Abstract

The aims of this study were to (1) compare diet quality between patients with heart failure (HF) and age- and sex-matched community-dwelling healthy older adults and (2) determine whether having HF was associated with a lower Healthy Eating Index-2015 (HEI-2015) score and risk of micronutrient deficiency. The HEI-2015 and macro- and micronutrient intakes of patients with HF were compared with healthy older adults (N 102; 55-92 years old; 53% female). A paired t-test or Wilcoxon singed-rank test, McNemar's test, and conditional logistic regression were used to assess the association between diet quality and HF status. Median values for HEI-2015 and the number of micronutrient deficiency were used to dichotomise into groups in the conditional logistic regression. There was no significant between-group difference in the HEI-2015 total score (P 0⋅059), whereas the whole grain component was lower in patients with HF than in healthy older adults (3⋅1 ± 3⋅5 v. 4⋅5 ± 3⋅1, P 0⋅037; respectively). Total caloric intake was lower in patients with HF than in healthy older adults (1683 ± 595 v. 2104 ± 670 kcal; P < 0⋅001). Patients with HF had a higher average number of micronutrient deficiencies than healthy older adults (4[2, 6] v. 1[0, 4], respectively, P < 0⋅001). Patients with HF had four times higher odds of being in a high micronutrient deficiency group than healthy older adults, controlling for socio-demographics and body mass index (adjusted odds ratio [95% confidence interval]: 4⋅04[1⋅06, 15⋅41]). Our findings demonstrate that diet quality measured by nutritional intake identifies patients with HF with lower caloric intake and higher micronutrient deficiencies compared with age- and sex-matched healthy older adults.

Highlights

  • Heart failure (HF) is a growing epidemic that affected approximately 6⋅2 million individuals in the United States between 2013 and 2016(1)

  • There was a higher proportion of hypertension and diabetes mellitus in patients with HF compared with healthy older adults (P < 0⋅001)

  • When we adjusted micronutrient intake per 1000 kcal/d, magnesium (174 [159, 192] v. 152 [140, 165], P 0⋅037) and vitamin C (74⋅8 [56⋅6, 98⋅7] v. 48⋅6 [35⋅4, 66⋅6], P 0⋅049) were still significantly lower in patients with HF compared with healthy older adults (Table 5)

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Summary

Introduction

Heart failure (HF) is a growing epidemic that affected approximately 6⋅2 million individuals in the United States between 2013 and 2016(1). Major advances in medical management of HF have decreased symptom burden and improved outcomes, patients remain at risk for frequent rehospitalisations and death after optimisation of medical treatment[4]. Nutrition is among the non-pharmacologic factors that can complement medical treatment to improve HF outcomes[5]. Most patients with HF need improvement in their diet quality[6]. Most patients with HF are older, and older age is associated with consuming lower quality diet[8]. It is not known whether lower diet quality in patients with HF is primarily a journals.cambridge.org/jns

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