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Heart Failure Diet: Foods To Eat and Avoid

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Heart failure” is as serious and life-threatening as it sounds. It’s the medical term for when your ticker can’t pump enough oxygenated blood to meet your body’s needs.

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There isn’t a cure for heart failure. But what you eat can help you manage the lifelong condition and minimize its impact on your life. Basically, your choices at mealtime can help you stay active and healthier.

So, what food should and shouldn’t be on your plate? Registered dietitian Julia Zumpano, RD, LD, has some definite menu recommendations. (SPOILER ALERT: There’s a big focus on reducing sodium intake.)

The need for a heart failure diet

Researchers estimate that more than 64 million people around the world are in various stages of heart failure. To put that in perspective, that’s a group nearly equal to the population of France.

Heart failure also stands as the leading cause of hospitalization for those aged 65 and older. Put bluntly, it’s a condition that often steals years off lives.

Given all of that, it’s no wonder some experts refer to heart failure as a global pandemic.

Successfully living with heart failure often requires immediate lifestyle changes, with dietary choices topping the list. Think of your meals as medicine. What you eat can help or hurt your weakened heart.

“Everything you eat affects your entire body, including your heart,” says Zumpano. “Making good dietary choices — especially when it comes to sodium — is critical if you’ve been diagnosed with heart failure.”

Why is reducing sodium important with heart failure?

A bit of sodium is essential within your diet, as the mineral helps your body maintain fluid levels. “Consuming sodium helps your body absorb and hold onto the fluid it needs,” explains Zumpano.

But take in too much sodium, and you can retain excess water. If you have heart failure, that’s a big issue. Here’s why.

With heart failure, your struggle to adequately pump blood can lead to fluid buildup in your body. This excess fluid can be anywhere, from your arms and legs to areas around critical organs such as your lungs.

So, if you have heart failure and consume high amounts of sodium, you’re basically boosting fluid retention in a system that’s already flooding. That can send blood pressure numbers soaring.

“You’re putting extra strain on a heart that’s already having trouble keeping up,” says Zumpano.

But reducing sodium in your diet lessens extra fluid retention, which can take some pressure off your hard-working heart. Basically, it’s a way to help a compromised cardiovascular system.

How much sodium is too much?

Someone living with heart failure should try to limit sodium consumption to less than 2,000 milligrams (mg) per day, advises Zumpano. To put that in perspective, that’s less sodium than what’s in a teaspoon of table salt.

(Quick science lesson: Salt and sodium are often used interchangeably, but they’re different. Salt is a combination of sodium and chloride. Sodium, meanwhile, is just … well, sodium, and one of the most common elements on Earth.)

Should fluid consumption be limited?

Does it make sense to cut back on drinking cups of water and other beverages if your body is struggling with too much fluid? Sometimes, says Zumpano.

“Some people with heart failure do need to restrict how much they drink because they’re holding onto so much fluid,” she says. “But not everyone needs to follow a low-fluid diet. It’s on a case-by-case basis.”

Zumpano recommends talking to your healthcare provider before cutting back on fluid consumption to address heart failure symptoms.

10 tips to adopt a low-sodium diet

So, how do you cut back on sodium intake to slow the progress of heart failure? Zumpano offers 10 suggestions to ease the transition into a low-sodium diet.

#1: Hide your salt shaker

Kind of obvious, right? Eliminating the habit of shake-shake-shaking salt onto your plate can bring an instant reduction in sodium consumption. (FYI, too: While sea salt and kosher salt are less processed than ordinary table salt, they aren’t low in sodium.)

#2: Use fresh herbs

Fresh herbs and spices can add flavor to meals without any sodium. But be wary of prepackaged spice and seasoning blends. “Salt usually gets mixed in with the herbs and spices — and the sodium adds up quickly,” notes Zumpano.

#3: Read nutrition labels

Food labels in the United States include a section that tells how much sodium is in a single serving of the food item. “My general rule is to try to keep that number below 140 mg of sodium,” says Zumpano. (Be mindful of what is classified as a serving size, too.)

“Take the time to read labels,” she adds. “The more you look, the more surprised you may be as to where sodium pops up.”

