Heart Failure
Publication Date: May 16, 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
...rition Assessment The RDN should as...
...1. Nutrition Assessment and Monitoring and...
...with HF should have a clear, detailed, and evid...
...ing Metabolic Rate (RMR) in Adults
...t calorimetry is available, the RDN should use a...
...Estimate RMR in AdultsIf indirect calorimetry is n...
...F: Estimate RMR in Adults with Advanced HF...
...tal Energy Needs Using RMR and Activity Facto...
Nutrition Intervention
...utrition Interventi...
...Individualize Energy IntakeFor adults with HF (N...
HF: Intentional Weight Loss in Obesity and...
...vidualize Protein IntakeFor adults with HF (NYHA...
...Individualize Sodium and Fluid IntakeFor...
...Encourage Individualized Physical A...
HF: Educate on Self-Care for AdultsFor...
...dination of Care for AdultsFor adults w...
...: Consult with Interdisciplinary Health Ca...
Nutrition Monitoring and Evaluation
...ion Monitoring and Evaluation...
...and Evaluate Effectiveness of MNTThe R...
