Is nutritional intake adequate in chronic heart failure patients?

Abstract

ObjectivesThe goal of this study was to investigate the nutrition adequacy and energy availability for physical activity in free-living, clinically stable patients with chronic heart failure (CHF). BackgroundLittle information exists regarding the nutrition adequacy and alimentary habits of patients with clinically stable CHF. We hypothesized that CHF patients have an inadequate intake of calories and protein, leading to a negative calorie and nitrogen balance, an expression of increased tissue breakdown. MethodsIn 57 non-obese patients with CHF (52 males and 5 females; 52 ± 3 years; body mass index <25 kg/m2) and in 49 healthy subjects (39 males and 10 females) matched for age, body mass index, and sedentary life style we evaluated total energy expenditure (TEE), calorie intake (kcalI), and nitrogen intake (NI) from a seven-day food diary, total nitrogen excretion (TNE), and energy availability (EA = kcalI− resting energy expenditure). A zero calorie balance (CB) occurred when kcalI= TEE; a nitrogen balance (NB) in equilibrium was set at NB (= NI− TNE) 0 ± 1 g/day. ResultsIn patients and controls kcalIand NIwere similar. However, in CHF patients the kcalIwas <TEE with a consequent negative CB (−186 ± 305 kcal/day vs. + 104.2 ± 273 kcal/day of controls; p < 0.01). Nitrogen balance resulted negative in CHF (−1.7 ± 3.2 g/24 h vs. + 2.2 ± 3.6 g/24 h in controls; p < 0.01). Energy availability in CHF patients was 41% lower than in controls (p < 0.05). ConclusionsNon-obese, free-living patients with clinically stable CHF have an inadequate intake of calories and protein and reduced energy availability for physical activity.