#4: Search out low-sodium or sodium-free products

Food manufacturers have definitely noticed that there are millions of people looking to cut sodium — and they’ve responded with product offerings that can better fit within a low-sodium diet, says Zumpano.

Shelves are loaded with products labeled “Low Sodium” or “No Sodium.” Low sodium means that food has 140 mg or less of sodium per serving. No sodium means that food has less than 5 mg of sodium per serving.

#5: Don’t confuse lower with low

Be cautious of foods labeled “lower, “reduced” or “less” sodium.” These products do offer lower sodium content than the regular version of the food, but that doesn’t mean they’re actually “low” when it comes to sodium content.

An example would be soy sauce, where a splash of the “reduced sodium” flavoring still may amount to a significant amount of sodium.

“This is where reading nutrition labels at the store becomes so important,” stresses Zumpano. “Be mindful of the milligrams of sodium that are actually in a serving — not just that it’s less than normal.”

#6: Focus on fresh foods

If you’re wondering where to steer your grocery cart to find food low in sodium, Zumpano has a map: “I often suggest that you try to shop the outside of the grocery store, where you’ll find your fresh produce, fresh meats and fresh dairy,” she says.

Ideal foods to grab include:

  • Fruits and vegetables. No shocker here, right? “Fresh fruit and vegetables are packed with nutrients and have no or very, very little natural sodium,” notes Zumpano. (If you go the frozen or canned route, look for no-salt-added options.)
  • Fresh meats. Fresh beef, pork, poultry and fish are just … well, raw meat with minimal amounts of natural sodium. “The best options for meat are where there has been little to no extra processing,” she says. (More on that in #7!)
  • Dairy. Yogurt and milk aren’t very high in sodium. Cheese can be tricky, but there are varieties (Swiss, fresh mozzarella, brick and goat cheeses) that are naturally lower. There are some reduced sodium options, too.
  • Nuts and seeds. Look for unsalted nuts and seeds to keep these nutritional powerhouses in your diet.
  • Fresh grains and dried beans. Can it take a little longer to prepare dried beans or fresh grains like brown rice, wild rice and oats? Yes. But the payoff is healthier food for very little sodium compared to many convenience options. (For a shortcut, check the freezer section. Some of these foods can be found cooked and frozen without any added salt.)

#7: Limit processed and convenience foods

The majority of sodium in the average American’s diet comes from processed foods and convenience foods. By some estimates, more than 70% of consumed sodium is added during commercial processing.

Check the labels and you’ll often see high sodium content in canned soups, luncheon meats, breads, pasta and rice mixes, frozen dinners, instant cereals, puddings and many, many more items.

“Sodium is one of the best ways to preserve convenience foods and extend their shelf life,” explains Zumpano. “It’s simple, inexpensive and effective, which is why so much of it ends up in processed food.”

Dodging this sodium comes down to spending more time in the kitchen cooking with fresh ingredients. Is that less convenient? Without question.

But eating smarter and healthier is key to living better with heart failure. “Adding a few steps to your food preparation process can help you eliminate a tremendous amount of sodium from meals,” encourages Zumpano.

#8: Cook smartly

Getting low-sodium food items into the house won’t help if you use high-sodium sauces, dressings and seasonings during preparation. Do an ingredient inventory of your fridge, pantry and cupboards to get a sense of what’s there.

 

“Take an extra look at what you’re using while cooking,” advises Zumpano.

And if you have a favorite recipe that includes salt, experiment and try reducing how much you use to minimize sodium content. Using a bit less often won’t seriously change the taste of the dish.

#9: Go simple when eating at restaurants

Let’s be realistic: Odds are you aren’t going to eat every meal at home. Grabbing a bite at a restaurant or hitting the buffet table at a party is part of life.

When you do eat out, look for more simply prepared foods. The more processed the food is, the more likely it is high in sodium. So, opt for a baked potato instead of mashed potatoes, or choose a side salad (dressing on the side) over a bowl of soup.

“Cut the sodium where you can while still finding joy in what you’re eating,” says Zumpano. “Every little bit helps.”

