What To Eat If…You Have Heart Failure

Keep your heart strong with these expert-backed nutrition tips.

Medically reviewed in February 2021

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If you’ve been diagnosed with heart failure, you may assume there’s very little you can do to manage your condition. But that’s not true. There’s actually plenty of changes you can make to your everyday life. Diet is especially key.

If you have heart failure—or even if you don’t—follow these good-for-you nutritional habits.

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Eat heart-healthy foods

The American Heart Association (AHA) recommends eating a variety of nutrient-rich foods. These include:

  • Fresh or frozen fruits and vegetables
  • Whole grains—whole grain bread, plain oatmeal, brown rice, barley
  • Low-fat dairy
  • Fish, skinless chicken and other lean proteins
  • Nuts and legumes like kidney beans and lima beans
  • Good-for-you vegetable oils such as canola, corn, olive and safflower oils.

If you have heart failure, your doctor may recommend the lower-sodium version of the DASH eating plan, short for Dietary Approaches to Stop Hypertension. DASH has been proven to lower blood pressure and LDL (bad) cholesterol. Unlike the regular DASH diet, which caps your sodium intake at 2300 milligrams per day, the lower-sodium version limits sodium to 1500 milligrams per day. Both approaches are built around food groups that contain blood pressure-lowering nutrients like potassium, magnesium and fiber.

“It’s not that we want to prevent you from eating what you like,” says Poorna Nalabothu, MD, a heart failure cardiologist at St. Marks Hospital in Salt Lake City, Utah. The idea is to make tweaks. “Instead of fried chicken, have grilled chicken with lots of spices. If you like pizza, top with vegetables instead of pepperoni. Rather than desserts with high fructose corn syrup, choose dark chocolate.”

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A Day of DASH eating

Here’s what a typical day of following the DASH diet could look like.

Regular oatmeal
Mini whole wheat bagel with peanut butter
Low-fat milk

Chicken breast sandwich with reduced-fat, low-sodium Swiss cheese, mayonnaise, lettuce and tomato on whole wheat bread
Cantaloupe chunks
Apple juice

Spaghetti made with low-sodium tomato paste and sprinkled with Parmesan cheese
Spinach salad topped with fresh carrots and mushrooms
Fresh pear

Unsalted almonds
Dried apricots
Fat-free, no-sugar fruit yogurt

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Shake the salt habit

Cutting back on sodium is arguably the most important part of your treatment plan. That’s because sodium acts like a sponge in your body. It holds on to extra fluids, which makes your heart work harder.

“The most common symptom of heart failure is fluid in the legs, which causes swelling, and fluid in the lungs, which causes shortness of breath,” says Nalabothu. “Why is this happening? It’s because of excessive sodium intake. People with heart failure can’t excrete extra sodium. Where sodium stays, water follows.”

A new report from the US Centers for Disease Control and Prevention found that the average sodium intake is 3535 mg per day—well beyond what is typically recommended for those at risk for heart conditions. Although your doctor is the best judge of how much sodium you should be consuming, the AHA recommends 1500 milligrams per day, but no more than 2300 milligrams. That may sound like a lot, but it’s actually only the amount found in one teaspoon of salt.

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Creative ways to cut sodium

Keep in mind that stashing the salt shaker isn’t enough. Sodium is hiding in canned foods, frozen dinners, salad dressings, crackers, chips and other packaged foods. When possible, choose “low sodium” or “sodium free” varieties. Better yet, whip up your own versions of these pre-made foods so you can control the amount of salt.

Get creative with your prep: When a recipe calls for salt, substitute with your favorite spices and herbs. Adding citrus—fresh-squeezed lemon, lime or orange juice—is another easy way to enhance the flavor of fish, vegetables, poultry and even steak.

Eating out? Skip fast-food and buffet-style restaurants and try, instead, to choose restaurants with made-to-order food. Ask the waiter to suggest low-sodium items on the menu.

Whether you’re eating out or at home, try to avoid what the AHA calls the “salty six.”

  • Breads and rolls
  • Cold cuts and cured meats
  • Pizza
  • Sandwiches
  • Soup
  • Burritos and tacos
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Monitor your fluid intake

If you have heart failure, it’s common for your body to retain fluid. For most people, decreasing sodium consumption will be enough to rid the body of excess fluids. However, for those with advanced heart failure, your healthcare team may recommend limiting the amount of liquids you consume, since too much fluid in your body can make it harder for your weakened heart to do its job. Your doctor may also prescribe a diuretic (a.k.a., “water pills”) to help your body eliminate excess fluid.

Talk to your doctor about how much fluid you should consume every day, as it differs for everyone. Don’t forget: water and other beverages aren’t the only form of fluids. Any food that melts (ice cream, frozen yogurt and gelatin, for instance) or is mostly liquid to begin with (such as soups and certain fruits) are considered fluids. Be sure to count these in your overall daily intake.

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Avoid or limit alcohol

Too much alcohol is a bad idea for anyone, but for people with heart failure, it can exacerbate their condition. Talk to your doctor about your alcohol consumption and how much is safe to drink.

If you drink, do so in moderation. According to the AHA, that means no more than two drinks per day for men and one drink per day for women. A drink is considered one 12-ounce beer, a 4-ounce glass of wine, 1 ½ ounces of 80-proof liquor or 1 ounce of 100-proof liquor.

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Be careful with caffeine

Researchers can’t say for sure if caffeine is a bad idea for people with heart disease, but they do know that it stimulates the central nervous system and affects the kidneys by increasing urination, which can lead to dehydration.

Speak to your doctor about whether caffeine is safe for you, as well as the proper amount. People with conditions like atrial fibrillations (a-fib for short) may be advised to avoid it completely. If you can have caffeine, it may be best to limit your consumption—one cup of coffee per day, suggests Nalabothu. And don’t forget that caffeine is also hiding out in chocolate, teas and soft drinks.

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Reduce foods filled with saturated fats

Foods high in saturated fats such as fatty meats, butter, whole-milk dairy and coconut and palm oils are a no-no because they tend to raise blood cholesterol levels.

To help limit your intake, check the nutrition labels and replace foods high in saturated fats with leaner products. Try a fish that is high in omega-3s or skinless poultry, instead of using red meat. Stick to cooking with non-tropical vegetable oils—canola, corn, olive, safflower, sesame, sunflower and soybean oils are all good options. Swap coffee creamer for low-fat milk and try implementing a meatless eating day into your schedule.

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