Heart Failure

HF: Effectiveness of RD-delivered MNT in Patients with Heart Failure (2006)

• Assessment
  For optimum management of a patient with heart failure, what is the benefit of individualized medical nutrition therapy provided by a registered dietitian?

  • Conclusion

    Three studies that examined the impact of RD-led dietary intervention for heart failure patients found that with two or more visits, patients reported reductions in sodium and fluid intake and improvements in quality of life. One study found a reduction in urinary sodium excretion, extra-cellular water, edema and fatigue and increases in physical activity. Two studies reported RD-led interventions involved an initial planned visit that lasted 45 minutes and follow-up visits lasting 30 minutes over a six-week to nine-month time period. Data on long-term adherence and sustained diet and physiological responses are unavailable. The optimal duration and frequency of follow-up visits by a RD is not known.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Effectiveness of RD-delivered MNT
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Arcand JL, Brazel S, Joliffe C, et al, Education by a dietitian in patients with heart failure results in improved adherence with a sodium-restricted diet:  A randomized trial. Am Heart J. 2005; 150: 716e1-716e5.
      • Kuehneman T, Saulsbury D, Splett P, Chapman DB. Demonstrating the impact of nutrition intervention in a heart failure program. J Am Diet Assoc. 2002; 102: 1,790-1,794.
      • Ramirez EC, Martinez LC, et al. Effects of a Nutritional Intervention on Body Compositiion, Clinical Status, and Quality of Life in Patients with Heart Failure. Nutrition, 2004; 20: 890-895.
  • Search Plan and Results: Effectiveness of RD-MNT for Heart Failure Patients 2006