H

University of Pittsburgh Medical Center Information for Patients

eart Failure and Nutrition

Tips for limiting sodium If there is 250 mg of sodium or more in a serving of any food, thats a lot. Avoid it unless you can work it into your daily allowance of 2,000 mg per day. Avoid salt. It has the most sodium of any food. One teaspoon of salt has 2,360 mg of sodium. That is more than you should get in a whole day! Even 1/4 tsp. of salt has 590 mg. Do not add salt to your food while cooking or at the table. Try using fresh or dried herbs or spices to season your food. Do not use a salt substitute, unless your doctor says you may. Avoid snack foods with visible salt on them, such as salted crackers, pretzels, potato chips, and salted nuts. Check ingredient lists. Avoid products that contain the following words: salt, sodium, sodium chloride, monosodium glutamate (MSG), brine, broth, corned, pickled, or smoked. These foods generally are high in sodium. Always think fresh and eat fresh. Jarred, canned, and boxed foods generally are much higher in sodium than fresh foods. You will get used to eating in a lower sodium way. It may take many weeks, so keep working hard at changing your eating habits.

When you have CHF (congestive heart failure), what you eat and drink is important in helping you get better. A diet low in sodium and fluid will help keep your heart working its best. You already may be on a special diet for health problems such as coronary artery disease, diabetes, or obesity. You will need to continue following that diet in addition to limiting your sodium and fluids. It is important to meet with a registered dietitian to develop your own meal plan. He or she can teach you what you need to know about your diet. The more sodium and fluid you consume, the more fluid you will hold, or retain, in your body. When your body holds fluid, this is called edema (eh-DEE-muh). This can worsen your condition and make it more difficult for your heart to work. If you are overweight, you may be given a diet to help you lose weight. Losing weight can lessen the work load for your heart.

Limiting sodium
Limit your sodium to 2,000 mg (milligrams), or 2 grams, per day. How do you know how many milligrams you are getting? One good way is to read food labels carefully. Look at the serving size first on the food label. Then look at how many milligrams of sodium each serving has. If you eat 2 servings, you are eating double the amount of sodium on the label.

continued

HEART FAILURE AND NUTRITION

Limiting fluids
Your doctor probably will have you limit how much you drink. This sometimes is called a fluid restriction. If you are told to limit fluids to 2,000 cc a day, that equals 2 quarts.
University of Pittsburgh Medical Center Information for Patients

Other items that count as fluids

Item
Crushed ice Broth Soup Fruit ice Fruited gelatin Gelatin, plain, Ice cream Frozen yogurt Sherbet Milkshake Popsicle

Quantity
1/2 cup 1 cup 1 cup 1/2 cup 1/2 cup 1/2 cup 1/2 cup 1/2 cup 1/2 cup 1 cup 2 halves

Count as
1/4 cup fluid 1 cup fluid 3/4 cup fluid 1/2 cup fluid 1/3 cup fluid 1/2 cup fluid 1/2 cup fluid 1/2 cup fluid 1/2 cup fluid 1 cup fluid 1/3 cup fluid

Any item that is liquid at room temperature counts. All drinks count, including: alcoholic drinks coffee flavored waters fruit drinks hot chocolate juice Kool-Aid liquid medicine milk nectar soft drinks (soda pop) tea water

Keeping on track
For at least one day, keep track of how much you drink. If you are limited to 2,000 cc or 2 quarts, fill a 2-quart container of water. Before you drink anything, measure it. Pour out the same amount of water from the container. You can estimate when you eat out. This will let you see how much fluid you have left for the day. Try to use your fluid allowance evenly throughout the day. Make sure you save enough fluid to take the medicines you need to take late in the day.

HEART FAILURE AND NUTRITION

Some tips for when you get thirsty Rinse your mouth with water. Spit it out dont swallow. Add lemon juice to ice water or crushed ice. Suck on lemon drops or tart hard candies. Or chew a piece of gum. Use sugar-free candy or gum if you are diabetic. Suck on a lemon slice. Put an ice cube in your mouth to melt. Or eat crushed ice. It takes longer to consume than water. Ice is twice as bulky as water. So you can count 1/2 cup of ice as just 1/4 cup of fluid. Eat mandarin oranges, grapefruit sections, or grapes (regular or frozen).

Weighing yourself daily

Weighing yourself daily can help you better manage your CHF. Because CHF can cause your body to hold onto fluid and salt, you may gain weight. If you weigh yourself every day at the same time, you will be able to notice slight gains in weight. This may be a sign that your heart failure is getting worse. If you gain 2 or 3 pounds overnight or more than 1 pound each day for 3 days in a row, call your doctor. Your doctor then will be aware that your symptoms may be getting worse. Your doctor will decide if you should change any medicines or come in to his or her office. A few tips: Weigh yourself once a day in the morning. Right after you awaken and urinate is the best time. Wear the same clothes each time you weigh yourself. Write down your weight on your diary sheet. Make copies of the chart on the next page. Write down your weight each day.Or use an ordinary calendar, and write your weight in each day.

Fluid restriction guide

This chart may help you understand the amount of fluid you are allowed.

Ounces
1 4 8 32

Cups
2 Tbsp 1/2 cup 1 cup 4 cups (1 quart) 6 cups 8 cups (2 quarts or 1/2 gallon)

cc
30 cc 120 cc 240 cc 960 cc

48 64

1,440 cc 1,920 cc

HEART FAILURE AND NUTRITION

Weight Chart
Sun. Mon. Tues. Wed. Thur. Fri. Sat.

9/1 Week of _______ [sample]

University of Pittsburgh Medical Center Information for Patients Week of _______

150

151

150

150

151

152

151

Week of _______

Week of _______

Week of _______

Week of _______

Week of _______

Week of _______ Week of _______

Week of _______

Week of _______

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 800-533-UPMC (8762).
Pittsburgh, PA, USA www.upmc.com
University of Pittsburgh Medical Center 2003 SYS216360 EJD/SHZ ORIG 12/03 Form # 7094-82190-1203

The University of Pittsburgh Medical Center is an equal opportunity employer. Policy prohibits discrimination or harassment on the basis of race, color, religion, national origin, ancestry, sex, age, marital status, familial status, sexual orientation, disability, or veteran status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.