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This guide provides basic information to help you start or continue following
your heart failure diet. Planning what you eat and balancing your meals are
important ways to manage your health. Eating healthy often means making changes
in your current eating habits. A registered dietitian can provide in-depth
personalized nutrition education, tailor these general guidelines to meet your
needs, and help you begin a personal action plan.
Here are some basic guidelines that will help you get started. These
guidelines are explained in more detail inside this handout.
Control the sodium in your diet. Decreasing the total amount of sodium
you consume to 2,000 mg (2 g) per day is one of the most important ways to
manage heart failure.
Learn to read food labels. Use the label information on food packages to
help you to make the best low-sodium selections.
Eat a variety of foods to get all the nutrients you need.
Your health care provider may advise you to: eat foods that are high in
potassium such as:
Bananas
Strawberries
Dried fruits (such as prunes, dates and raisins)
Spinach
Potatoes
Avocados
Tomatoes
Squash
Nuts and whole grains
Broccoli
Oranges, other citrus fruits and citrus juices
If you are taking certain diuretics, your potassium levels may drop. Review
the signs and symptoms of low potassium with your health care provider.
The signs of low potassium, include fatigue, weakness, severe thirst, excessive
urination, and heart beat changes. Always talk to your doctor, or nurse, about
the diuretic you are taking and call your provider if you have any signs of low
potassium.
Include high-fiber foods such as vegetables, cooked dried peas and beans
(legumes), whole-grain foods, bran, cereals, pasta, rice and fresh fruit. Fiber
is the indigestible part of plant food that helps move food along the digestive
tract, better controls blood glucose levels and may reduce the level of
cholesterol in the blood. Foods high in fiber include natural antioxidants,
which reduce the risk of cardiovascular disease. The goal for everyone is to
consume 25 to 35 grams of fiber per day.
Carefully follow your fluid management guidelines. Reduce your fluid
intake if you have advanced heart failure or if you become more short of breath
or notice swelling. General rule: limit fluids to 8 cups or less per day (which
is equal to 2 liters or less OR 64 ounces or less), even if you feel
thirsty. If you sweat a lot with vigorous exercise, you may need to drink
one cup of extra fluid. Your health care provider will give you specific fluid
guidelines that may be more or less than 64 ounces per day.
Maintain a healthy body weight. This includes losing weight if you are
overweight. Limit your total daily calories, follow a low-fat diet and exercise
regularly to achieve or maintain your ideal body weight.
Learning to read food labels
Food labels are standardized by the U.S. government's National Labeling and
Education Act (NLEA). Nutrition labels and an ingredient list are required
on most foods so you can make the best selection for a healthy lifestyle.
Review the food label below. If you do not know how much total sodium is
in this product, ask your dietitian, or health care provider, to show you how to
read food labels and apply the information to your personal needs.
A. The serving size represents the typical amount eaten by an adult.
B. The sodium content is listed on the food label per serving
size. Ignore the % daily value and focus on the amount of mg
sodium per serving. Decreasing the total amount of sodium you consume to
2,000 milligrams (mg) or 2 grams (g) per day is one of the most
important ways to manage heart failure.
Low sodium=140 mg or less per serving
No sodium=less than 5 mg per serving
Sodium guidelines
Sodium is a mineral found in many foods. It helps keep normal fluids
balanced in the body. Most people eat foods containing more sodium than
they need. Some foods may be high in sodium and not taste salty.
Eating too much sodium causes the body to keep or retain too much water,
worsening the fluid build-up in heart failure. Following a low-sodium diet
helps control high blood pressure (hypertension), swelling and water build-up
(edema), and/or decrease breathing difficulties for people who have kidney,
heart or liver problems. In heart failure, the heart will not have to pump as
hard if there is less fluid to move through the blood vessels.
You should consume no more than 2,000mg (2g) of sodium per day. A
low-sodium diet means more than just eliminating the salt shaker from the
table! However, that is a good start since one teaspoon salt = 2,300mg of
sodium. It is important to keep a record of the amount of sodium you consume
each day. Write down the amount in mg after each meal.
Don’t use a salt substitute unless you check with your doctor first.
Salt substitutes generally contain other ingredients that can be just as
harmful.
