Heart failure is a weakness of the heart muscle.

The weakness can affect the left or right heart (left heart failure, right heart failure)

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Classification according to the degree of severity:

Grade I:

Heart disease without impairment of physical performance. Normal physical activity does not lead to dyspnoea (shortness of breath), angular pain or palpitations (palpitations).

Grade II:

Patients with mild physical limitations. These sick people feel good at rest and with light activity. Complaints only become noticeable when exercising more forcefully.

Grade III:

Patients with severe physical limitations. The patients feel comfortable in peace, but have problems even with light activities.

Grade IIII:

Patients who cannot exercise any physical activity without discomfort. Heart failure symptoms can occur even at rest and are aggravated by physical activity.

Left heart failure: = congestion in the pulmonary circulation / pulmonary vein

Leading symptom: shortness of breath

By backing up the blood in front of the left heart and thus in the lungs

Dyspnea - (shortness of breath) initially only under exertion

Orthopnea - difficulty breathing in an upright position; Immediate shortness of breath when lying flat

Tachypnea - acceleration of breathing as compensation

Congestive bronchitis / cyanosis

(blue-red discoloration of the skin and mucous membranes due to lack of oxygen in the blood):

especially on the lips and face, as a result of a low O² content in the peripheral vessels (lips, face)

            - Cardiac asthma

            - Pulmonary congestion / pulmonary edema with bright red sputum

            - Distance rattles

            - with simultaneous right heart failure: pleural effusion

Right heart failure: = congestion in the venous area of the great circulation, increased central venous pressure, congested neck veins

First ankles, lower legs, sacral edema in bedridden people, ascites and pleural effusion in severe cases

= nocturnal urination, because the body can better relieve pressure in a horizontal position. Leads to insomnia by constant  Going to the toilet.

Enlargement of the liver (= congested liver due to increased blood filling)

Congestion in the area of the portal vein

Gastroenteritis caused by venous congestion (bloating, flatulence, loss of appetite)

Cyanosis (lips, face)

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Global insufficiency: (left and right heart failure)

Due to the insufficiency of the left heart, the stress on the right heart is increased. Gradually, global insufficiency develops (late stage).

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Why is nutritional therapy important?

Nutritional therapy supports you in relieving your heart. Weight reduction is essential if you are overweight or obese. An energy-adjusted wholesome diet under the supervision of a certified nutritionist can lead to your long-term success. The diet is adapted to your current weight and a jointly defined goal for weight gain / or loss.

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The aim is to supply all of the fatty acids, micronutrients (vitamins and minerals) that are important to you, energy and protein in the measure that your body is optimally supplied with. For this purpose, foods that promote inflammation are specifically avoided and plenty of anti-inflammatory foods are consumed.

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For heart failure with a fluid-restricted diet, the following is required:

A fluid restriction to 1500 - 500 ml / d

A negative fluid balance is desirable.

A fluid balance is required:

1. Drinking liquid

2. Meal-specific recommendations (soups, porridge ...)

3. Weight monitoring: weigh daily under the same conditions

Amount of liquid in food:

100% fruit, vegetables, soups, sauces, spoon stews, broths, drinking liquid

75% mashed potatoes, fork stews, quark dishes and dishes with the same consistency, milk and nutrient porridge

50% potatoes, rice, pasta (all cooked), casseroles, muesli, fruit groats

25% fried potatoes, fried pasta, potato fritters

0% honey, jam, jelly, fat, baked goods without fruit toppings

The meals-specific recommendations are derived from this:

Salt restricted diet - Suitable mineral water:

Choose mineral water that is low in sodium. That means Na <20 mg / l (e.g. alwa, Römerquelle, Gerolsteiner naturell)

Fluid-lowering measures:

• Select dry cooking methods: roasting and grilling, for example, vegetables, potatoes, rice and pasta

• Omit soups or stews

• Offer dishes without sauce or reduce the sauce.

