Good Nutrition Is a
Tool for Managing Heart Failure
Good nutrition is important for everyone. It is
especially important if you have heart failure.
You can feel better and improve your quality
of life just by making the right food choices.
With the right kinds foods in the right
amounts...
• You can maintain your strength.
• You can make your immune system stronger.
• You may be able to prevent the disease from
getting worse quickly.
Sodium
Sodium is a mineral
found in our body that
is important in maintaining fluid balance.
Sodium occurs naturally in most foods.
It is also found in
food additives and
some medicines. We
need some sodium to keep our body working
correctly. Heart failure causes extra sodium
to build up in your body. Sodium causes
your body to hold on to extra fluid.
When you have extra fluid...
• Your heart works harder.
• Your lungs and kidneys overwork.
• You have shortness of breath.
• You weight gain.
• You have uncomfortable swelling.
your diet. It may take a little while to get used
to a low sodium diet, but it is well worth it.
With a low sodium diet...
• You can feel better and do
more of the things you enjoy.
• Your heart failure medicines work
better.
• You can perhaps prevent trips to the
hospital.
Sodium is measured in
milligrams (mg). A lowsodium diet contains
2000 mg of sodium per
day. Your doctor will
probably advise you to
eat or drink no more than
2000 mg per day. Follow
your doctor’s advice.
The average
American eats
2 to 3 times
more sodium
than people
with heart
failure need.
Luckily, you can help reduce or prevent this
fluid buildup when you reduce the sodium in
page 1 of 8 pages
This is for education only. Ask your own doctor any questions you have about your health. © 2008 by Vanderbilt University.
All rights reserved. Vanderbilt Medical Center Patient & Family Centered Care HC-0067 06/09
Learn to Read Food Labels
Reading food labels is the best way to find out
how much sodium an item has. This is very
important with processed foods, which tend to
be very high in sodium. Fresh fruits, vegetables, and meats have no nutrition labels. You
will have to find out for yourself. You will
find it in a list of Internet websites at the end
of this section. Also, many restaurants now
have nutrition lists as handouts or on their
website.
1. First, look for the serving size. It is listed at the
top of the label. For example, on this label of
canned soup a serving is 1/2 cup.
2. Find how many milligrams (mg) of sodium is in a
serving size. Sodium is generally listed about half
way down the label. For example, this product
contains 870 mg sodium per 1/2 cup serving.
3. If you eat a 1/2 cup serving, you are eating 43%
of the sodium you need for the day.
4. Half a cup of soup is not much. If you ate a whole
cup, you would be eating twice the amount of
sodium. That is nearly all the sodium you are
allowed for one day!
Ingredients to avoid on
a list of ingredients
monosodium glutamate (MSG)
sodium metabisulfite
disodium
sodium phosphate
sodium nitrite
brine
baking soda, baking powder
High in sodium
Pre-packaged convenience foods
Frozen TV dinners
Canned vegetables and soups
Good news. If you look, you might find
packages that say Low Sodium! That’s good,
but you must read the label to see how low.
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How to Make Low Sodi um Easier
Do not add salt to your food. Table salt is
about one-half sodium. Most of the
sodium that we eat comes from table salt.
In fact, one teaspoon of salt contains
2,300 mg of sodium!
Remove the salt shaker from the table.
Do not add salt while cooking.
Experiment with herbs, spices, and fruit
juices to add flavor.
Stay away from
seasonings that contain One teaspoon of
the word salt. They will
salt contains
be high in sodium.
2,300 mg of
Do not use salt substitutes. They are very
high in potassium.
Too much potassium
can be dangerous for
some people.
sodium. Your
doctor probably
tells you no
more than 2,000
per day.
Sodi um-Free Spice & Herb Blends
You can blend sodium-free spices and herbs to
enhance flavor of many of your favorite dishes. Mix all ingredients together. Store the
mixture in a closed container in a dry place.
Blend #1
For vegetables,
poultry and meat
3/4 teaspoon marjoram
1/2 teaspoon oregano
1/2 teaspoon rosemary
1/2 teaspoon thyme
1/2 teaspoon sage
Each blend makes two to three tablespoons.
These blends have almost no calories or
nutrients. From A Change of Seasons, a cookbook published by Vanderbilt University Nutrition Service
Blend #3
For meat, potatoes,
vegetables
1/2 teaspoon garlic powder
1/2 teaspoon onion powder
1/4 teaspoon ground celery seed
Patient & Family Centered Care HC-0067 06/09
Blend #2
For fish
3/4 teaspoon parsley flakes
1/2 teaspoon sage
1/4 teaspoon paprika
1/4 teaspoon onion powder
1/4 teaspoon marjoram
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More Seasoning Suggestions
If you enjoy developing your own flavor combinations, try these spices and herbs for extra
flavor. Remember, a little goes a long way.
