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Cardio Diabetes Medicine 2017 601

supplements because they may aggravate cardiac and cakes
arrhythmias. It remains unclear if vitamin D supple- Salted Buttermilk, most cheese spreads and chees-
mentation truly is needed in HF patients
es, salted butter
Magnesium deficiency is common in patients with Carbonated beverages & Proprietary /Energy Drinks
HF because of poor dietary intake and the use of
diuretics.The practitioner should encourage patients Soy sauce, salad dressing, chilisauce, ketchup, bar-
with heart failure (HF) to consume at least the Dietary becue sauce, and monosodium glutamate (MSG)
Reference Intake (DRI) for magnesium through food Add fresh herbs, spices, and salt-free seasoning
and/or supplements. Low levels of magnesium may blends in cooking and at the table (Lemon, mint,
be present in patients with heart failure and irregular corianderleaves).
heart rhythms may occur (3).
Table 2 FOOD LABELING GUIDE FOR SODIUM (4)
Fish consumption and fish oils rich in omega-3 fatty
acids can lower elevated triglyceride levels and may Sodium-free Less than 5 mg per stan-
prevent atrial Librillation in HF patient. However, fur- dard serving; cannot con-
ther studies are needed. tain any sodium chloride
Routine use of nutritional supplements is not recom- Very low sodium 35 mg or less per standard
mended for patients with heart failure with preserved serving
ejection fraction. (3) Low sodium 140 mg or less per stan-
Standard fluid restrictions are to limit total fluid in- dard serving
take to 2000 ml daily. When patients are severely de- Reduced sodium At least 25% less sodium
compensated, depending on fatigue or shortness of per standard serving than
breath., a more restrictive fluid intake (1000 to 1500 in the regular food
ml daily) may be warranted for adequate diuresis. Light in sodium 50% less sodium per stan-
Limit caffeine only if needed. The evidence is not de- dard serving than in the
fenitive in this area. regular food
Chronic alcohol ingestion may lead to cardiomyopa-
thy and HF. If alcohol is consumed, intake should not
exceed one drink per day for women and two drinks
per day for men.

Enteral feeding, use a low-sodium product and in-
crease volume gradually.
With total parenteral nutrition, ensure adequate in-
take of all micronutrients as well as macronutrients.

Tips For Lowering Sodium In The Diet
Choose More OftenFresh fruits and vegetables, fresh
lean poultry, fish, and lean meat,egg white rather than
canned or processed types
Rice and hot cereals cooked without salt.

Cut back on
Extra Salt, Salt on the dining table, salted chips, nuts,
papads, savouries & popcorn
Instant, ready to heat and eat rice, gravies,cereal
mixes, instant noodles, instant soup mixes, canned
foods and preserved foods which usually have added
salt.
Cut back on baked foods- pizza, burgers, biscuits

Cardio Diabetes Medicine