Effect of a Sodium-Restricted Diet on Intake of Other Nutrients in Heart Failure: Implications for Research and Clinical Practice
Abstract
Background Sodium restriction is the primary dietary therapy for heart failure (HF) patients. Currently, it is unknown if changing diets to reduce dietary sodium in HF causes secondary changes to the intake of other nutrients in this patient population already at nutritional risk. Methods and results HF patients (n = 16; 52 ± 12 years old; 78% male) followed a sodium-restricted diet for 1 week. Nutritional changes were documented at baseline and after a Conclusions We found multiple unintentional nutritional consequences with dietary sodium reduction in HF patients. These findings highlight the need to consider the whole diet when counseling HF patients to lower sodium intake.
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Small studies suggest associations between restrictive diets and undernutrition.
“and small studies suggesting associations between restrictive diets and undernutrition.101,102”
From Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association (2026) · cites this paper as [102]
Cites
HFSA 2010 Comprehensive Heart Failure Practice Guideline
Heart Failure Society of America (2010) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2010.04.004 · Cited by 1,285 · see citing works
Relative contributions of dietary sodium sources
Mattes, R. D., & Donnelly, D. (1991) · Journal of the American College of Nutrition · doi:10.1080/07315724.1991.10718167 · Cited by 595 · see citing works
Chronic heart failure and micronutrients
Witte, K. K., Clark, A. L., & Cleland, J. G. F. (2001) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(01)01227-x · Cited by 237 · see citing works
Arnold, J. M. O., Howlett, J. G., Ducharme, A., Ezekowitz, J. A., Gardner, M. J., Giannetti, N., Haddad, H. A., Heckman, G. A., Isaac, D., Jong, P., et al. (2008) · Canadian Journal of Cardiology · doi:10.1016/s0828-282x(08)70545-2 · Cited by 103 · see citing works
Arcand, J., Brazel, S., Joliffe, C., Choleva, M., Berkoff, F., Allard, J. P., & Newton, G. E. (2005) · American Heart Journal · doi:10.1016/j.ahj.2005.02.016 · Cited by 94 · see citing works
Self-citationSodium food sources in the Canadian diet
Fischer, P. W. F., Vigneault, M., Huang, R., Arvaniti, K., & Roach, P. (2009) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/h09-077 · Cited by 74 · see citing works
A conflict between nutritionally adequate diets and meeting the 2010 dietary guidelines for sodium
Maillot, M., & Drewnowski, A. (2012) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2011.10.009 · Cited by 72 · see citing works
Factors Influencing Food Intake in Patients With Heart Failure
Lennie, T. A., Moser, D. K., Heo, S., Chung, M. L., & Zambroski, C. H. (2006) · The Journal of Cardiovascular Nursing · doi:10.1097/00005082-200603000-00008 · Cited by 72 · see citing works
Furosemide in the long-term management of heart failure
Weber, K. T. (2004) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2004.06.046 · Cited by 70 · see citing works
Nutritional Inadequacies in Patients with Stable Heart Failure
Arcand, J., Floras, V., Ahmed, M., Al‐Hesayen, A., Ivanov, J., Allard, J. P., & Newton, G. E. (2009) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2009.08.011 · Cited by 60 · see citing works
Self-citationFemoral bone mineral density in patients with heart failure
Kenny, R. A., Boxer, R. S., Walsh, S. J., Hager, W. D., & Raisz, L. G. (2006) · Osteoporosis International · doi:10.1007/s00198-006-0148-4 · Cited by 57 · see citing works
Arcand, J., Floras, J. S., Azevedo, E., Mak, S. S., Newton, G. E., & Allard, J. P. (2010) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.110.004457 · Cited by 55 · see citing works
Self-citationEffect of dietary sodium restriction on overall nutrient intake
