Assessment of Dietary Behaviors and Influencing Factors Among Patients with Heart Failure: A Cross-Sectional Study

Year 2025, Volume: 15 Issue: 3, 661 - 673, 30.09.2025

Duygu Mataracı Değirmenci , Yasemin Kalkan Uğurlu , Zehra Tuğçe Bayrak , Aleyna Aksu

https://doi.org/10.33808/clinexphealthsci.1685936

Abstract

Objective: This study was conducted to determine the nutritional behaviours and related factors in individuals with heart failure (HF).
Methods: The study was descriptive in nature and was conducted with a sample of 178 individuals over 18 years of age and diagnosed with HF. Data were collected using the Patient Information Form and the Scale for Dietary Behaviors in Heart Failure (SDBHF)
Results: It was found that SDBHF total scores of the participants differed according to variables such as comorbidity, hypertension, smoking duration, special diet application status, reason for skipping lunch and snack consumption status (p<.05). In addition, it was determined that the scores of the Healthy Habits Subscale of the SDBHF differed according to the snack consumption status of the participants (p<.05). It was found that the Salt Restriction Subscale scores differed according to variables such as hypertension and special diet application status (p<.05). It was determined that the Sugar Restriction subscale scores differed according to variables such as gender, employment status, presence of diabetes, smoking duration, alcohol consumption status and special diet application status (p<.05). Prevention of Fluid Retention subscale scores were found to differ according to variables such as gender, marital status, educational status, employment status, income level, smoking duration, chewing difficulty after memory, and presence of constipation after diagnosis (p<.05).
Conclusion: The results showed that the nutritional status of HF patients is in accordance with the current guidelines.

Keywords

Diet , heart failure , nutrition

Ethical Statement

The informed consent form was read to the volunteers by the researcher, their written consent was obtained and they were included in the study. The informed consent form included explanations that the participants could leave the study at any time, that their answers to the questions would be kept confidential and would not be shared with anyone, that participation in the study was completely voluntary and that there was no obligation to participate. Written permission for use was obtained from the author who developed the scale used in the study. Ethical approval was obtained from the Non-Interventional Scientific Research Ethics Committee of Ordu University and institutional approval was obtained from Giresun Provincial Health Directorate.

Thanks

We would like to thank the cardiology clinic staff for their friendly attitude during the collection of study data and the heart failure patients who volunteered to participate in the study and patiently answered the questions.