#10: Be patient

Reducing sodium in your diet can be difficult at first. As you make changes, it might help to keep a record of how much sodium you’re eating every day. You can write it down or use a meal-tracking app to make things easier.

“The idea isn’t deprivation,” notes Zumpano. “Look for adjustments you can make so you can enjoy the foods you want to eat while backing off of others. It’s about building knowledge about sodium so you can make the best choices.”

And as you make changes to your diet, your taste buds will adjust. (FYI: That’s a good thing!)

“Something that didn’t taste salty to you in the past will taste extremely salty to you after adhering to a low-sodium diet for just a week or two,” Zumpano continues. “It will help reinforce your good choices and it will become easier to follow sodium restrictions.”

An added bonus to better eating? High-sodium foods often are high in fat and calories, too, so you may drop some pounds after cutting back on items like processed meats, chips and snack foods, fried foods and breads.

Research shows that losing weight can ease stress on your heart and extend your life with heart failure, particularly if you have obesity.

Low-sodium diet sample menu

Going low-sodium doesn’t mean you won’t eat fabulous food. In fact, your meals can be amazing while adjusting to help manage heart failure. Just consider this example of a one-day meal plan:

Breakfast

  • 1 cup fresh fruit.
  • 1 slice of sprouted grain bread.
  • An egg white omelet made with 1/2 cup egg whites, veggies (mushrooms, bell pepper and onion) and 2 tablespoons feta cheese or nutritional yeast.

Lunch

  • 3 ounces grilled salmon.
  • 2 cups of grilled veggies.
  • 1 tablespoon extra virgin olive oil and vinegar dressing.
  • 1/2 cup berries.
  • 2 tablespoons salt-free slivered almonds.

Dinner

  • 4 ounces grilled chicken.
  • 1 cup roasted red-skin potatoes in rosemary and olive oil.
  • Steamed green beans.
  • 2 cups tossed salad with low-sodium dressing.
  • 1 cup fresh melon.

Snack

  • 1 small banana with 1 tablespoon unsalted natural peanut butter.

Note: For a diet in which you consume 2,000 mg of sodium per day, a sample plan might involve eating 300–400 mg at breakfast, 200 mg for snacks twice daily, 600 mg for lunch and 600–700 mg for dinner.

 

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Helping people living with dementia ‘flourish’ through dance

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Dr. Pia Kontos, a Senior Scientist at UHN’s KITE Research Institute, is co-leading an initiative to help people living with dementia flourish. (Photo: Tim Fraser/UHN KITE Studio)

Dr. Pia Kontos believes in the power of the arts to support people to live well with dementia.

The Senior Scientist at UHN’s KITE Research Institute focuses on challenging policies and practices that discriminate against those living with dementia and developing and evaluating arts-based and digital knowledge translation initiatives to reduce stigma, improve social inclusion and quality of care for them.

“The predominant assumption is people living with dementia don’t have the capacity to be creative,” says Dr. Kontos, who is also a professor in the Dalla Lana School of Public Health at the University of Toronto. “However, we know through extensive research that dance…powerfully supports people living with dementia to be creative and to flourish.

“And flourishing should be a goal that we all have.”

Dr. Kontos co-produced in 2023 Dancer Not Dementia, a short documentary film. It captured the power of a dance program for seniors – Sharing Dance Older Adults (SDOA) – to challenge the stigma associated with dementia, support social inclusion and enrich lives. It’s told through the eyes of residents and staff at Alexis Lodge Dementia Care Residence and Cedarhurst Dementia Care Home in Toronto.

SDOA was jointly developed by Canada’s National Ballet School (NBS) and Baycrest Centre in 2013 for older adults with a range of physical and cognitive abilities, including dementia.

Typically, dance programs in dementia care settings are provided as a therapeutic intervention for older adults. However, SDOA’s goal is to provide a creative outlet for participants and opportunities for social interaction with other people living with dementia, staff and loved ones.

Now, Dr. Kontos will look to incorporate traditions from marginalized communities into SDOA through a $750,000 Canadian Institutes of Health Research (CIHR) Institute of Aging Implementation Science Team Grant. Dr. Rachel Bar, Director of Research and Health at NBS is co-principal applicant for the grant.

