Abstract 1434: Adherence to Three Gram Sodium-Restricted Diet is Associated With Lower Symptom Burden
Background. Despite the emphasis on sodium-restricted diets to limit heart failure (HF) symptoms, there is little direct evidence of the association between dietary sodium intake and symptom burden.
Purpose. The purpose of this study was to determine whether adherence to a sodium-restricted diet is associated with symptom burden of patients with HF.
Methods. A total of 195 patients with HF (31% female, 61±12 years, 51% NYHA class III/IV, ejection fraction 34±13%) completed a detailed 4-day food diary that was reviewed in person with a registered dietitian to measure dietary sodium intake. Adherence to a sodium-restricted diet was defined as average daily intake of ≤ 3g sodium. Patients completed the Memorial Symptom Assessment Scale -Heart Failure (MSAS-HF) to assess the frequency, severity, and distress of HF symptoms (shortness of breath during day or lying flat, lack of energy, ankle swelling, and sleep difficulty) on a 5-point Likert scale. Covariate data on age, gender, HF etiology, body mass index, NYHA class, ejection fraction, total comorbidity score, and depressive symptoms (Beck Depression Inventory II) were collected through patient interview and medical record review. Hierarchical logistic regression was used to determine the relationship between adherence to the sodium-restricted diet and symptom burden (median split of total MSAS-HF score: lower vs. higher symptom burden).
Results. Fifty percent of patients had a dietary sodium intake ≤ 3g/day. Approximately 60% experienced at least two HF symptoms and more than 20 % experienced symptoms daily. Lack of energy and shortness of breath were the most severe and distressful symptoms. Patients with HF had lower symptom burden if dietary sodium intake was ≤ 3g/day (p < .001). Daily sodium intake > 3g was independently associated with higher symptom burden (odds ratio=3.37, 95% confidence interval=1.56 –7.27) than daily sodium intake ≤ 3g after controlling for covariates.
Conclusion. These findings provide the relevant evidence based on actual sodium intake to support a 3 g sodium-restricted diet.