The heart failure and sodium restriction controversy: Challenging conventional practice

Katherine R. Beich, Clyde Yancy

Research output: Contribution to journalReview articlepeer-review

25 Scopus citations


Optimal care of patients with heart failure requires a multifaceted approach that includes guideline-driven, evidence-based therapies, intensive patient education, careful initial and follow-up assessment, and appropriately constructed nutrition prescriptions. Central to the construct of the nutrition prescription is advice regarding sodium consumption. It is intuitively and generally agreed upon that sodium restriction is appropriate for patients with heart failure, despite the lack of evidence-based research studies. Whereas limiting sodium is most appropriate for the hypertensive patient at risk for developing heart failure and the patient who is overtly volume overloaded, less certainty exists regarding the sodium prescription for patients with diagnosed heart failure that is well compensated. Sodium intake is only 1 component of medical nutrition therapy, and prescription must be individualized according to nutrition assessment and priority of needs. However, in the absence of new compelling data, sodium restriction remains the most appropriate dietary intervention in general for patients with heart failure.

Original languageEnglish (US)
Pages (from-to)477-486
Number of pages10
JournalNutrition in Clinical Practice
Issue number5
StatePublished - Oct 2008


  • Diet
  • Heart failure
  • Hypertension
  • Nutrition therapy
  • Sodium
  • Sodium-restricted

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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