References

• Wickman BE, Enkhmaa B, Ridberg R, Romero E, Cadeiras M, Meyers F, Steinberg F. Dietary management of heart failure: DASH diet and precision nutrition perspectives. Nutrients. 2021;13(12):4424-4448. https://doi.org/10.3390/nu13124424
• Chen AT, Zhang J, Zhang Y. Gut microbiota in heart failure and related interventions. Imeta. 2023;2(3),e125-e143. https://doi.org/10.1002/imt2.125
• Ishikawa Y, Sattler EL. Nutrition as treatment modality in heart failure. Curr Atheroscler Rep. 2021;23:1-9. https://doi.org/10.1007/s11883-021-00908-5
• Asil E, Yıldız E. Kalp yetersizliği hastalarında beslenme durumunun belirlenmesi. Beslenme ve Diyet Dergisi. 2017;45(3):273-277. (Turkish)
• Driggin E, Cohen LP, Gallagher D, Karmally W, Maddox T, Hummel SL, Maurer MS. Nutrition assessment and dietary interventions in heart failure: JACC review topic of the week. J Am Coll Cardiol. 2022;79(16):1623-1635. https://doi.org/10.1016/j.jacc.2022.02.025
• Razavi AC, Monlezun DJ, Sapin A, Sarris L, Schlag E, Dyer A, Harlan T. Etiological role of diet in 30-day readmissions for heart failure: implications for reducing heart failure–associated costs via culinary medicine. Am J Lifestyle Med. 2020;14(4):351-360. https://doi.org/10.1177/1559827619861933
• Sedlar N, Lainscak M, Farkas J. Self‐care perception and behaviour in patients with heart failure: A qualitative and quantitative study. ESC Heart Fail. 2021;8(3):2079-2088. https://doi.org/10.1002/ehf2.13287
• Burgermaster M, Rudel R, Seres D. Dietary sodium restriction for heart failure: a systematic review of intervention outcomes and behavioral determinants. Am J Med. 2020;133(12):1391-1402. https://doi.org/10.1016/j.amjmed.2020.06.018
• Kkeveetil CV, Thomas G, Chander SJU. Role of micronutrients in congestive heart failure: A systematic review of randomized controlled trials. Tzu Chi Med J. 2016;28(4),143-150. https://doi.org/10.1016/j.tcmj.2016.08.001
• Colin-Ramirez E, Sepehrvand N, Rathwell S, Ross H, Escobedo J, Macdonald P, Ezekowitz JA. Sodium restriction in patients with heart failure: A systematic review and meta-analysis of randomized clinical trials. Circ Heart Fail. 2023;16(1): e009879. https://doi.org/10.1161/CIRCHEARTFAILURE.122.009879
• Boy Y, Enç N. A scale development study for evaluating the dietary behaviors of patients with heart failure. Heart Lung. 2022;53:61-66. https://doi.org/10.1016/j.hrtlng.2022.01.017
• Kida K, Miyajima I, Suzuki N, Greenberg BH, Akashi YJ. Nutritional management of heart failure. J Cardiol. 2023;81(3):283-291. https://doi.org/10.1016/j.jjcc.2022.11.001
• Drazner, M. H., Dunlay, S. M., Evers, L. R., Fang, J. C., Fedson, S. E., Fonarow, G. C., ... & Nnacheta, L. C. (2022). 2022 AHA/ACC/HFSA Guideline for the management of heart failure: A report of the American college of cardiology/American heart association joint committee on clinical practice guidelines. Circulation 145:1-138. https://doi.org/10.1161/CIR.0000000000001063
• Hersberger L, Dietz A, Bürgler H, Bargetzi A, Bargetzi L, Kägi-Braun N, Schuetz P. Individualized nutritional support for hospitalized patients with chronic heart failure. J Am Coll Cardiol. 2021;77(18):2307-2319. https://doi.org/10.1016/j.jacc.2021.03.232
• Bianchi VE. Nutrition in chronic heart failure patients: a systematic review. Heart Fail Rev. 2020;25(6):1017-1026. https://doi.org/10.1007/s10741-019-09891-1
• Szlagor M, Dybiec J, Młynarska E, Rysz J, Franczyk B. Chronic kidney disease as a comorbidity in heart failure. Int J Mol Sci. 2023;24(3):2988-3002. https://doi.org/10.3390/ijms24032988
• Bosch L, Assmann P, de Grauw WJ, Schalk BW, Biermans MC. Heart failure in primary care: prevalence related to age and comorbidity. Prim Health Care Res Dev. 2019;20: e79-e87. https://doi.org/10.1017/S1463423618000889
• Bozkurt B, Aguilar D, Deswal A, Dunbar SB, Francis GS, Horwich T, Yancy C. Contributory risk and management of comorbidities of hypertension, obesity, diabetes mellitus, hyperlipidemia, and metabolic syndrome in chronic heart failure: a scientific statement from the American Heart Association. Circulation. 2016;134(23):e535-e578. https://doi.org/10.1161/CIR.0000000000000450
