Congestive Heart Failure Diet: What to Eat and Sample Menu

Congestive heart failure (CHF), or simply heart failure, is a condition in which your heart doesn’t fill with blood or pump blood like it should.

The condition can cause fluid buildup in your body, causing shortness of breath or trouble breathing, fatigue, and swelling in the arms, legs, and stomach.

While medications are commonly used to manage heart failure, diet plays an important role in reducing its signs and symptoms as well as the risk of other health complications.

This article explains what heart failure is, which foods you should eat and which foods to avoid with the disease, as well as a sample congestive heart failure diet. 

congestive heart failure diet

What is heart failure?

Heart failure is a condition in which the chambers of your heart (ventricles) don’t fill with enough blood or your heart isn’t strong enough to pump sufficient blood from these chambers to your body’s tissues.

It’s commonly caused by heart disease, high blood pressure, and diabetes, and most often occurs in older adults and people who are obese (1).

Heart failure signs and symptoms may include (2):

  • Shortness of breath
  • Fatigue and weakness
  • Swelling (edema) in your ankles and feet
  • Swelling of your abdomen (ascites)
  • Rapid weight gain from fluid retention
  • Poor appetite
  • Fast heart rate

Your doctor may review your medical history, conduct a physical examination, and perform tests like a chest x-ray or heart ultrasound (echocardiogram) to diagnose heart failure (2).

Heart failure increases fluid retention

With heart failure, your heart pumps less blood than it otherwise would if it was healthy, causing a decrease in blood pressure.

To compensate for reduced blood flow, your heart beats faster, your veins constrict, and your kidneys retain water in an effort to maintain proper blood circulation (3).

Overtime, these compensatory methods to maintain proper blood circulation to your body’s tissues causes fluid buildup or congestion in and around organs such as the lungs, ankles, and feet.

This fluid accumulates gradually overtime, causing shortness of breath and swelling in your lower legs. Your doctor may prescribe you medications to reduce fluid buildup, but eating the right diet can also help.

Low-sodium diet for heart failure

A low sodium diet restriction is commonly recommended for reducing fluid buildup and other health complications from heart failure.

A low-sodium diet generally refers to a limit of 1,500 – 2,000 mg per day.

For reference, most Americans consume about 3,400 mg per day, primarily from restaurant, prepackaged, and processed foods in the form of salt (4).

Sodium is one of the two components of salt, the other being chloride. Salt by weight is 40% sodium and 60% chloride.

The current research, however, remains mixed as to whether a low-sodium diet is actually beneficial for heart failure, and many observational studies have even suggested harm (5, 6, 7, 8).

Moreover, a low-sodium diet can be difficult to follow long-term and make foods less palatable and enjoyable, increasing the risk for unintentional weight loss and malnutrition, especially for older adults (9).

That said, a more liberalized sodium allowance of allowance of 2,500-3,000 mg may be more beneficial for heart failure (5).

You can meet this recommendation by eating a diet that contains mostly fruits and vegetables, lean meats, low-fat dairy, whole grains, beans and other legumes.

These foods are naturally low in sodium and contain other important nutrients beneficial for heart health, including potassium, magnesium, inorganic nitrates, and antioxidants (10).

Heart healthy diet food list

Following a heart healthy diet can help you reduce fluid buildup, improve heart health, as well as reach and maintain a healthy weight (11).

Foods to eat

While limiting sodium is a primary focus of any heart healthy diet, it shouldn’t be the only focus.

Here are some foods essential to a heart healthy diet:

  • Vegetables: Arugula, asparagus, beets, broccoli, cauliflower, peppers, spinach, etc.
  • Fruits: Apples, bananas, berries, cherries, grapes, melons, oranges, pomegranates, etc.
  • Lean proteins: chicken, cod, pork loin, tilapia, turkey, and lean cuts of beef, such as sirloin and tenderloin steaks.
  • Low-fat dairy: cottage cheese, milk, mozzarella and feta cheese, and yogurt.
  • Whole grains: brown rice, oats, popcorn, quinoa, and whole-grain breads and pastas.
  • Seafood: Cod, scallops, shrimp, tilapia, and fatty fish (salmon, trout, tuna, and halibut).
  • Legumes: beans (great northern, kidney, lima, navy, pinto, and soy beans), black-eyed peas, chickpeas, lentils, and peas.
  • Fats and oils: Almonds, avocado, chia seeds, flaxseed oil, olive oil, nuts (almonds, pistachios, cashews, and pecans).

Foods to limit

While research suggest that a low sodium diet may not be helpful for heart failure, you can benefit from limiting your consumption of added sugars, processed meats, and alcohol.

  • Added sugars: These are added to foods and beverages during the manufacturing process. They include candy, cakes, soft drinks, cookies, juices, dairy deserts, and many breakfast cereals.
  • Processed meats: These contain high amounts of sodium and saturated fats, and excess consumption has been linked with colorectal cancer. Examples include sausages, hot dogs, salami, bacon, canned meat, and smoked meat (12).
  • Alcohol: While some research suggest that moderate drinking may have heart-protective effects, excess consumption should be avoided due the risk of further heart damage (13, 14, 15).

Sample congestive heart failure diet plan

Here is a one-day sample congestive heart failure diet plan.

Breakfast

  • Oatmeal made with water or low-fat milk and flavored with cinnamon
  • Blueberries

Snack

  • Greek yogurt
  • Walnuts

Lunch

  • Roasted salmon, green beans, and tomatoes

Snack

  • Mix of carrots and peppers with hummus

Supper

  • Bean burrito bow with brown rice, black beans, romaine lettuce, fresh cilantro, avocado, red onion, and low-fat sour cream.

Fluid restriction in heart failure

In addition to a low-sodium diet, a fluid restriction is commonly recommended for heart failure.

Limiting the amounts of fluids you consume is thought to reduce excess fluid from accumulating in your body, which can overload your heart and cause shortness of breath and swelling in your legs (16).

A fluid restriction usually limits fluids to 1,500 – 2,000 mL (51-68 ounces) per day, but can be as low as 800 mL (27 ounces).

Here are examples of fluids:

  • Water
  • Coffee
  • Tea
  • Juice
  • Soda
  • Sports drinks
  • Alcohol
  • Soups

Foods ice cream, yogurt, pudding, and sauces may also need to be taken into consideration as fluids.  

Like a low-sodium diet, however, the evidence for fluid restriction in heart failure remains mixed.

A review of six studies found there were no significant differences in hospital readmission rates or death from any cause in patients who restricted their fluid intakes compared with those who didn’t (17).

The same review, however, found that brain natriuretic peptide (BNP) levels were significantly higher in patients who didn’t follow a fluid restriction.

BNP is hormone that is secreted when the heart becomes stressed, and increased levels have been associated with poor health outcomes and longer hospital stays for heart failure (18, 19).

While these results suggest that people who follow a fluid restriction have similar health outcomes as those who don’t, additional research is necessary to determine whether fluid restriction can strongly be recommended or discouraged as a treatment option for heart failure (19).

Bottom line

Heart failure is a condition where your heart doesn’t pump enough blood to meet your body’s needs.

A low-sodium diet is commonly recommended to reduce fluid buildup that causes swelling and shortness of breath.

Despite these widespread recommendations, research suggest that a diet containing a more moderate amount of sodium in the range of 2,500-3,000 mg may be best for heart failure.

A fluid restriction is also commonly recommended for heart failure, but research has yet to confirm whether it can be confidently recommended or discouraged.

In either case, a congestive heart failure diet should consist of mostly fruits and vegetables, lean meats, low-fat dairy, whole grains, beans and other legumes.