Congestive Heart Failure



Congestive heart failure (CHF) is a condition where the heart is unable to properly pump blood to the rest of the body, causing fluid to back up in the vessels, leading to swelling and inadequate blood flow to the organs. There are two types of CHF: systolic and diastolic. Systolic heart failure (now referred to as “heart failure with reduced ejection fraction”) occurs when the heart muscle is weak and unable to contract with as much force. Diastolic heart failure (now referred to as “heart failure with preserved ejection fraction”) occurs when the heart muscle is stiff and unable to relax, inhibiting the heart chambers from filling with blood properly. Both of these can result in significant disability.

 
  • Overview
  • Action Plan
  • Ask The Doctor
  • Related Info
  • Success Stories

Overview


The key is prevention of congestive heart failure with a Nutritarian diet and active lifestyle; however, once CHF has developed, a Nutritarian diet can significantly improve symptoms and quality of life and, in some cases, reverse impaired heart function. From 2007 to 2010, an estimated 5.1 million Americans older than age 20 had heart failure. This is projected to increase by 46% to 8 million Americans older than age 18 by the year 2030. In 2010, the cost of heart failure in the U.S. was $30.7 billion and will likely increase to $69.7 billion by the year 2030.1

Because of impaired pumping of the heart, blood will back up into the lungs and lower extremities causing difficulty breathing and swelling. Patients with CHF often have to sleep with the heads elevated on several pillows because of shortness of breath. They can have trouble breathing while exerting themselves, as well as palpitations or chest pain. Swelling can occur in the feet, ankles or whole leg and even into the back. Patients often complain of dizziness or fatigue. CHF can significantly affect the quality of life.

Anything that damages heart muscle increases the risk of developing congestive heart failure. The primary causes are modern eating habits, smoking, substance abuse, and a sedentary lifestyle. The Standard American Diet leads to a constellation of dietary-caused risk factors including being overweight, diabetes/insulin resistance, high blood pressure, high cholesterol, and inflammation. Arterial cholesterol plaques and inflammation can lead to heart attacks causing damage to the heart muscle. Valvular heart disease can affect blood flow and how the heart pumps, causing changes to the heart muscle and eventual heart failure. Thyroid disease can also contribute to the development of CHF. The key to prevention, improvement, and even reversal is a Nutritarian diet.

 
References
  1. Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation 2014, 129:e28-e292.

Action Plan


Diet

  • The most aggressive and effective approach to reversing heart disease is described in my book, The End of Diabetes. It describes a micronutrient-dense diet with an array of cruciferous vegetables, non-green vegetables, beans, fruits, nuts, and seeds. This will reduce inflammation, oxidative stress, and atherosclerotic plaque formation in the blood vessels.
  • Limit extra sodium intake to 0-300mg daily based on lower leg edema and lung congestion. More sodium may be indicated, if use of diuretics necessitate it, and this should be determined by physician monitoring.
  • Monitor fluid intake. Drink only when thirsty or when exercising, sweating, etc. It is important to maintain normal hydration without overloading on fluids. Vegetables and fruits have high water content and will lower your water requirement. Monitor your weight daily, and check for edema of lower extremities and lung congestion.
  • Limit or eliminate animal products. If choosing to include animal products in the diet, use servings of only two ounces or less as a condiment only a few times a week. Use predominantly wild seafood, such as salmon, sardines, squid, flounder, scrod, or trout.
  • If you are taking any medication, please talk to your doctor before and after changing your diet, as reducing medication may be necessary. A Nutritarian diet is so effective that a reduction in medications will most often be needed to prevent the risks of over-medicating. Blood pressure, serum electrolytes, renal function, and glucose need to be monitored closely.

Exercise

Moderate exercise has been shown to be helpful with heart failure patients.1 Workouts need to be customized for each patient. Exercise tolerance must be increased slowly.

Tobacco cessation

Tobacco use increases risk of cardiovascular disease including CHF. Quitting smoking, even for as little as two years, has a significant beneficial effect on morbidity and mortality in patients with heart failure.2

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References
  1. Pina IL, Apstein CS, Balady GJ, et al. Exercise and heart failure: A statement from the American Heart Association Committee on exercise, rehabilitation, and prevention. Circulation 2003, 107:1210-1225.
  2. Suskin N, Sheth T, Negassa A, Yusuf S. Relationship of current and past smoking to mortality and morbidity in patients with left ventricular dysfunction. J Am Coll Cardiol 2001, 37:1677-1682.

Ask The Doctor


The following are sample questions from the Ask the Doctor Community Platinum and higher members can post their health questions directly to Dr. Fuhrman. (All members can browse questions and answers.)

Q.

I have been diagnosed with congestive heart failure. My ejection fraction is 15%. Have you had any patients increase their EF following a Nutritarian diet? My cardiologist said that it would never increase.

A.

Yes, I have seen some improvement in heart function in congestive heart failure patients, including dramatic improvement in ejection fraction over time. It depends on the degree of permanently dead heart muscle and if there is some "hibernating myocardium" or diseased tissue that is not totally destroyed. Let’s see if we can work together to do whatever possible to prolong your life. Since we are discussing such a serious condition, I would suggest you set up an appointment in my office.

 
Q.

Can congestive heart failure and arterial fibrillation be reversed?

A.

It depends on the cause. If it’s caused by something such as hyperthyroidism, then reversal is possible, but, if it is related to coronary artery disease, hypertension or heart valve problems, the heart chambers enlarge and often scar, making complete reversal less likely. A Nutritarian diet with targeted supplementation reduces inflammation, lowers blood pressure, and reduces the propensity for arrhythmias and clot formation. All of this improves cardiac reserve and function over time.

 
Q.

I am a 53-year-old white male with congestive heart failure. I am still very overweight, although, to date, I have lost 53 pounds. I have had many years of alcohol and tobacco abuse but have not taken a drink for 4 years. I had a bi-ventricular pacemaker fitted two years ago and am taking large amounts of medication, especially to rid my body of excess fluid. I spent the last weekend in the hospital as I was feeling very poorly, and my cardiologist says that my heart now has an extra beat (which is apparently a progression of the disease and an enlarged heart).

In your opinion, is it possible at this stage to reverse congestive heart failure?

A.

Yes, you may be able to see considerable progress in your condition, however, there is no room for compromise. Stick strictly to natural plants (mostly greens), avoid too much spinach (sodium), not a speck of salt in anything, and do not drink more than a few sips of water a day. That should allow you to reduce your diuretics and meds somewhat quickly. You should weigh yourself every day. If you are losing or staying the same day to day, fine. If you ever put on any weight you may need some more diuretic. The risk here is to follow my advice and be over-medicated which could cause dehydration and excessive blood pressure lowering, leading to kidney damage, so you need to work with a doctor to decrease your diuretics as you begin this program. You may need to set up an appointment in my office for more guidance. Careful adherence to the program should continue to unload fat weight and excess water weight pretty rapidly if you stay strictly on the program. Remember, this can be a delicious way to improve your health.