The Role of Diet and Nutrition in Heart Failure Care

Abstract

Introduction. Heart failure is a complex state of systemic metabolic dysfunction characterized by progressive myocardial energy deficiency. Traditionally managed through pharmacological and mechanical means, the role of nutritional status has emerged as a primary determinant of disease progression and clinical stability.
Methodology. A review was conducted using PubMed, Google Scholar and ResearchGate. Search terms included: heart failure, sodium restriction, Mediterranean diet, DASH diet, mitochondrial bioenergetics, gut-heart axis and nutrition. Studies and clinical guidelines published between 2015 and 2026 were reviewed.
Results. Evidence from recent trials indicates that aggressive sodium restriction does not significantly reduce mortality and may stimulate compensatory neurohormonal mechanisms. In contrast, dietary patterns like the Mediterranean and DASH diets attenuate cardiac remodeling, reduce systemic inflammation and improve left ventricular ejection fraction. Research into the gut-heart axis has identified microbial metabolites, such as trimethylamine N-oxide and short-chain fatty acids, as key modulators of fibrosis and vascular health. Additionally, nutritional interventions targeting mitochondrial bioenergetics and protein intake have shown potential in mitigating sarcopenia and improving functional independence. However, the efficacy of these interventions is heavily dependent on patient behavioral readiness and individualized multidisciplinary support.
Conclusions. Nutritional management offers broad therapeutic potential in heart failure through a shift from restrictive paradigms toward precision nutrition. Nevertheless, the integration of structured behavioral models and stage-matched educational support is necessary to improve long-term adherence and clinical outcomes.