• Avoid salty foods because you feel very thirsty.

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Table salt: 5-7 g NaCl / day: 85-119mmol Na

Corresponds to the DACH reference values for nutrient intake for healthy adults;

Prevention basis; Basic therapeutic concept in connection with antihypertensive therapy.

(Low-salt diet: 3g NaCl / d; 51 mmol Na; strictly low-salt diet; nowadays of no importance as it is not practicable)

Potassium-rich diet, 2-3 g K / day

Possible leap days: extended Kempner rice diet, juice and fruit day, raw food day

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Tip : Use plenty of herbs and spices to save salt and fat.

Classification of your weight - definition and classification of weight in relation to height.

Special percentile curves apply to children and adolescents; the BMI cannot simply be used here.

BMI and interpretation: BMI: body mass index. Formula: Body weight in kg : (body height in m) 2

Underweight: <18.5

Normal weight: 18.5 - 24.9

Overweight = pre-obesity: 25-29.9

Obesity grade I: 30 - 34.9

Obesity grade II: 35-39.9

Obesity grade III:> 40 = per magna

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Nutritional therapy

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• Anti-inflammatory diet with moderate salt consumption and a selection of foods rich in potassium.

• Holistic therapy - do you have any comorbidities that need to be taken into account during the consultation?

• Body weight: Weight reduction is recommended if you are overweight / obese.

• Avoid micronutrient deficiencies and mineral deficiencies & possibly counteract them with nutrient preparations

• Prevent protein deficiency

• Which nutrients do I need in which ratio?

• Consume fiber according to the respective level (low fiber or high fiber)

• Sufficient fluid: total fluid per day: 30 - 35 ml per kg body weight and day. Attention, this is not just a drinking liquid. The liquid from food (approx. 500 - 800 ml) must still be subtracted from this, so that an amount of 1.3 - 2 l drinking liquid is created.

• add valuable anti-carcinogenic (anti-cancer) secondary plant substances

• A selection of foods tailored to your needs with cooking and technical information (for breakfast, snacks, lunch, dinner)

• Do you like to eat your warm meal in the evening? I am happy to cater to your individual situation and we will create a plan on how you can implement your wholesome diet into your everyday life.

• Overall fat selection, how should it be designed?

• which oils are good for me? What should I watch out for in relation to the anti-inflammatory diet?

• How much fat spread (butter / margarine / vegetable fat) can I use and which products are recommended?

• Get enough Omgea-3 fatty acids and essential fatty acids

• How can I boost and support my metabolism with natural foods?

• Coordinate sensible meal frequency for your individual case - meal allocation

• What do I have to look out for when choosing animal foods?

• How many animal foods (e.g. meat products, milk and dairy products, cheese, fish products, eggs) are recommended?

• Define the desired weight stabilization / normalization & the estimated period for this

• what should be considered with beverages and alcoholic beverages?

• How does exercise affect your body and thus also your diet?

• Avoid blood sugar fluctuations

• Sweetening foods - sweeteners, glucose, fructose, sugar and sugar substitutes, what can I use and in what quantities? How high is the respective sweetness of the different products?

• what should be considered when baking and cooking?

• what are cheap snacks / main meals

• Eating out - what should you watch out for?

• Vacation, boat trip or hospital stay, what should be considered?

• Flatulence, bloating, diarrhea, constipation, vomiting, heartburn, loss of appetite, pain related to eating, what can I do about it?

• Daily plans as an example for practical implementation in everyday life

• Enjoyment training

• Optimizing your eating situation

• long-term maintenance of a jointly defined weight

• Strengthen the stomach and intestines with natural foods

• Additional therapy options

• Dietetic products in support of nutritional therapy

• Food supplements - under certain circumstances, a supplement can be useful

• and other topics

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Any questions? I look forward to your call or email. To contact form

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Assistance:

• KISS self-help groups

• Self-help network

• German Infarct Research Aid eV

• German Heart Foundation eV

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