Which diet choices by a client who has heart failure indicate that the nurse is teaching about diet has been effective?

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The cardiac diet is an eating plan that can help you minimize the impact of your diet on your heart health. The overall goal is to reduce sodium and fat intake. Too much sodium can increase your blood pressure, leading to hypertension. Hypertension is a major risk factor for heart attacks and other heart problems. Fat, on the other hand, can cause plaque to build up on your artery walls, also leading to heart disease.

Other names for the cardiac diet include the heart-healthy diet, the low-sodium diet, and the DASH diet. (DASH stands for dietary approaches to stop hypertension.)

Cancer treatments can lead to short-term and long-term heart problems. The cardiac diet is helpful for people who are trying to manage high blood pressure, reduce their blood cholesterol level, or lower their risk of heart disease.

Here are some guidelines that can help you avoid fat and sodium:

• No more than 25 to 35 percent of your daily calories should come from total fat (this includes saturated fat).
• Less than 7 percent of your daily calories should come from saturated fat.
• Avoid trans fats.
• Consume less than 200 milligrams a day of dietary cholesterol.
• Limit your salt intake; aim for less than 2 grams of sodium per day or less
• Drink alcohol in moderation: one serving per day for women and two per day for men. (One serving is equal to 12 ounces of beer, 5 ounces of wine, and 1.5 ounces of distilled spirits.)

If you are following the cardiac diet, the major foods to watch are salt and saturated fat. Saturated fats are usually animal-based sources of fat, such as butter and lard.

If you have been prescribed a blood thinner, such as warfarin (Coumadin®, Jantoven®), be sure to eat foods rich in vitamin K on a daily basis. This will help prevent blood clots and bleeding. Leafy green vegetables, including kale, spinach, and collards, are the best sources of vitamin K. For more information on vitamin K and blood thinners, ask your doctor or dietitian.

The most common complaint among people on the cardiac diet is the lack of salt. Fortunately, there are a number of ways you can enhance the flavor of your food without the need for sodium.

Here are some suggestions:

• A burst of acidity can brighten a dish. Try lemon juice, lime juice, and vinegar.
• Dry or fresh herbs add flavor. Try basil, bay leaf, dill, rosemary, parsley, sage, dry mustard, nutmeg, thyme, and paprika. You can also buy a sodium-free seasoning blend or make your own at home.
• Black pepper, red pepper flakes, and cayenne pepper can spice up your meals without adding sodium. Hot sauce contains sodium, but if you use just a drop or two, it will not add up to much.
• Buy a sodium-free seasoning blend, such as Mrs. Dash or McCormick’s salt-free blend, or make your own at home.

Here’s a blend of seasonings you can use when trying to cut back on salt. This makes about 1/3 cup.

• 5 teaspoons onion powder
• 2½ teaspoons garlic powder
• 2½ teaspoons paprika
• 2½ teaspoon dry mustard
• 1½ teaspoon crushed thyme leaves
• ½ teaspoon white pepper
• ¼ teaspoon celery seed

Choose heart-healthy carbohydrates.

• Increase your viscous (soluble) fiber intake with foods such as Brussels sprouts, sweet potatoes, turnips, apricots, mangoes, oranges, legumes, barley, oats, and oat bran. Aim for 5 to 10 grams daily. As you increase your fiber intake gradually, also increase the amount of water you drink. This will help you avoid problems with gas.
• Limit refined carbohydrates, such as table sugar, sweets, and beverages sweetened with added sugar.

Choose heart healthy fats.

• Decrease saturated fat by choosing lean protein and low-fat dairy products.

• Monounsaturated fats and omega-3 polyunsaturated fats are good for your heart’s health. Choose nuts, avocados, olives, or olive oil to get monounsaturated fat. Use canola, soybean, or walnut oil to get omega-3 fats.

Reduce fat through your protein choices.

• Bake, broil, roast, stew, or stir-fry very lean cuts of beef or pork, such as those labeled “loin” or “round,” as well as fish and poultry.
• Take the skin off poultry (such as chicken or turkey) before serving it.
• Get protein from plant foods (such as soy, dried beans and legumes, nuts, and seeds) or egg whites instead of meat.

Cut back on sodium.

• Cook foods at home to take charge of the salt content in what you eat.
• When you buy canned goods, select no-sodium or low-sodium options.
• Useas little salt in cooking as possible. You can cut at least half of the salt from most recipes.

Check with your doctor before using any salt substitutes. These products contain large amounts of potassium that your doctor may not want you to have. In particular, people with kidney problems or those taking potassium-sparing diuretics need to take care with potassium. Other salt substitutes, such as Mrs. Dash, do not contain potassium and are safe for everyone.

Sodium claims:

Phrases like “low sodium” and “reduced saturated fat” refer to specific measurements. Here’s a key to understanding those terms:

• Sodium free or salt free means less than 5 milligrams of sodium.
• Very low sodium means 35 milligrams of sodium or less.
• Low sodium means 140 milligrams of sodium of less.
• Reduced sodium means at least 25 percent less sodium than the regular product (beware as the sodium content may still be high).
• Lightin sodium means at least 50 percent less sodium than the full-sodium product.

Saturated fat claims:

How do I know what foods are the right amount of salt or saturated fat? Here are a few tips for reading saturated fat labels.

• Saturatedfat free means less than 0.5 grams of saturated fat and less than 0.5 grams of trans fatty acids.
• Lowin saturated fat means1 gram of saturated fat or less and no more than 15 percent calories from saturated fat.
• Reducedsaturated fat means at least 25 percent less saturated fat and reduced by more than 1 gram of fat compared with the full-fat product.

Try and choose foods with less than 5 grams of total fat per serving, less than 2 grams of saturated fat per serving, and 0 grams of trans fat per serving.

When at a restaurant, don’t hesitate to make special requests. Here are some suggestions:

• Choose entrées, potatoes, and vegetables prepared without sauces, cheese, or butter (or ask for them on the side).
• Eat a small portion of meat. Fill up on vegetables.
• Avoid such toppings as crumbled bacon or cheese.
• Ask for soft margarine or olive oil instead of butter.
• Select foods that are steamed, broiled, baked, roasted, or stir-fried.

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