Comparison of Sodium in Foods
Protein
Food
Serving Size
Milligrams/Sodium
Bacon
1 medium slice
155
Chicken (dark meat)
3.5oz roasted
87
Chicken (light meat)
3.5oz roasted
77
Egg, fried
1 large
162
Egg, scrambled with milk
1 large
171
Dried beans, peas or lentils
1 cup
4
Haddock
3oz cooked
74
Halibut
3oz cooked
59
Ham (roasted)
3.5oz
1300-1500
Hamburger (lean)
3.5oz broiled medium
77
Hot dog (beef)
1 medium
585
Peanuts, dry roasted
1oz
228
Pork loin, roasted
3.5oz
65
Roast lamb leg
3.5oz
65
Roast veal leg
3.5oz
68
Salmon
3oz
50
Shellfish
3oz
100 to 325
Shrimp
3oz
190
Spareribs, braised
3.5oz
93
Steak, T-bone
3.5oz
66
Tuna, canned in spring water
3oz chunk white
300
Turkey, dark meat
3.5oz roasted
76
Turkey, light meat
3.5oz roasted
63
Dairy Products
Food
Serving Size
Milligrams/Sodium
American cheese
1oz
443
Buttermilk, salt added
1 cup
260
Cheddar cheese
1oz
175
Cottage cheese, low fat
1 cup
918
Milk, whole
1 cup
120
Milk, skim or 1%
1 cup
125
Swiss cheese
1 oz
75
Yogurt, plain
1 cup
115
Vegetables and Vegetable Juices
Food
Serving Size
Milligrams/Sodium
Asparagus
6 spears
10
Avocado
1/2 medium
10
Beans, white cooked
1 cup
4
Beans, green
1 cup
4
Beets
1 cup
84
Broccoli, raw
1/2 cup
12
Broccoli, cooked
1/2 cup
20
Carrot, raw
1 medium
25
Carrot, cooked
1/2 cup
52
Celery
1 stalk raw
35
Corn (sweet, no butter/salt) boiled
1/2 cup
14
Cucumber
1/2 cup sliced
1
Eggplant, raw
1 cup
2
Eggplant, cooked
1 cup
4
Lettuce
1 leaf
2
Lima beans
1 cup
5
Mushrooms
1/2 cup (raw or cooked)
1-2
Mustard greens
1/2 cup chopped
12
Onions, chopped
1/2 cup (raw or cooked)
2-3
Peas
1 cup
4
Potato
1 baked
7
Radishes
10
11
Spinach, raw
1/2 cup
22
Spinach, cooked
1/2 cup
63
Squash, acorn
1/2 cup
4
Sweet potato
1 small
12
Tomato
1 small
11
Tomato juice, canned
3/4 cup
660
Fruits and Fruit Juices
Food
Serving Size
Milligrams/Sodium
Apple
1 medium
1
Apple juice
1 cup
7
Apricots
3 medium
1
Apricots (dried)
10 halves
3
Banana
1 medium
1
Cantaloupe
1/c cup chopped
14
Dates
10 medium
2
Grapes
1 cup
2
Grape juice
1 cup
7
Grapefruit
1 medium
0
Grapefruit juice
1 cup
3
Orange
1 medium
1
Orange juice
1 cup
2
Peach
1
0
Prunes (dried)
10
3
Raisins
1/3 cup
6
Strawberries
1 cup
2
Watermelon
1 cup
3
Breads and Grains
Food
Serving Size
Milligrams/Sodium
Bran flakes
3/4 cup
220
Bread, whole wheat
1 slice
159
Bread, white
1 slice
123
Bun, hamburger
1
241
Cooked cereal (instant)
1 packet
250
Corn flakes
1 cup
290
English muffin
1/2
182
Pancake
1 (7-inch around)
431
Rice, white long grain
1 cup cooked
4
Shredded wheat
1 biscuit
0
Spaghetti
1 cup
7
Waffle
1 frozen
235
Convenience Foods
Food
Serving Size
Milligrams/Sodium
Canned soups
1 cup
600-1,300
Canned and frozen main dishes
8oz
500-2,570
Please note: These are sodium content ranges - the
sodium content in certain food items may vary. Please contact your
dietitian for specific product information.
Source: Food Values of
Portions Commonly Used, 16th edition, 1994 Bowes & Church
Sodium guidelines: Foods to choose
Protein - choose 2-3 servings per day
- 2-3 ounces of fresh or frozen fish, shellfish, meat (beef, veal,
lamb, pork) or poultry
- 1/2 cup cooked dried beans or peas
- 1/2 cup low-sodium canned fish (such as salmon or tuna)
- 1 low-sodium frozen dinner (less than 600mg sodium per meal) - Limit
to one per day
- 1 egg (no more than 3 whole eggs per week)
Dairy products - choose 2 or more servings/day
- 1-1/2 ounces of low-sodium cheese
- 1 cup milk (non-fat or 1% recommended)
- 1/2 cup low-sodium cottage cheese
- 1 cup soy milk
Vegetables and fruits - choose 5 or more servings/day
- 1/2 cup fresh whole, chopped, cooked, frozen or canned
fruit
- 1/2 cup chopped, cooked, frozen or no-salt added canned
vegetables
- 1/2 cup low-sodium tomato juice or V-8 juice
- 1/2 cup low-sodium tomato sauce
- 1 cup raw leafy vegetables
Bread and grains - choose 6 or more servings/day
- Low-sodium breads, rolls, bagels and cereals (1 serving = 1
slice bread, 1 small roll, 1/2 bagel, 1/2 English muffin or a 4-inch pita
- 1/2 cup pasta (noodles, spaghetti, macaroni)
- 1/2 cup rice
- Low-sodium crackers (read label for serving size)
Sweets and snacks (include sparingly)
- 1 ounce unsalted nuts
- 1/2 cup low-sodium pretzels or chips
- 3 cups popped low-sodium popcorn
- 3 fig bars or gingersnaps
- 1 slice angel food cake
- 1 tbsp jelly or honey
