Nutritional and Metabolic Aspects of Congestive Heart Failure

Among the Various aspects of the management of heart failure, nutrition has continued for many years to occupy a position of prominence. In cardiac decompensation, regardless of its etiology, alterations in cellular metabolism and physiology may rapidly influence alimentation and absorption of an adequate diet, the utilization of assimilated food elements, and the distribution of substrate, electrolytes, and water throughout the body. The immediate problem in nutritional management is that of reducing the work load of the heart and preventing and eliminating abnormal water and sodium storage in extracellular space. The long-term problem is essentially that of maintaining the caloric, nitrogen, and accessory food factor balances at the minimum level of caloric intake to which the organism can be successfully adapted. 1. REDUCTION OF THE WORK LOAD OF THE HEART Since cardiac output and the work of the heart are geared to the over-all metabolism of the individual person, a