• Special Considerations for Your Diet

     
     
     
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    When you have high blood pressure, heart failure, or heart valve disease, you should be aware of special dietary considerations that will contribute to your wellness. For many patients, these are critical for health and may even help manage symptoms and make you feel better.

    1. High Blood Pressure
    2. Congestive Heart Failure
    3. Heart Valve Disease
    4. Additional Information

     


     

    High Blood Pressure

    Blood pressure is the force of blood against artery walls. Blood pressure varies throughout the day, but when it remains high, it is called high blood pressure (or hypertension). High blood pressure is dangerous because it makes the heart work too hard. If untreated, over time this can lead to heart failure. In addition, the force of the blood flow can harm organs such as the kidneys, eyes and brain.

    Fortunately, you may be able to lower your blood pressure by what you choose to eat. General heart-healthy guidelines are important for people with high blood pressure. But research, called the Dietary Approaches to Stop Hypertension (DASH), shows that a low-sodium eating plan full of potassium-rich whole grains, fruits and vegetables; lean meats; and dairy products can lower your blood pressure, which helps your heart pump more efficiently.

    Here are some simple ways to change your eating plan to lower blood pressure:

    1. Follow a DASH-like Eating Plan
      • Whole grains: 6 to 8 servings per day
      • Fruits and vegetables: 8 to 10 servings per day
      • Low-fat or nonfat milk and cheese products: 2 to 3 servings per day
      • Lean meats, poultry or fish: 6 ounces or less per day
      • Fats: 2 to 3 teaspoons of oil per day
      • Nuts, Seeds, Legumes: 4 to 5 servings per week
      • Sugar: 5 tablespoons or less per week
      This eating plan is based on a 2,000 calorie-diet, so depending on your individual calorie needs, you may require more or fewer servings than are listed. But it is an example of how an eating plan to lower blood pressure is based on many servings of whole grains, fruits, and vegetables; some low-fat dairy products; a small amount of lean meat; a little healthy unsaturated fat; and very little sugar. Following an eating plan that is full of these fresh foods makes it easier to avoid sodium. Consider other ways to slash sodium from your diet as well.
    2. Achieve a Healthy Weight
      Maintaining a healthy weight or losing weight helps prevent and manage high blood pressure.  Losing 5 to 10 percent of your current weight can help achieve better blood pressure levels. It is important to balance calories eaten with regular physical activity. You may want to estimate your daily need for calories to help you keep track. Reading food labels can also help you become aware of the calories in foods. When you are ready to lose weight, it helps to first analyze your eating behaviors and then move on to starting a plan and setting goals.
    3. Limit Alcohol Intake
      Excessive alcohol increases blood pressure. If you drink alcohol, drink in moderation (no more than one drink per day for women, one to two drinks per day for men).

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    Congestive Heart Failure

    Congestive heart failure (CHF) occurs when the heart does not pump efficiently and is not able to deliver enough oxygen to the body. It can be caused by high blood pressure or other heart problems. When you eat too much sodium (and salt) or drink too many fluids, your heart has to work even harder to pump the extra blood volume through your blood vessels. The heart does not have to work quite as hard when you make changes to your diet.

    All heart-healthy guidelines are important for people with CHF, but it is extra important to follow a low-sodium diet-1,500 milligrams-to prevent fluid retention in the body. Sodium makes you thirsty and makes your body hold onto fluids rather than urinating them out. In addition, it is important to limit the amount of fluids you drink. The amount can vary and your doctor will let you know how much you should be drinking in a day. The extra fluid may make it very hard to breathe and it may be life-threatening and require hospitalization. So, following low-sodium and fluid guidelines are a vital part of the treatment for CHF.

