Abstract 17418: Daily Intake of Fruits and Vegetables Moderates the Effect of a Nutrition Intervention on Symptom Burden in Patients With Heart Failure

Abstract

Introduction: Patients with heart failure (HF) often remain symptomatic after optimization of medical treatment. Complementary interventions may reduce symptom burden. We conducted a 6-month randomized controlled trial of a nutrition intervention (NIHFT) to reduce fluid overload, oxidative stress, and inflammation, which are major pathologic pathways underlying HF symptoms.Aims: 1) To examine the effects of NIHFT on HF symptom burden (i.e., shortness of breath, edema, and fatigue); and 2) to determine if intake of fruits and vegetables, primary sources of antioxidants and anti-inflammatories, moderated the effect of the NIHFT on HF symptom burden. Methods: Patients with HF (n=116) with complete baseline data were included (61% male, 63±12 years old, 64% NYHA III/IV). Intervention group received 1) individualized educational intervention for sodium reduction that included promoting fruit and vegetable intake, 2) daily low sodium tomato or vegetable juice, and 3) omega-3 supplementation (1050 mg EPA, 150 mg DHA/capsule/day) for 6 months. Symptom burden was measured by the Memorial Symptom Assessment Scale-HF at baseline and 3 and 6-month. Daily intake of fruits and vegetables at baseline was dichotomized (≤1 vs ≥2 servings/day). A linear mixed-effect model was used. Results: There was no direct effect of the NIHFT on symptom burden. However, baseline intake of fruits and vegetables moderated the effect of the intervention on overall symptom burden scores (beta estimate= -4.67, SE=1.89, P=0.015). Reduction in symptom burden was greater among patients with lower baseline fruit and vegetable intake compared to those with higher intake. Among the subscales (i.e., frequency, severity, and distress) of overall symptom burden, frequency (beta estimate= -1.63, SE=0.66, P=0.014) and severity (beta estimate= -1.81, SE=0.61, P=0.004) were significantly moderated by the intake of fruits and vegetables. Conclusions: The findings indicate that the nutrition intervention was more effective in reducing symptom burden for patients with lower baseline intake of fruits and vegetables. This suggests that increased fruit and vegetable intake may further reduce HF symptom burden in patients on optimal medication therapy.