcare team by designing the optimal nutrition prescription that complements drug therapy, physical activity, and behavioral therapy.

Based on the client’s treatment plan and comorbid conditions, other nutrition practice guidelines may be needed in order to provide optimal treatment.


HF: Medical Nutrition Therapy (MNT)

For adults with heart failure (HF) (NYHA Classes I–IV/AHA Stages B, C and D), the RDN should provide MNT to treat HF and contributing comorbidities, such as hypertension, disorders of lipid metabolism, diabetes mellitus and obesity. Every patient with HF should have a clear, detailed, and evidence-based plan of care that ensures the achievement of guideline determined medical therapy (GDMT) goals, effective management of comorbid conditions, timely follow-up with the healthcare team, appropriate dietary and physical activities, and compliance with secondary prevention guidelines for cardiovascular disease. Research reports that MNT resulted in a significant decrease in sodium intake and maintenance of body weight. (Strong, Imperative)
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HF: Frequency and Duration of MNT

For adults with HF (NYHA Classes I–IV/AHA Stages B and C), the RDN should provide an initial MNT encounter lasting 30–60 minutes, with a follow-up encounter four to six weeks later, and determine if and when additional MNT encounters are needed. Research reports that this frequency and duration of MNT resulted in a significant decrease in sodium intake, as well as maintenance of serum sodium levels and body weight. (Fair, Conditional)
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HF: Frequency and Duration of MNT in Advanced HF

For adults with advanced HF (NYHA Class IV/AHA Stage D), the RDN should provide an initial MNT encounter and additional follow-up encounters as often as every two weeks. Research reports that this frequency and duration of MNT resulted in increased exercise tolerance, higher physical component scores on quality of life measures and decreased anxiety, as well as maintenance of body weight. (Fair, Conditional)
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Nutrition Assessment

...ion Assessment

...ssessment The RDN should assess the fo...


...1. Nutrition Assessment and Monitoring and Evaluat...


...tient with HF should have a clear, detailed,...


...ing Metabolic Rate (RMR) in Adults...

If indirect calorimetry is available, the RDN s...

...R in AdultsIf indirect calorimetry is not a...

HF: Estimate RMR in Adults with Adva...

...F: Estimate Total Energy Needs Using...


Nutrition Intervention

Nutrition Inter...

...vidualize Energy IntakeFor adults with HF (NYH...


HF: Intentional Weight Loss in Obesity and...


...ize Protein IntakeFor adults with HF (NYHA Class...


...Individualize Sodium and Fluid IntakeFor adults w...


...ourage Individualized Physical Activ...


...on Self-Care for AdultsFor adults wit...


...ordination of Care for AdultsFor adults with H...


...onsult with Interdisciplinary Health Car...


Nutrition Monitoring and Evaluation

...n Monitoring and Evaluation...

...itor and Evaluate Effectiveness of MNTThe RDN sh...