This CIHR funding supports projects that evaluate the effectiveness of existing programs, services and models of care that show promise for those impacted by cognitive impairment and dementia. An important focus is improving equitable and inclusive access to care and support.

The three-year grant to Drs. Kontos and Bar will support SDOA efforts to partner with organizations in Black, Chinese and South Asian communities to integrate their cultural practices into its programming.

Training dancers from these communities to teach the adapted program is central to these partnerships.

“People living with dementia from marginalized communities rarely have their traditions honoured with art and leisure programming,” says Dr. Kontos.

“It’s important to align dance programs with the cultural traditions of these communities. Otherwise, the music and movements wouldn’t reflect the experiences of ethno-culturally diverse populations, and the programs wouldn’t be inclusive.

“We wouldn’t be supporting their capacity to be creative or to be in relationships with others through dance. We would be falling short.”

SDOA has already partnered with Alexis Lodge, Alzheimer Society of Canada, Baycrest, NBS, Indus Community Services, Social Planning Council of Ottawa, and Yee Hong for this initiative.

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CDC: Heat may have contributed to four human cases of bird flu in Colorado

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Credit: Alexas Fotos from Pexels

Heat probably played a role in at least four cases of bird flu in poultry workers confirmed by U.S. health officials Sunday—the first cases in poultry workers in two years.

Sweltering temperatures in Colorado rose to at least 104 degrees, which is suspected to have contributed to the human cases, according to Dr. Nirav Shah, principal deputy director at the Centers for Disease Control and Prevention. The barns where poultry workers were culling chickens were “no doubt even hotter,” Shah said during a press conference on the most recent outbreak of bird flu in humans.

The new cases bring the U.S. total to at least nine cases since the first human case of the current outbreak was detected in 2022, also in a Colorado poultry worker. Eight of the nine were reported this year.

The workers were separating chickens that were going to be killed to stop the spread of the virus. The fans may also have contributed to the human infections because, while helping to keep the environment cooler, they “also spread things like feathers around which are known to carry the virus,” Shah added.

The large and strong fans also make it difficult for protective goggles and face masks to stay in place, he said.

About 60 workers at the poultry farm showed symptoms of illness and were tested for bird flu. Four tested positive for bird flu and one additional presumptive case is awaiting confirmation.

The illnesses were relatively mild, with symptoms including conjunctivitis and common respiratory infection symptoms like fever, chills, coughing, and runny nose, according to the CDC. None were hospitalized, officials said. The other U.S. cases have also been mild.

Officials said they are bracing for more cases.

The CDC says the risk to the general public remains low and the health agency is not recommending livestock workers be vaccinated against bird flu given the “mild symptoms noted thus far,” Shah said.

An initial analysis of virus samples from an infected poultry worker does not show any changes in the virus that would make it easier to spread among people and there is no evidence of person-to-person spread in the U.S.

“It’s important to note that this assessment is based on what we know today and may change,” Shah said. “CDC is constantly looking for key changes that may alter our risk assessment of the virus, such as the severity of illness that it causes, the ease with which it can transmit to humans or changes to its genetic fingerprint.”

At the request of Colorado’s officials, the CDC sent a 10-person team to Colorado to help the state manage the bird flu outbreak in humans and poultry. The team included epidemiologists, veterinarians, clinicians and industrial hygienists.

Shah also noted it was a bilingual team. Overall in the U.S., it is estimated about half of farm workers are Latino.

An analysis of the virus from an infected worker indicates that the infections at the chicken farm are “largely the same” as the strain detected in dairy herds in Colorado and other states, according to Shah. But an investigation is ongoing to determine exactly how the outbreak is spreading between wild birds, chicken and cattle.

Since 2022, a highly contagious strain of bird flu has spread across the U.S. at an unprecedented rate.

Georgia’s powerhouse poultry industry, which produces more broiler chickens than any other in the country, has mostly dodged the kinds of major outbreaks that have resulted in the deaths of more 90 million birds in commercial and backyard poultry flocks in the U.S.

About 1.8 million chickens will be killed at the Colorado poultry farm after these latest bird flu cases were detected.

