Nutritional Interventions in Older, Frail Persons with Heart Failure-A Systematic Narrative Review

Frailty is a clinical condition common among older persons with heart failure (HF) and has been associated with an increased risk of adverse outcomes such as falls, disability, long-term care, and death. Malnutrition in terms of weight loss and sarcopenia is closely related to frailty. This review summarises nutritional interventions to improve components of frailty in older persons with HF. The online databases of Medline, Embase, Web of Science and Cinahl were searched in 2022 to identify studies of nutritional interventions among older persons with HF with outcomes related to frailty (e.g., body composition or functional measures). The records were screened, and eligible articles identified. In addition, reference lists of eligible articles and of four previously published reviews regarding HF and nutrition were screened. Eight articles were included in the review, of which seven were controlled trials and one was a feasibility study. Nutritional interventions included: vitamin D supplementation (n =2), protein supplementation (n =3), enteral nutrition (EN) or oral nutritional supplements (ONS) (n =2), or a low carbohydrate diet (n =1). The studies using protein supplementation, ONS or EN reported improvements on functional measures or body composition. Furthermore, the results from this review add to the evidence of the importance of combining nutritional support with physical activity to improve muscle mass and functional outcomes among older persons with HF.