Which Foods Should You Avoid With Congestive Heart Failure?

If you have heart failure, you’ll quickly learn that in order to feel better, the foods and beverages that you don’t eat can be as important as the ones you eat.

Heart failure, sometimes called congestive heart failure, means your heart continues to pump blood and push oxygen throughout your body. But it’s not working at a top notch rate.

“Your organs aren’t getting the nourishment and oxygen they need,” says Leslie Beck, a registered dietitian in Toronto. You may find that you tire more easily or that you are short of breath.

In addition, “when your heart has more difficulty pumping blood, the body has a hard time getting rid of this extra fluid and water.” If this happens, you may notice that your legs and ankles seem more swollen, she says.

Along with taking your medications and exercising regularly, avoiding or cutting back on certain types of foods and drinks can help guard against this uncomfortable swelling, says Barry Greenberg, MD, who leads the Advanced Treatment Program for heart failure at the University of California at San Diego. Health.

“They are really important for improving long term results,” he says. “The payoff can be substantial, and it is definitely worth doing.”


Diet choices you should add to your watchlist to limit or avoid when you have heart failure include:

Sodium. You’ve probably heard this before, but it bears repeating that sodium can encourage fluid build-up, says Sitaramesh Emani, MD, a cardiologist specializing in advanced heart failure at Wexner Medical Center at State University of London. ‘Ohio to Columbus. The reason, he says: “When excess sodium is consumed from food sources, the body wants to retain more fluid to accompany that sodium.”

Your doctor will recommend a sodium goal that is best for you, typically no more than 1,500 to 2,000 milligrams per day, Emani says. (One teaspoon of salt contains 2,300 milligrams of sodium.) That limit falls well below the 3,400 milligrams each day that are part of the average American diet, according to federal data.


Sodium is often hiding in places that are much less obvious than your salt shaker. A slice of bread can contain up to 230 milligrams. This favorite breakfast cereal could reach 150-300 milligrams. Other potential culprits: processed meats for lunch and canned soups.

Restaurant food. It may be faster than cooking at home, but meals sold at fast food establishments can be packed with calories and sodium, says Greenberg, who recommends looking at the nutrition facts. This risk also extends to restaurants at the table, explains Emani, who advises asking your server for sodium amounts.

“Salt is a great flavor enhancer,” says Emani, noting that restaurants want happy customers. “I often advise my patients that if you or someone you know directly has not prepared the food, there is a high probability that more salt than you think will be used.”

Daily fluids. You may need to watch your fluid intake, even water. Drinking too much can cause extra fluids to build up in your body. People with heart failure may be advised to limit fluids to 2 liters per day or less, depending on how well their condition is under control, Greenberg says.

All liquids count, he adds. Keep track of not only water and coffee, but also soups and juicy fruits, like grapefruit. “It doesn’t matter what form it takes,” says Greenberg. “If it’s a liquid, it will count.” Also, avoid drinks that contain salt, such as certain sports drinks, he says.

Alcohol. If your heart failure is controlled with medication and you are not retaining fluids, Greenberg is OK with alcohol, but no more than one drink per day. Keep in mind that it will count towards your daily fluid intake.

Your doctor may tell you not to take alcohol completely if you’re taking certain medications, such as certain types of blood thinners, Emani explains. Be honest about your drinking – with yourself and your doctor. An extra-large margarita is not a standard size drink. And you can’t skip wine at dinner on certain days and drink more later in the week, Emani says. “You can’t bank your alcohol consumption.”


Caffeine. Watch out for coffee, soda, and chocolate, says Emani. It is best not to exceed one to two servings per day. “Too much caffeine can make heart failure worse,” he says. “It can increase the heart rate and increase the risk of an irregular heartbeat.”

Processed foods. These foods should be limited, not only because they’re more likely to be high in sodium, but also because they tend to be low in fiber, Emani says. This is especially important if you have heart failure, because drugs can sometimes cause constipation and fiber helps prevent this, he says.

“It’s not just from a comfort standpoint,” Emani says. “If patients put in a lot of effort to have a bowel movement, this act of straining increases the pressure on the heart.”

Manage temptation

The dietary rules for people with heart failure aren’t absolute and can be adjusted based on your symptoms and lifestyle, says Greenberg. For example, if you live in a hot climate, your doctor may not want you to limit fluids because you will sweat a lot of that fluid.

It’s not always easy to make these diet changes, especially when you’ve developed lifelong eating habits, Beck says. If you’re used to eating some type of salty or sweet snack after dinner, see if you can distract yourself for awhile by doing something else you enjoy, she says. “Because the cravings pass.”

Or find a food substitution. If you want to munch on a bag of chips, swap them out for unsalted popcorn so you can still enjoy that satisfying crunch, says Beck.

If your favorite comfort food goes on the sweet side, Beck suggests keeping fresh berries or frozen grapes on hand for a quick fix. Enjoy a square of dark chocolate. Or make your own hot chocolate with cocoa and low fat milk and sip it slowly.

“It may take you 40 minutes to finish a hot drink,” says Beck. “At that point, you went through this period of envy and you nourished your body at the same time.”



Johns Hopkins Medicine: “Heart Failure”.

Leslie Beck, RD, Toronto, Canada.

Barry Greenberg, MD, director, Advanced Heart Failure Treatment Program, University of California at San Diego Health.

Sitaramesh Emani, MD, cardiologist, Wexner Medical Center at Ohio State University, Columbus.

UpToDate.com: “Self-management of heart failure”.

CDC: “Get the Facts: Sodium and the Dietary Guidelines.”

American Heart Association: “Follow Directions: Heart Failure”.

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