In late 2023, ducks at a commercial breeding farm in Sumter County, Georgia, tested positive for H5N1. This year, in March, the virus made a jump to a mammal species that surprised many scientists: cows.

With a significant dairy industry, plus even larger beef and poultry interests, the potential arrival of the virus here threatens Georgia’s economy and the health of residents.

As of Monday, the H5N1 virus has been confirmed in 158 dairy herds in 13 states, according U.S. Agriculture Department.

So far in Georgia, there have been no bird flu cases in cattle, and there have been no human cases.

Since the unprecedented spread of H5N1 in poultry in 2022, the Georgia Department of Public Health has quietly monitored 132 people for signs of the virus, according to DPH spokeswoman Nancy Nydam. Those tracked were either first responders to one of the state’s few virus outbreaks in backyard and commercial poultry flocks or farmworkers where the infections occurred. Of those monitored, fewer than 10 people were tested for H5N1 and none came back positive.

Since the virus was discovered in cattle, a small number of first responders from Georgia who went to other states to help with investigations—fewer than 15—have also been monitored for signs of illness.

Federal officials said Tuesday they still believe they can eliminate the bird flu virus from , even as the number of herds infected continues to grow. The latest state to recently report infected dairy cattle was Oklahoma. North Carolina is the only state adjacent to Georgia to report an infected dairy herd.

Eric Deeble, acting senior adviser for the H5N1 response at the USDA, said investigations show the is spreading among cattle through cattle moved from one herd to another and the shared use of milking equipment. It can be contained through enhanced biosecurity measures such as thoroughly cleaning milking “parlors” and equipment, separating sick cows, and having dairy workers wear protective equipment.

Deeble also noted USDA scientists are also working with partners to develop a cattle-specific H5N1 vaccine—a process requires many steps and will take time.

The USDA is also exploring the possibility of developing a poultry vaccine as the number of cases soar, and outbreaks lead to the slaughter of millions of farmed birds. But USDA and industry stakeholders point to challenges that would hinder a vaccination program.

The biggest sticking point is around trade.

Mike Giles, president of the Georgia Poultry Federation, said mass vaccination would be impractical for several reasons, including the fact that the industry would lose its lucrative export market: The United States and many of its trade partners restrict the import of products or eggs from countries affected by the highly pathogenic strain or flocks that have been vaccinated against it.

“(Bird flu) has been, from an animal health standpoint, our top concern,” Giles said. “The challenge, and I think the industry has responded to it well, has been maintaining the state of preparedness and urgency and focus on biosecurity, and I think that has been accomplished.”

2024 The Atlanta Journal-Constitution. Distributed by Tribune Content Agency, LLC.

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Here is the new guidance for RSV vaccines

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Health officials recently changed the guidelines for respiratory syncytial virus vaccines. Here’s what Canadians need to know about the guidance and the virus itself.

New guidance on vaccines

As of July 12, the National Advisory Committee on Immunization (NACI) now recommends RSV vaccines for individuals who are 75 years old and older, especially those who have a greater risk of developing severe RSV.

Based on current evidence and expert opinion, NACI said in a news release, it also strongly recommends vaccines for those aged 60 and older who live in nursing homes and other chronic care facilities.

What is RSV?

RSV is a common contagious virus that often causes bronchiolitis, a lung infection, and pneumonia.

Infants face the highest risk of developing severe RSV disease, however, this risk also increases with age and with certain medical conditions, according to the Public Health Agency of Canada (PHAC). It can lead to serious complications for older people, including hospitalization and death.

What are the symptoms?

RSV typically causes mild, cold-like symptoms that usually begin two to eight days after exposure to the virus, according to PHAC.

Those with RSV may experience a runny nose, coughing, sneezing, wheezing, fever and less appetite and energy. Infants may be irritable, have trouble breathing and have less appetite and energy.

What is the treatment?

RSV infections are usually mild and last about one to two weeks. If you are infected, health officials recommend you stay home and limit contact with others.

They also recommend lots of rest and drinking plenty of fluids. Take over-the-counter products, such as acetaminophen or ibuprofen, if you have a fever. Seek immediate care or go to the hospital if you’re having trouble breathing or become dehydrated, PHAC adds.

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