Spices and herbs are intended to enhance natural flavors, not to hide them. When you do not
have a recipe, start with about 1/4 teaspoon of
spice or dried herbs to each pound of meat or
pint of sauce or soup. For red pepper or garlic
powder, use 1/8 teaspoon. You can always add
more. Also, add a small amount of sugar to
vegetables during cooking. It brings out the
flavor.You also might try finding a low-sodium cookbook. Libraries and bookstores will
have helpful cookbooks. The Internet is another great place to find low-sodium recipes. See
the resource list at the end of this section. It’s
best when you can change your own favorite
recipes to their low-sodium versions.
Beef - dry mustard, marjoram, nutmeg, sage,
thyme, pepper, bay leaf, basil, caraway seed,
curry, dill, rosemary, savory onion, garlic
delete grape jelly
• Roast beef - Rub with pepper and ginger
• Goulash - cook with onions, bay leaf, tomato, paprika , pepper rosemary or oregano and
bitters
Egg - pepper, dry mustard, paprika, curry,
green pepper, onion; substitute serve omelet
with jelly
Asparagus - lemon juice, grated nutmeg.
Pork - sage, basil, caraway seed, thyme, marjoram, rosemary, chives, onion, garlic; serve
with applesauce or spiced apples
Lamb - mint, rosemary, curry, dill, whole
cloves, sage, marjoram, garlic, onion; serve
with broiled pineapple rings. Rub chops with
pepper and ginger before broiling
Veal - bay leaf, ginger, marjoram, curry, basil,
savory, sage, thyme, garlic, onion; serve with
currant jelly or spiced apricots.
• Rub chops with pepper and saffron.
• Veal stew - onion, bay leaf, powdered mace,
celery leaves, and bitters
Chicken - paprika, thyme, sage, parsley; serve
with cranberry sauce or candied apples
Special Sausage - mix fresh ground pork with
sage and freshly ground black pepper
Fish - dry mustard, paprika, curry, bay leaf,
lemon juice, lemon, margarine
Cabbage - mustard dressing, dill seed, margarine with lemon and sugar, vinegar
Carrots - parsley, mint, nutmeg, tarragon,
chives, glaze with margarine and sugar or
orange juice, sugar and cornstarch
Cauliflower - nutmeg, bitters
Cucumber - thinly sliced raw, with onion
rings in vinegar
Eggplant - peel, dice, boil, and drain; add
tomatoes, bay leaf, oregano
Green beans - marjoram, lemon juice, nutmeg, dill seed, onion
Onion - boil with clove and thyme
Potatoes, sweet - candied or glazed with
cinnamon or nutmeg; mash with orange juice,
top with marshmallows; scallop with apples
and sugar
Potatoes, white - mash; add freshly grated
onion and nutmeg or chives. Toss sliced
potatoes with olive oil, rosemary and black
pepper. Spread on a cookie sheet and bake
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Rice – cook and serve with honey or fresh
fruits
Tomatoes - Stew with bay leaf, onions,
basil, oregano and bitters
Squash - onion, ginger, mace
Avoid high sodium foods
Pick low sodium foods
soy sauce
onion or garlic salt
bouillon
seasoned salts
meat tenderizer
country ham
fast food meals
frozen dinners
pot pies
sausage
hot dogs
corned beef
pickles and pickled foods
canned soup
processed luncheon meats
sauerkraut
processed cheeses
chips, pretzels, nuts, popcorn
crackers
olives
canned vegetables
pork and beans
self-rising flour
biscuit mix
baking soda
fat back, salt pork
potted meats like Spam
prepared foods
Shop around the outside of a grocery store.
That’s where you will find fresh fruits,
vegetables, meats, fish, and poultry. They
are naturally low in sodium.
Substitute low-sodium foods for higher
sodium favorites. For example, cook your
own, turkey or roast beef without salt
fresh and frozen meats and fish
fresh or canned fruit
fresh or plain frozen vegetables without sauce
dried beans and peas
eggs
angel food cake
low-fat pudding
cooked cereals, pastas, rice made without salt
skim or 1% milk
nonfat or lowfat yogurt
small amounts of low-fat natural cheese.
Avoid processed
cheese or cheese products.
unsalted pretzels, popcorn, or nuts
tea
lemonade
club soda
vinegar
jelly beans
honey
unsalted peanut butter
instead of using packaged lunch meats for
sandwiches.
Try buying low-sodium versions of the
foods you like to use in recipes. Look for
products labeled sodium-free, no salt, low
sodium, or very low-sodium.
