Nutrition Education Based on the Sodium Consumption is Necessary to Improve Dietary Sodium Adherence in Heart Failure Outpatients

Sodium restriction is the primary dietary therapy in heart failure (HF); however, assessing sodium intake is challenging to clinicians, who commonly rely on patients' self-report of following a low-sodium diet to determine adherence. Outpatients with HF who have been taught on a low-sodium diet with a target of less than 6g/d were included. Nutrition education was performed based on the sodium consumption, which can be estimated with 24-h urinary sodium excretion from a single morning urine specimen. Overall, 20 patients (mean age, 76 years, 80% men) were included. The mean estimated 24-h sodium excretion was 10.0±2.8g, and 10% were adherent to the <6g recommendation. Patients who took the nutrition education (n=16) had significant reduction of sodium intake compared with patients who didn't take the nutrition education (n=4) during mean duration of follow-up of 34 days (-1.5±1.8g vs. 0.9±0.8g, p=0.02). Fluid management was improved by nutrition education without any drug add-on in 6 patients with HF deterioration. Nutrition education, based on the sodium consumption from urinary excretion, could be a practical treatment tool in deteriorated HF outpatients.