Morris, C. (1997) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/65.2.687s · Cited by 39 · see citing works
Effects of a salt-restricted diet on the intake of other nutrients
Korhonen, M. J., Järvinen, R., Sarkkinen, E. S., & Uusitupa, M. I. J. (2000) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/72.2.414 · Cited by 30 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure
Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., et al. (2022) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.12.012 · Cited by 2,862 · see citing works
Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001063 · Cited by 4,922 · see citing works
Domain Management Approach to Heart Failure in the Geriatric Patient
Gorodeski, E. Z., Goyal, P., Hummel, S. L., Krishnaswami, A., Goodlin, S. J., Hart, L. L., Forman, D. E., WENGER, N. K., Kirkpatrick, J. N., & Alexander, K. P. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.02.059 · Cited by 264 · see citing works
Vest, A. R., Chan, M. C. Y., Deswal, A. M., Givertz, M. M., Lekavich, C. L., Lennie, T. A., Litwin, S. E., Parsly, L., Rodgers, J. E., Rich, M. W., et al. (2019) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2019.03.007 · Cited by 233 · see citing works
Individualized Nutritional Support for Hospitalized Patients With Chronic Heart Failure
Hersberger, L., Dietz, A., Bürgler, H., Bargetzi, A., Bargetzi, L., Kägi-Braun, N., Tribolet, P., Gomes, F., Hoess, C., Pavlicek, V., et al. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.03.232 · Cited by 168 · see citing works
Home-Delivered Meals Postdischarge From Heart Failure Hospitalization
Hummel, S. L., Karmally, W., Gillespie, B. W., Helmke, S. T., Teruya, S. L., Wells, J., Trumble, E. L., Jimenez, O. G., Marolt, C., Wessler, J. D., et al. (2018) · Circulation Heart Failure · doi:10.1161/circheartfailure.117.004886 · Cited by 159 · see citing works
Iron Deficiency in Heart Failure: Mechanisms and Pathophysiology
Alnuwaysir, R. I. S., Hoes, M. F., van Veldhuisen, D. J., van der Meer, P., & Beverborg, N. G. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm11010125 · Cited by 170 · see citing works
Butrous, H., & Hummel, S. L. (2016) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2016.05.005 · Cited by 145 · see citing works
The role of diet and nutrition in heart failure: A state-of-the-art narrative review
Billingsley, H. E., Hummel, S. L., & Carbone, S. (2020) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2020.08.004 · Cited by 106 · see citing works
Wawrzeńczyk, A., Anaszewicz, M., Wawrzeńczyk, A., & Budzyński, J. (2019) · Heart Failure Reviews · doi:10.1007/s10741-019-09793-2 · Cited by 74 · see citing works
Micronutrient deficiency independently predicts time to event in patients with heart failure
Lennie, T. A., Andreae, C., Rayens, M. K., Song, E. K., Dunbar, S. B., Pressler, S. J., Heo, S., Kim, J., & Moser, D. K. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.117.007251 · Cited by 69 · see citing works
d’Almeida, K. S. M., Rabelo, E. R., Souza, G. C., Trojahn, M. M., Barilli, S. L. S., Aliti, G. B., Rohde, L. E. P., Biolo, A., & Neto, L. B. D. S. (2018) · Nutrition · doi:10.1016/j.nut.2018.02.007 · Cited by 56 · see citing works
The role of dietary salt in metabolism and energy balance: Insights beyond cardiovascular disease
Wu, Q., Burley, G., Li, L., Lin, S., & Shi, Y. (2023) · Diabetes Obesity and Metabolism · doi:10.1111/dom.14980 · Cited by 57 · see citing works
Bilgen, F., Chen, P., Poggi, A. D., Wells, J. M., Trumble, E. L., Helmke, S. T., Teruya, S. L., Catalan, T., Rosenblum, H., Cornellier, M. L., et al. (2020) · JACC Heart Failure · doi:10.1016/j.jchf.2020.04.004 · Cited by 45 · see citing works
Abu‐Sawwa, R., Dunbar, S. B., Quyyumi, A. A., & Sattler, E. L. P. (2019) · Heart Failure Reviews · doi:10.1007/s10741-019-09781-6 · Cited by 30 · see citing works
Dietary management of heart failure: room for improvement?
