Nutrition
Heart disease & heart failure
For coronary disease the target is cholesterol and blood pressure. In heart failure, fluid and sodium control matter most.
What you are aiming for
- Lower saturated fat and replace it with unsaturated fat
- Reduce sodium; in heart failure this is the main dietary lever
- Follow any individual fluid restriction exactly
- Maintain muscle — cardiac cachexia is common and harmful in advanced heart failure
Build meals around
- Oily fish twice weekly: sardines, mackerel, salmon, tilapia where oily species are available
- Olive, rapeseed or groundnut oil instead of butter, lard and palm oil
- Oats, barley and beans — soluble fibre lowers cholesterol
- Vegetables, fruit, nuts and seeds daily
- Lean protein at each meal to protect muscle
Limit or avoid
- Salt, stock cubes and processed meat — critical in heart failure
- Butter, ghee, palm oil, fatty cuts and full-fat processed dairy
- Pastry, fried foods and commercial baked goods
- Alcohol, especially in cardiomyopathy
- Large fluid volumes if you have been given a restriction
Meal timing
- Smaller, more frequent meals reduce breathlessness after eating in heart failure.
- Weigh yourself at the same time each morning, after passing urine, before breakfast.
- Take diuretics early in the day so you are not up all night.
Portions
- Fill half the plate with vegetables, a quarter with whole grains, a quarter with lean protein.
- In heart failure, count all fluids including soup, ice, jelly and the milk in tea.
- A weight gain of 2 kg over two to three days usually means fluid — follow your action plan.
A sample day
- BreakfastOats with milk and berries; unsalted nuts
- LunchLentil soup made without stock cubes, wholemeal bread, salad
- SnackApple and a small handful of walnuts
- DinnerGrilled mackerel, steamed greens, small potato portion
Common myths
“All fat is bad for the heart.”
Replacing saturated fat with unsaturated fat lowers risk. Removing fat entirely does not.
“Drinking lots of water is always healthy.”
In heart failure with a fluid restriction, extra fluid causes breathlessness and admissions.
Treatment-related challenges
- Breathlessness while eating — try softer foods, smaller portions and rest before meals.
- Loss of appetite and taste changes with heart failure medication.
- Unintentional weight loss in advanced disease needs energy-dense food, not restriction.
See a registered dietitian if
- · You have a fluid restriction you cannot keep to
- · You are losing weight or muscle
- · You have heart failure plus kidney disease or diabetes
Afya Companion offers education and self-help support. It does not diagnose, treat or replace care from your doctor, nurse, psychologist or dietitian. If something in your health changes, speak to your care team.