• Goyal P, Balkan L, Ringel JB, Hummel SL, Sterling MR, Kim S, Levitan EB. The dietary approaches to stop hypertension (DASH) diet pattern and incident heart failure. J Card Fail. 2021;27(5):512-521. https://doi.org/10.1016/j.cardfail.2021.01.011
• Lehrke M, Marx N. Diabetes mellitus and heart failure. Am J Cardiol. 2017;120(1),37-47. https://doi.org/10.1016/j.amjcard.2017.05.014
• Świątoniowska-Lonc N, Mak MA, Klausa F, Ściborski K, Banasiak W, Doroszko A. The nutritional status of patients with heart failure and its impact on patient’ outcomes—the center’s own experience. Nutrients. 2025;17(5):761-775. https://doi.org/10.3390/nu17050761
• Duffy VB. Causes of smell, taste, and oral somatosensory disorders affecting eating and drinking. Handb Eat Drink 2020;1281-1320. http://dx.doi.org/10.1007/978-3-319-75388-1_182-1
• Astori E, Garavaglia ML, Colombo G, Landoni L, Portinaro NM, Milzani A, Dalle-Donne I. Antioxidants in smokers. Nutr Res Rev. 2022;35(1):70-97. https://doi.org/10.1017/S0954422421000093
• Baj J, Flieger W, Teresiński G, Buszewicz G, Sitarz R, Forma A, Maciejewski R. Magnesium, calcium, potassium, sodium, phosphorus, selenium, zinc, and chromium levels in alcohol use disorder: a review. J Clin Med. 2020;9(6):1901-1925. https://doi.org/10.3390/jcm9061901
• Grochowski C, Blicharska E, Baj J, Mierzwińska A, Brzozowska K, Forma A, Maciejewski R. Serum iron, magnesium, copper, and manganese levels in alcoholism: a systematic review. Molecules. 2019;24(7):1361-1375. https://doi.org/10.3390/molecules24071361
• Tasnim S, Tang C, Musini VM, Wright JM. Effect of alcohol on blood pressure. Cochrane Database Syst Rev. 2020;(7): 1-138. https://doi.org/10.1002/14651858.CD012787.pub2
• Remde A, DeTurk SN, Almardini A, Steiner L, Wojda T. Plant-predominant eating patterns – how effective are they for treating obesity and related cardiometabolic health outcomes? – a systematic review. Nutr Rev. 2022;80(5):1094–1104. https://doi.org/10.1093/nutrit/nuab060
• Dziewa M, Bańka B, Herbet M, Piątkowska-Chmiel I. Eating disorders and diabetes: Facing the dual challenge. Nutrients. 2023;15(18):3955-3974. https://doi.org/10.3390/nu15183955
• Kaluzna-Oleksy M, Sawczak F, Kukfisz A, Szczechla M, Krysztofiak H, Wleklik M, Uchmanowicz I. Appetite and nutritional status as potential management targets in patients with heart failure with reduced ejection fraction—the relationship between echocardiographic and biochemical parameters and appetite. J Pers Med. 2021;11(7):639-656. https://doi.org/10.3390/jpm11070639
• Krysztofiak H, Wleklik M, Migaj J, Dudek M, Uchmanowicz I, Lisiak M, Kałużna-Oleksy M. Cardiac cachexia: a well-known but challenging complication of heart failure. Clin Interv Aging. 2020;2041-2051. https://doi.org/10.2147/CIA.S273967
• Arslan N, Akbulut G, Süleymanoğlu M, Alataş H, Yaprak B. The relationship between body mass index, anthropometric measurements and GRACE risk score in acute coronary syndrome. Nutr Food Sci. 2023;53(5):913–925. https://doi.org/10.1108/NFS-06-2022-0177
• Matsuo H, Yoshimura Y, Fujita S, Maeno Y, Tanaka S. Association of poor oral health with increased incidence of dysphagia and impaired improvement in nutritional status among patients with acute heart failure: a prospective cohort study. Eur Geriatr Med. 2023;14(4):879-888. https://doi.org/10.1007/s41999-023-00810-0
• Gallo A, Pellegrino S, Pero E, Agnitelli MC., Parlangeli C, Landi F, Montalto M. Main disorders of gastrointestinal tract in older people: An overview. Gastrointest Disord. 2024;6(1):313-336. https://doi.org/10.3390/gidisord6010022
• Park SC, Jung J, Kwon YE, Baeg SI, Oh DJ, Kim DH, Choi, H. M. Constipation and risk of death and cardiovascular events in patients on hemodialysis. Kidney Res Clin Pract. 2025;44(1):155-163. https://doi.org/10.23876/j.krcp.24.174
• Udovičić M, Grizelj D, Falak H. Cardiorespiratory disorders. In: Banić M, Erceg D, eds. Drug interactions in gastroenterology. Clin Gastroenterol. 2024;329–345. https://doi.org/10.1007/978-3-031-69800-2_2