- 1 cup sherbet, sorbet or Italian ice; 1 popsicle
- 8-10 jelly beans; 3 pieces hard candy
Fats, oils and condiments (use sparingly)
- Olive and canola oils
- Low-sodium butter and margarine
- Low-sodium soups
- Low-sodium salad dressing
- Homemade gravy without salt
- Low-sodium broth or bouillon
- Low-sodium catsup
- Low-sodium mustard
- Low-sodium sauce mixes
Fats, oils and condiments (can use freely)
- Lemon juice
- Vinegar
- Herbs and spices without salt
Sample Menu
Breakfast
Lunch
Dinner
Snacks
· Fresh fruit
· Low sodium cereal (hot or cold)
· Milk
· Low sodium wheat bread
· Reduced sodium margarine or peanut butter
· Lean roast turkey on whole wheat bread with low sodium
mustard
· Raw carrot sticks
· Applesauce
· Unsalted pretzels
· Grilled chicken
· Boiled potatoes
· Steamed fresh vegetables
· Tossed salad and low sodium dressing
· Low sodium roll with low sodium margarine
· Fresh melon
· Angel food cake
· Fresh fruit
Note: For a diet in which you consume 2,000 mg pf sodium per day, a sample
plan might involve eating 500 mg at breakfast, 150 mg for snacks twice daily,
600 mg for lunch, and 600 mg for dinner.
Sodium guidelines
- Use fresh ingredients and/or foods with no salt added.
- For favorite recipes, you may need to use other ingredients and
delete or decrease the salt added. Salt can be removed from any recipe
except from those containing yeast.
- Try orange or pineapple juice as a base for meat marinades.
- Avoid convenience foods such as canned soups, entrees,
vegetables, pasta and rice mixes, frozen dinners, instant cereal and puddings,
and gravy sauce mixes.
- Select frozen entrees that contain 600 mg or less of
sodium. However, limit to one of these frozen entrees per day.
Check the Nutrition Facts label on the package for sodium content.
- Use fresh, frozen, no added salt canned vegetables, or canned
vegetables that have been rinsed before they are prepared.
- Low sodium canned soups may be used.
- Avoid mixed seasonings and spice blends that include salt, such
as garlic salt
Directions: Combine all ingredients in a small bowl and blend
well. Spoon into shaker. Store in a cool, dark place.
Spicy blend
2 tbsp dried savory, crumbled
1/4 tsp freshly ground white pepper
1 tbsp dry mustard
1/4 tsp ground cumin
2 1/2 tsp onion powder
1/2 tsp garlic powder
1/4 tsp curry powder
Saltless surprise
2 tsp garlic powder
1 tsp basil
1 tsp oregano
1 tsp powdered lemon rind or dehydrated lemon juice
Spicy seasoning
1 tsp cloves
1 tsp pepper
2 tsp paprika
1 tsp coriander seed (crushed)
1 tbsp rosemary
Herb seasoning
2 tbsp dried dill weed or basil leaves, crumbled
1 tsp celery seed
2 tbsp onion powder
1/4 tsp (pinch) dried oregano leaves, crumbled freshly ground pepper
Restaurant dining tips
Appetizers
- Select fresh fruit or vegetables
- Avoid soups and broths
- Stay away from bread and rolls with salty, buttery crusts
Salads
- Select fresh fruits and vegetables
- Avoid pickles, canned or marinated vegetables, cured meats,
seasoned croutons, cheeses, salted seeds
- Order salad dressings on the side and use small amounts of them
Main courses
- Select meat, poultry, fish or shellfish choices that includes
the words broiled, grilled or roasted
- Select plain vegetables, potatoes and noodles
- Ask the server about the low sodium menu choices, and ask how
the food is prepared
- Request food to be cooked without salt or monosodium glutamate
(MSG)
- Avoid restaurants that do not allow for special food
preparation (such as buffet style restaurants, diners or fast food chains)
- Avoid casseroles, mixed dishes, gravies and sauces
* At fast food restaurants, choose the salad entrees or non-fried and
non-breaded entrees (such as a baked potato) and skip the special sauces,
condiments and cheese
* Avoid salted condiments and garnishes such as olives and pickles
Desserts
- Select fresh fruits, ices, ice cream, sherbet, gelatin and
plain cakes
Alcohol guidelines
Because alcohol can slow your heart rate and worsen your heart failure, your
health care provider may tell you to avoid or limit alcoholic beverages. Alcohol
may also interact with the medications you are taking. Ask your health care
provider for specific guidelines regarding alcohol.
© Copyright 1995-2005 The Cleveland Clinic Foundation. All rights reserved.
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