MALNUTRITION AND HEART FAILURE
Patients with HF often describe difficulties eating a balanced diet due to nausea, abdominal bloating, early fullness after meals, and changes in taste and smell. Prior studies suggest that as many as half of patients with HF have nutritional intake that does not meet their health needs.
Micronutrient (vitamin and mineral) insufficiencies and inadequate protein intake are common. Micronutrition supplementation has not been shown to be beneficial in patients with HF to date, with the possible exceptions of omega-3 fatty acids and co-enzyme Q10.
Protein-calorie supplementation, for example with high protein shakes, has not been well-studied, but is often recommended in this setting. A recent study from Switzerland demonstrated the value of individualized malnutrition treatment for patients with HF during a hospitalization.
MUSCLE WASTING IN HEART FAILURE
Patients with HF frequently report loss of muscle mass and strength, particularly in the arms and legs, that progresses as the HF syndrome becomes more advanced. It is thought that this skeletal muscle wasting contributes to the physical limitations experienced by patients with HF.
It has also been shown in a European cohort that patients with HF with greater muscle wasting have a shorter life-expectancy than those with preserved muscle mass. Our research team is seeking both methods to accurately and conveniently measure skeletal muscle mass and an understanding of the metabolic processes driving muscle wasting to enable us to develop new therapies to maintain muscle mass.
Obesity is strongly associated with HF development and maintenance of a normal-range weight throughout the lifespan is a key strategy for preventing HF.
Small studies suggest that dietary, exercise, pharmacotherapy and surgical strategies can all be important for achieving weight loss and improving cardiovascular health for patients with HF.
Bariatric surgery achieves the greatest weight loss and is known to improve cardiac structure and function. More recently, bariatric surgery has been shown to halve the development of new HF for adults with obesity and also reduces HF hospitalizations and cardiovascular mortality in patients with pre-existing HF.