    Here are some ways to help manage congestive heart failure with your eating plan:

    1. Slash Sodium.

    • Eat plenty of fruits and vegetables, which are naturally low in sodium.
    • Choose fresh foods, including lean meats, fish, poultry, dry and fresh legumes (or rinsed canned beans), eggs, milk, yogurt, plain rice, pasta and oatmeal.
    • Choose lower-sodium sensible snacks.
    • Avoid using the salt shaker. Or replace it with a sodium-free blend of herbs, such as Mrs. Dash.
    • Cut the sodium completely, or at least reduce it by half in recipes. Be a creative cook-use herbs, onion, garlic, citrus and other fruit juices, and vinegars to add flavor.
    • Be careful of condiments-ketchup, mayonnaise, mustard, pickles, olives, marinades, tenderizers, soy sauce, lemon pepper and some seasoning blends contain a lot of sodium. Check the ingredient list for salt.
    • Avoid convenience foods, Chinese food, and fast foods. Follow tips for heart-healthy dining out, but limit how frequently you go out to eat because it is very difficult to restrict sodium enough even when special requests can be made.
    • Read food labels for sodium content before you buy packaged or canned foods.

    2. Weigh Yourself Daily

    In order to catch any fluid retention or worsening of congestive heart failure early, it is very important to weight yourself every day. A gain of 1 to 2 pounds overnight, or 5 pounds in a week, is a signal that your body is retaining extra fluid. If this occurs, call your healthcare provider right away because you may need to make adjustments in your diet or medications. Noting and dealing with fluid weight gain promptly may prevent worsening heart failure and the need for hospitalization.

    Weigh yourself on the same scale every day when you wake up. Urinate first, and always wear the same amount of clothing. Record your weight, and bring your log with you to all of your appointments with your healthcare provider. 

    3. Keep Food Intake (and Calories) in Check

    Because CHF can make it hard to breathe, physical activity may be restricted by your doctor. As a result, it may be difficult to maintain or reach a healthy weight with weight loss. It is even more important to restrict calorie intake to prevent weight gain if exercise must be limited due to heart-related breathing problems. Learning how to read food labels can help you keep track of calories.

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    Heart Valve Disease

    The heart has four valves through which blood flows. Sometimes one or more of the valves do not open fully or they let blood leak back into the heart chambers. This can make your heart work harder and affect its ability to pump blood. If left untreated, heart valve disease can lead to heart failure, stroke, blood clots, or heart attack.

    All heart-healthy guidelines are important for people with valve disease, but a diet that is low in sodium is particularly important. Sodium causes the body to retain fluid, which raises blood pressure and makes the heart work harder. But valve disease already makes the heart work harder. So, following a low-sodium diet will help keep the heart from working even further.

    Here are some ways to change your eating plan to help manage heart valve disease:

    1. Slash Sodium

    Read more about reducing the sodium in your diet.

    2. Keep Vitamin K Intake Constant

    Valve disease may require medications to thin the blood to prevent clots. These medications are prescribed for mitral stenosis or other valve defects that raise your risk of blood clots. A blood clot could become life-threatening if it travels to your brain (causing stroke), heart (leading to a heart attack), or lungs (known as pulmonary embolism). When taking blood-thinning medications, such as Coumadin, being aware of vitamin K in foods is important because vitamin K helps with blood clotting. So if you are trying to prevent blood clotting with medications, you don't want to undo the effects by eating a lot of vitamin K-rich foods.

    Your doctors measure your blood to determine clotting time. While your doctors are titrating (changing) your medications to achieve a desirable clotting time, eat the same amount of vitamin K-rich foods you plan to eat regularly. Then once your doctors have you at a desirable level, it is recommended that you do not increase or decrease the amount or frequency of these vitamin K-rich foods. If you do, you risk forming a life-threatening clot despite taking anti-clotting medication.

    Vitamin K-Rich Foods:

    • Green leafy vegetables, such as kale, collards, spinach, turnip greens
    • Brussels sprouts
    • Cabbage
    • Broccoli
    • Asparagus

    3. Take Care of Your Teeth

    When you have valve disease, bacteria from your mouth and gums can travel through the bloodstream and enter the heart, causing infective endocarditis. Good oral hygiene can prevent further valve damage from this infection. It's more important than ever to floss and brush your teeth daily and see a dentist regularly when you have valve disease. Gum infections and tooth decay can increase the risk of infection.

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    Need More Help?

    Putting a heart-healthy eating plan into practice can be difficult. Don't give up. Start with setting small goals. If you need help, don't hesitate to ask your doctor for a referral to see a registered dietitian. Nutrition counseling can help you figure out where you are and where you want to be with your heart-healthy eating plan.

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