HF: Introduction (2008)
Heart Failure (2005) Evidence-Based Nutrition Practice Guideline
Guideline Narrative Overview
Evidence-Based Nutrition Practice Guideline Development
This guideline is intended for use by dietetic practitioners involved in the nutrition care for patients with heart failure. It is expected that this knowledge will be integrated into providing individualized nutrition care with practical recommendations that are based on the current state of the science for nutrition and patients with a diagnosis of heart failure based on a left ventricular ejection fraction (LVEF) of 45% or less. This includes the following New York Heart Association Functional Classification (NYHA):
- NYHA Class I: Asymptomatic; patient is not short of breath or fatigued with any activity
- NYHA Class II: Patient is short of breath or fatigued after moderate activity (such as climbing two flights of stairs, golfing nine holes, or carrying a load of wash up from the basement)
- NYHA Class III: Patient is short of breath or fatigued even after very mild exertion (such as walking around the house or up half a flight of stairs)
- NYHA Class IV: Patient is exhausted, short of breath, or fatigued at rest (just sitting still or lying in bed).
- Medical Nutrition Therapy
- Sodium and Fluid Restriction
- Energy and Protein Needs
- Vitamin, Mineral, and Herbal Supplements
- Recommendations: 11
- Conclusion Statements: 15
- Evidence Summaries: 13
- Article worksheets: 33
Application of the Guideline
This guideline will be accompanied by a set of companion documents (i.e., a toolkit) to assist the practitioner in applying the guideline. The toolkit will contain materials such as the Medical Nutrition Therapy protocol, documentation forms, outcomes management tools, client education resources and case studies. The toolkit is currently under development and will undergo pilot-testing through the ADA's Dietetic Practice-Based Research Network prior to publication.
The literature search will be repeated for each guideline topic on an annual basis to identify new research that has been published since the previous search was completed. Based on the quantity and quality of new research, a determination will be made about whether the information could change the published recommendation or rating.
Medical Nutrition Therapy and Heart Failure
Scientific evidence supports the effectiveness of nutrition therapy to control the symptoms of heart failure and to improve the quality of life of patients with the disease. Topics included in this guideline:
- Use of medical nutrition therapy and dietitian intervention
- Sodium and fluid prescription
- Determination of energy and protein needs
- Use of vitamin, mineral, and herbal supplementation
Populations to Whom This Guideline May Apply
This guideline applies to adult patients with heart failure who have been diagnosed with left ventricular dysfunction (LVEF 45% or less).
- Scope of Guideline
- Statement of Intent and Patient Preference
- Guideline Methods
- Specific Topics Search Methods
- Implementation of the Guideline
- Benefits and Harms of Implementing the Recommendations.