Heart Failure Diet: Foods To Eat and Avoid

Successfully living with heart failure often requires immediate lifestyle changes, with dietary choices topping the list. Think of your meals as medicine. What you eat can help or hurt your weakened heart.

So what food should and should not be on your plate? Registered dietitian Julia Zumpano, RD, LD, has some definite menu recommendations. (SPOILER ALERT: There’s a big focus on reducing sodium intake.)

What should you eat if you have heart failure?

What you eat can help you manage heart failure to slow its progression and minimize its impact on your life. Basically, your mealtime choices can help you stay active and healthier while living with the condition.

“Everything you eat affects your entire body, including your heart,” says Zumpano. “Making good dietary choices — especially when it comes to sodium — is critical if you’ve been diagnosed with heart failure.”

Why is sodium such a no-no with heart failure? Basically, it’s because too much sodium in your diet can lead to your body retaining excess water. The resulting fluid buildup forces your compromised heart to work harder.

“You’re putting extra strain on a heart that’s already having trouble keeping up,” says Zumpano.

But reducing sodium in your diet lessens extra fluid retention, which can take some pressure off your ticker. Basically, it’s a way to help a compromised cardiovascular system.

Someone living with heart failure should try to limit sodium consumption to less than 2,000 milligrams (mg) per day, advises Zumpano. To put that in perspective, that’s less sodium than what is in a teaspoon of table salt.

Foods to include in a heart-failure diet

If you’re wondering where to steer your grocery cart to find food low in sodium, Zumpano has a map: “I often suggest that you try to shop the outside of the grocery store, where you’ll find your fresh produce, fresh meats and fresh dairy,” she says.

Ideal items to grab include:

• Fruits and vegetables: No shocker here, right? “Fresh fruit and vegetables are packed with nutrients and have no or very, very little natural sodium,” notes Zumpano. (If you go the frozen or canned route, look for no-salt-added options.)
• Fresh meats: Fresh beef, pork, poultry and fish are just … well, raw meat with minimal amounts of natural sodium. “The best options for meat are where there has been little to no extra processing,” says Zumpano. It’s best to opt for leaner cuts of meat, too.
• Dairy: Yogurt and milk aren’t very high in sodium, says Zumpano. Cheese can be tricky, but there are varieties (Swiss, fresh mozzarella, brick and goat cheeses) that are naturally lower. There are some reduced-sodium options, too.
• Nuts and seeds: Look for unsalted nuts and seeds to keep these nutritional powerhouses in your diet.
• Fresh grains and dried beans: Can it take a little longer to prepare dried beans or fresh grains like brown rice, wild rice and oats? Yes. But the payoff is healthier food for very little sodium compared to many convenience options. (For a shortcut, check the freezer section. Some of these foods can be found cooked and frozen without any added salt.)
• Herbs and spices: A dash of an herb or pinch of spice can add flavor to meals without sodium. But be wary of prepackaged spice and seasoning blends. “Salt usually gets mixed in with the herbs and spices — and the sodium adds up quickly,” says Zumpano.

What about low-sodium products?

Grocery shelves are loaded with products labeled “Low Sodium” or “No Sodium.” Low sodium means that food has 140 mg or less of sodium per serving. No sodium means that food has less than 5 mg of sodium per serving.

Be cautious of foods labeled “lower, “reduced,” or “less” sodium, warns Zumpano. While these products do offer lower sodium content than the regular version of the food, they might not actually be “low” when it comes to sodium content.

An example would be soy sauce, where a splash of the “reduced sodium” flavoring still may contain a significant amount of sodium.

“This is where reading nutrition labels at the store becomes so important,” says Zumpano. “Be mindful of the milligrams of sodium that are actually in a serving — not just that it’s less than normal.”

Foods to avoid with heart failure

As you might suspect, the big emphasis is on limiting or cutting out foods high in sodium.

Thankfully, food labels in the United States include a section that tells how much sodium is in a single serving of a food item. Zumpano suggests avoiding foods that include more than 140 mg of sodium per serving.

“Take the time to read labels,” says Zumpano. “The more you look, the more surprised you may be as to where sodium pops up.”

The long list of foods high in sodium includes:

• Processed meats like hot dogs, sausages and sandwich fixings (ham, salami, pepperoni, etc.)
• Frozen dinners
• Pizza
• Pasta and rice mixes
• White bread and products like bagels and biscuits
• Soup
• Sauces and dressings
• Canned vegetables
• Vegetable juice
• Salty snacks like chips and pretzels
• Pudding

It’s worth noting that most sodium in the average American’s diet comes from processed foods and convenience foods. By some estimates, more than 70% of consumed sodium is added during commercial processing.

“Sodium is one of the best ways to preserve convenience foods and extend their shelf life,” explains Zumpano. “It’s simple, inexpensive and effective — which is why so much of it ends up in processed food.”

So, again, check those labels.

Other diet tips if you have heart failure

Eating smarter and healthier is key to living better with heart failure. Steps you can take in that direction include:

• Hiding your salt shaker: Ditching the habit of shake-shake-shaking salt onto food brings an instant reduction in sodium consumption. (FYI, too: While sea salt and kosher salt are less processed than ordinary table salt, they aren’t low in sodium.)
• Cooking smartly: If you have a favorite recipe that includes salt, experiment and try reducing how much you use to minimize sodium content. Adding a bit less salt often won’t seriously change the taste of the dish.
• Going simple at restaurants: Look for simply prepared foods if you eat out. More processed food is more likely to be high in sodium. So, opt for a baked potato instead of mashed potatoes, or choose a side salad (dressing on the side) over a bowl of soup.
• Keeping a journal: It might help to keep a record of how much sodium you eat every day to track progress. You can write it down or use a meal tracking app. “It’s about building knowledge so you can make the best choices,” says Zumpano.

Final thought: Be patient

Reducing sodium in your diet can be difficult at first. Food probably won’t taste the same as you cut back. But as you make healthy changes, your taste buds will adjust — and that’s a good thing!

“Something that didn’t taste salty to you in the past will taste extremely salty to you after adhering to a low-sodium diet for just a week or two,” says Zumpano. “It will help reinforce your good choices, and it will become easier to follow sodium restrictions.”