Butler, T. (2016) · British Journal Of Nutrition · doi:10.1017/s000711451500553x · Cited by 28 · see citing works
Sattler, E. L. P., Ishikawa, Y., Trivedi, R., Zhang, D. “., Quyyumi, A. A., & Dunbar, S. B. (2019) · Nutrients · doi:10.3390/nu11112608 · Cited by 26 · see citing works
Montgomery, R. A., Mauch, J., Sankar, P. R., Martyn, T., Engelman, T., Martens, P., Faulkenberg, K. D., Menon, V., Estep, J. D., & Tang, W. H. W. (2023) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2023.03.018 · Cited by 24 · see citing works
Colin-Ramírez, E., & Ezekowitz, J. A. (2018) · American Heart Journal · doi:10.1016/j.ahj.2018.08.005 · Cited by 20 · see citing works
Belak, L., Owens, C. E., Smith, M. E., Calloway, E. E., Samnadda, L., Egwuogu, H., & Schmidt, S. (2022) · BMC Nutrition · doi:10.1186/s40795-022-00602-y · Cited by 19 · see citing works
Effect of Dietary Sodium Restriction on the Quality of Life of Patients With Heart Failure
Zhu, C., Cheng, M., Su, Y., Ma, T., Lei, X., & Hou, Y. (2021) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0000000000000880 · Cited by 16 · see citing works
Vest, A. R., DiDomenico, R. J., Lichtenstein, L., Slater, T., Ekpo, E., Damluji, A. A., Bohula, E., Alviar, C. L., on behalf of the American Heart Association Acute Cardiac Care and General Cardiology Committee of the Council on Clinical Cardiology, & Council on Cardiovascular and Stroke Nursing (2026) · Circulation · doi:10.1161/cir.0000000000001405 · Cited by 15 · see citing works
Medically Tailored Meals in Heart Failure: A Systematic Review of the Literature, 2013-2023
McIntosh, N. M., Billingsley, H., Hummel, S. L., & Mills, W. L. (2024) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2024.10.446 · Cited by 12 · see citing works
Therapeutic Ketosis for Heart Failure: A State-of-the-Art Review
Kodur, N., Nguyen, C. T., & Tang, W. H. W. (2025) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2025.01.028 · Cited by 12 · see citing works
Bahat, G., Ribeiro, H., Sheppard, J. P., Bogaerts, J. M. K., Camafort, M., Dallmeier, D., Backer, T. L. M. D., Desideri, G., Olszanecka, A., Persu, A., et al. (2024) · Journal of Hypertension · doi:10.1097/hjh.0000000000003844 · Cited by 9 · see citing works
Nonpharmacological Strategies in Heart Failure with Preserved Ejection Fraction
Bohmke, N. J., Billingsley, H., Kirkman, D. L., & Carbone, S. (2022) · Cardiology Clinics · doi:10.1016/j.ccl.2022.06.003 · Cited by 9 · see citing works
Colin-Ramírez, E., Arcand, J., Woo, E., Brum, M., Morgan, K., Christopher, W. H., VELÁZQUEZ, L. D. S., Sharifzad, A., Feeney, S., & Ezekowitz, J. A. (2019) · CJC Open · doi:10.1016/j.cjco.2019.11.006 · Cited by 7 · see citing works
Self-citationInsight Into Differences in Dietary Sodium Adherence Between Men and Women With Heart Failure
Lennie, T. A., Moser, D. K., & Chung, M. L. (2020) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0000000000000641 · Cited by 7 · see citing works
Dietary Sodium Intake and Outcomes: a Secondary Analysis From Sodium-HF
Saldarriaga, C., Colin-Ramírez, E., Islam, S., Alemayehu, W. G., Macdonald, P. S., Ross, H. J., Escobedo, J., Lanas, F. T., Troughton, R. W., McAlister, F. A., et al. (2024) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2024.04.031 · Cited by 6 · see citing works
Dietary Self-management in Heart Failure: High Tech or High Touch?
