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
...Assessment The RDN should assess the...
...le 1. Nutrition Assessment and Monitori...
...very patient with HF should have a...
...F: Measure Resting Metabolic Rate (RMR) in Adul...
...direct calorimetry is available, the RDN should u...
...R in AdultsIf indirect calorimetry is not availab...
...te RMR in Adults with Advanced HFIf in...
...al Energy Needs Using RMR and Activity Fac...
Nutrition Intervention
...ividualize Energy IntakeFor adults wi...
...Intentional Weight Loss in Obesity and HFFor...
...alize Protein IntakeFor adults with HF (NYHA...
...ividualize Sodium and Fluid IntakeFor ad...
...Encourage Individualized Physical Activ...
...on Self-Care for AdultsFor adults with HF...
...oordination of Care for AdultsFor adu...
...with Interdisciplinary Health Care Team Regar...
Nutrition Monitoring and Evaluation
Nutrition Monitoring and Evaluatio...
...Evaluate Effectiveness of MNTThe RD...
