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Caloric restriction in heart failure: A systematic review
1Department of Endocrinology and Metabolism, Clinical Center Stella Maris, San Marino.
Clinical Nutrition ESPEN
|July 22, 2020
Summary
Calorie restriction (CR) diet may improve myocardial efficiency in overweight heart failure (HF) patients by reducing body fat and enhancing insulin activity. However, severely restricted diets pose risks, especially for underweight HF patients.
Area of Science:
- Cardiology
- Metabolic Health
- Nutritional Science
Background:
- Nutrition is crucial for cardiac function, insulin regulation, and mitochondrial efficiency, supporting myocardial contractility.
- Heart failure (HF) is characterized by reduced myocardial efficiency and impaired mitochondrial oxidative capacity.
- In HF, cardiomyocytes shift to glucose utilization, decreasing fatty acid use, while calorie restriction (CR) shows controversial benefits.
Purpose of the Study:
- To evaluate the impact of a calorie restriction (CR) diet on myocardial efficiency in patients with heart failure (HF).
Main Methods:
- A literature search was conducted on PubMed and Embase.
- Keywords included "chronic heart failure" combined with "diet," "nutrition," "insulin resistance," and "caloric restriction."
- Studies involving exercise or food supplementation were excluded.
Main Results:
- Weight loss, driven by insulin activation and kinase pathways, was shown to regulate myocardial tissue efficiency.
- Insulin resistance is identified as a significant cardiovascular risk factor that impairs cardiac function.
Conclusions:
- The CR diet is a primary therapy for overweight HF patients (HFpEF and HFrHF), improving myocardial function by reducing body fat.
- Insulin activity is key to mitochondrial function and cardiac efficiency.
- Severely restricted diets may increase all-cause mortality risk, particularly in underweight HF patients; long-term studies are needed.
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