Colin-Ramírez, E., Arcand, J., & Ezekowitz, J. A. (2017) · Current Treatment Options in Cardiovascular Medicine · doi:10.1007/s11936-017-0515-9 · Cited by 6 · see citing works
Self-citationNutrition in Heart Failure: More Than Drugs and Devices
Rich, M. W., & Hauptman, P. J. (2015) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2015.10.013 · Cited by 6 · see citing works
Nutrition Intervention Process for Heart Failure Patients according to Their Nutritional Problems
Lee, H., Jeong, S. Y., Choi, H.-R., & Kang, S. (2021) · Clinical Nutrition Research · doi:10.7762/cnr.2021.10.2.172 · Cited by 5 · see citing works
Anderson, K. M., Schroeder, S. E., DiDomenico, R., Carbone, S., Barsness, C., Denfeld, Q., McPherson, A., Bergeron, A., Alonso, W. W., Hallman, C. M., et al. (2025) · Heart & lung : the journal of critical care · doi:10.1016/j.hrtlng.2025.11.009 · Cited by 4 · see citing works
Marolt, C., Miller, A., Carlozzi, N. E., Karmally, W., Helmke, S. T., Teruya, S. L., Wells, J., Trumble, E. L., Maurer, M. S., & Hummel, S. L. (2019) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2019.09.011 · Cited by 3 · see citing works
Domain management as the best way of manage patient with heart failure and geriatrics syndromes
Fedin, M. A., Дмитриевич, И. А., Eruslanova, K. A., Kotovskaya, Y. V., & Ткачева, О. Н. (2021) · Russian Journal of Geriatric Medicine · doi:10.37586/2686-8636-4-2020-313-326 · Cited by 3 · see citing works
Association between energy intake patterns and outcome in US heart failure patients
Fang, Z., Wang, Z., Cao, X., Wang, Z., Yu, C., Ju, W., & Li, D. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.1019797 · Cited by 3 · see citing works
Nutritional Assessment and Dietary Interventions in Older Patients with Heart Failure
Lee, R., Tam, M., CASCINO, T. M., & Hummel, S. L. (2018) · Current Cardiovascular Risk Reports · doi:10.1007/s12170-018-0580-y · Cited by 2 · see citing works
Nutrition Assessment and Education of Patients with Heart Failure by Cardiologists
Dotare, T., Maeda, D., Matsue, Y., Nakamura, Y., Sunayama, T., Iso, T., Nakade, T., & Minamino, T. (2024) · International Heart Journal · doi:10.1536/ihj.23-462 · Cited by 2 · see citing works
Matsui, M., Kokubu, M., Nishimoto, M., Kosugi, T., Eriguchi, M., Samejima, K., & Tsuruya, K. (2026) · Kidney & Blood Pressure Research · doi:10.1159/000550676 · Cited by 1 · see citing works
Ernährung bei Herzinsuffizienz
Mueller, M., Siegenthaler, J., Fäh, D., & Schüetz, P. (2022) · Praxis · doi:10.1024/1661-8157/a003860 · Cited by 1 · see citing works
MEDICAL DIAGNOSIS DOES NOT INFLUENCE FOOD INTAKE IN FRAIL LONG-TERM CARE RESIDENTS
Barkema, W. S., Heckman, G. A., Slaughter, S. E., Carrier, N., Lengyel, C. O., & Keller, H. (2019) · The Journal of Nursing Home Research Sciences · doi:10.14283/jnhrs.2019.9 · Cited by 1 · see citing works
Oyabu, C., Ushigome, E., Ono, Y., Kobayashi, A., Hashimoto, Y., Sakai, R., Iwase, H., Okada, H., Yokota, I., Tanaka, T., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18136913 · Cited by 1 · see citing works
OBSOLETE: Diet in Heart Failure
Ezekowitz, J. A. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-801238-3.99653-3
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Baloğlu, H. T. (2020) · Sağlık Bilimleri Dergisi · doi:10.34108/eujhs.446752
