Applied nutritional investigationDietary fatty acids intake and mortality in patients with heart failure

ObjectiveDietary strategies in heart failure (HF) are focused on sodium and fluid restriction to minimize the risk for acute volume overload episodes. However, the importance of dietary factors beyond sodium intake in the prognosis of the disease is uncertain. The purpose of this study was to evaluate the association of macro- and micronutrients intake on 1-y mortality in patients with HF.MethodsA secondary analysis of 203 patients with chronic HF enrolled in a randomized trial of sodium reduction was completed. Patients with a complete 3-d food record at baseline were included in this analysis (N = 118); both control and intervention arms were combined. Three-d mean dietary intake was estimated. Cox multivariable regression analysis was used to evaluate the association between dietary factors and 1-y mortality.ResultsAmong the 118 included patients, 54% were men, median (25th-75th percentiles) age 66 y (52-75 y), median ejection fraction 45% (30%-60%), and ischemic etiology present in 49% of patients. The association with 1-y mortality was significant for both polyunsaturated fatty acids (PUFA; adjusted hazard ratio [HR], 0.67; 95% confidence interval [CI]. 0.51-0.86 for intake as percentage of daily energy) and saturated fatty acids (SFA; adjusted HR, 1.15; 95% CI, 1.03-1.30 for intake as percentage of daily energy). Median of intake as percentage of daily energy was 5.3% for PUFAs and 8.2% for SFAs.ConclusionsIntake of PUFAs and SFAs was independently associated with 1-y all-cause mortality in patients with chronic HF. Limiting dietary SFA and increasing PUFA intake may be advisable in this population.