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E ating Out
Sometimes it is hard to find enough tasty lowsodium foods in a restaurant. You can, however, if you are careful.
• Select a restaurant likely to serve at least one
item suitable for a low-sodium diet. For example, a place that serves only pre-processed
fried chicken is not the best choice. Baked
chicken or fish are nearly always safe, but
avoid gravy, catsup, mustard, and pickle.
• Plan what you might order ahead of time,
and count how much sodium you are likely to
have.
• Avoid soups and dishes with gravy or sauce.
- Pick items without breading. It often has salt.
- Ask for your food to be prepared without
added salt, MSG, or soy sauce.
• Select plain vegetables or fruit salads and
ask for dressing served separately.
• Ask if cooked vegetables are canned or
fresh, and estimate the sodium accordingly.
• Choose sherbet, fresh fruit or Jell-O for
dessert.
• If possible, eat foods with lower sodium
content at other meals during the day you
go out.
• Friends who invite you for a meal will
appreciate knowing you are limiting your salt.
If you are unable to tell your hostess about
your diet restrictions, eat a light meal before
leaving home and small amounts of the food
when you go out.
• At a pizza parlor ask for less sauce. Avoid
pepperoni, sausage, and extra cheese. Instead
pick more vegetable toppings like green peppers and fresh mushrooms. Thin crust is generally lower in sodium than thicker crusts.
More Great Tips
Learn what foods are high in sodium and do
not keep them in the house.
Choose main entrees with no more than
500 mg of sodium. Other food items should
have no more than 300 mg of sodium.
It may be easier to divide your sodium limit
by meals. For example, if you are following
a 2000 mg per day sodium diet, try to have
500 mg of sodium at breakfast, lunch, and
supper, and another 500 mg of sodium for
snacks.
2.000 mg per day
Breakfast ............500 mg sodium
Lunch ................500 mg sodium
Supper................500 mg sodium
Snacks................500 mg sodium
2,000 mg sodium
It’s harder to change your whole diet.
Instead, try just lowering the sodium in
things you already like.
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What To Do If You Don’t Feel Like Eating
Occasionally, some people with heart failure may
notice that they feel sick at their stomach or they
don’t have any appetite. Some people may feel
very full even if they have eaten only a little bit.
These can be side effects of some medicines.
Also, a built-up of fluid around the belly can
cause these complaints. The build-up of fluid
interferes with digestion. If you notice major
changes in your appetite, check with your doctor.
You need to make sure this is not a sign of your
heart failure getting worse.
Tips
Try eating small, frequent meals or snacks
5 – 6 times a day.
Try sipping on a liquid nutrition supplement
like Ensure, Boost, or instant breakfast
between meals. You will be getting good
nutrition, and you will still have room for
solid food at meals. If you are on a fluid
restriction do not forget to count the fluid.
Weigh yourself. If you notice you are gaining
weight contact your doctor. Your lack of
appetite might be a sign of fluid buildup that
needs special treatment.
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Good Nutrition Websites
www.abouthf.org/_downloads/module2.pdf
A detailed information booklet on low sodium
diet from the Heart Failure Society of
America.
www.heartfailurematters.org/English_Lang
/WarningSigns/Pages/index.aspx
Heart failure information for patients, families, and caregivers from the European Society
of Cardiology.
www.nutritiondata.com
Allows you to search for almost any food or
beverage to find detailed nutrition information. Includes sodium.
www.fatcalories.com
Nutrition information, including sodium
content, of many popular fast food chains.
www.lowsodiumcooking.com/free/Archive.h
tm#sidedishes
A great selection of low sodium recipes.
www.nhlbi.nih.gov/health/public/heart/hbp/
dash/new_dash.pdf
Detailed information booklet on the DASH
diet, a low sodium diet often recommended
for people with high blood pressure. It is
appropriate with heart failure too. It provides
a week of menus and some recipes for two
levels of daily sodium – 2,300 mg and
1,500 mg.
www.eatright.org/cps/rde/xchg/ada/hs.xsl/n
utrition.html
www.lowsodiumliving.com/index.htm
The American Dietetic Association provides a
wide variety of nutrition information and
nutrition facts sheets you can print. You can
ask them to help you find a registered dietitian
in your area.
A good source for low sodium recipes,
restaurant information, and links to heart
failure support groups.
www.diabetes.org/food-nutritionlifestyle/nutrition.jsp
www.americanheart.org/presenter.jhtml?id
entifier=1200010
About diabetes and following a diabetic diet,
including recipes and help with meal planning.
Recommendations on heart healthy eating
from the American Heart Association.
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