Rozmahel, M., Colin-Ramírez, E., & Ezekowitz, J. A. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-809657-4.99653-4
Belak, L., Owens, C. E., Smith, M., Calloway, E. E., Samnadda, L., Egwuogu, H., & Schmidt, S. (2022) · Research Square · doi:10.21203/rs.3.rs-1591141/v1
Malnutrition management of hospitalized patients with diabetes/hyperglycemia and heart failure
Murillo, A. Z., Chinchetru, M. A. J., Burgos, R., Almeida, J. M. G., Matía-Martín, P., Milla, S. P., París, A. S., Martínez, J. J. A., Fullana, A. A., Continente, A. J. C., et al. (2022) · Nutrición Hospitalaria · doi:10.20960/nh.04508
Cardiovascular rehabilitation and lifestyle modifications
Volterrani, M., Solal, A. C., Adamopulos, S., Miliopoulos, D., Iellamo, F., & Piepoli, M. F. (2023) · doi:10.1093/med/9780198891628.003.0058
Kashiwakura, D., Hiyama, A., Muramatsu, M., Hinotsu, A., Takeda, M., Suzuki, N., Akiyama, S., Kurihara, S., & Kida, K. (2024) · JMIR Research Protocols · doi:10.2196/60719
Nutrition and Diet Quality in Pulmonary Arterial Hypertension
Al‐Naamani, N., Prakash, M., Pugliese, S. C., Fritz, J. S., Smith, K. A., Palevsky, H. I., & Compher, C. W. (2024) · Annals of the American Thoracic Society · doi:10.1513/annalsats.202405-563rl
Belak, L., Owens, C., Smith, M., Calloway, E. E., Samnadda, L., Egwuogu, H., & Schmidt, S. (2022) · Figshare · doi:10.6084/m9.figshare.21268982
Belak, L., Owens, C., Smith, M., Calloway, E. E., Samnadda, L., Egwuogu, H., & Schmidt, S. (2022) · Figshare · doi:10.6084/m9.figshare.21268976
Belak, L., Owens, C., Smith, M., Calloway, E. E., Samnadda, L., Egwuogu, H., & Schmidt, S. (2022) · Figshare · doi:10.6084/m9.figshare.21268979
Rozmahel, M., Colin-Ramírez, E., & Ezekowitz, J. A. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-15734-9.00094-7
Lalande, A., Eppler, E., Chiang, T., Pow, L., Deng, Y., Gadhari, N., Zhao, J., & MacNeill, A. J. (2026) · The Lancet Planetary Health · doi:10.1016/j.lanplh.2026.101483
- Authors
- Jefferson, K., Ahmed, M., Choleva, M., Mak, S., Allard, J. P., Newton, G. E., & Arcand, J.
- Affiliations
- University of Toronto (CA)
- Mount Sinai Hospital (CA)
- University Health Network (CA)
- Corresponding author
- Arcand, JoAnne
- Venue
- Journal of Cardiac Failure
- Publisher
- Elsevier BV
- Published
- 2015-12
- Volume
- 21
- Issue
- 12
- Pages
- 959-962
- ISSN
- 1071-9164 (ISSN-L)
- OpenAlex
- W1945378553
- Cited by
- 55
- References
- 14
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 6 · 2023: 3 · 2022: 11 · 2021: 6 · 2020: 4 · 2019: 7 · 2018: 6 · 2017: 3 · 2016: 2 · 2015: 1
- FWCI
- 3.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Cardiac Failure (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Heart and Stroke Foundation of Ontario (NA-5897)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- heart failure, sodium restriction, dietary sodium reduction, nutrient intake, energy intake, carbohydrate intake, calcium intake, thiamine, folic acid, saturated fat, potassium, nutritional risk, nutrition counseling
- MeSH terms
- Adult, Energy Intake, Diet, Sodium-Restricted, Feeding Behavior, Female, Follow-Up Studies, Heart Failure, Humans, Male, Middle Aged, Ontario, Outpatients, Sodium, Dietary, Cohort Studies, Clinical Medicine, Nutrition Assessment, Treatment Outcome, Risk Assessment, Biomedical Research, Tertiary Care Centers
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