Hidden Malnutrition in Overweight and Obese Individuals with Chronic Heart Failure: Insights from the Pro-HEART Trial

Background/Objectives: Poor nutritional status and cachexia have been well-documented as predictors of adverse outcomes in individuals with chronic heart failure (HF). However, despite obesity being a common observation in this patient population, a growing body of evidence indicates that these individuals may still suffer from nutrient deficiencies and malnutrition. This study aimed to characterize the food and nutrient intake of participants enrolled in the Pro-HEART clinical trial-a study evaluating dietary interventions in overweight and obese individuals with HF-and to compare their consumption patterns to national nutritional guidelines. Methods: A cohort of 92 overweight and obese individuals with chronic HF enrolled in the Pro-HEART trial. Baseline food consumption was assessed via a validated 3-day Food Record. The data were analyzed using descriptive statistics to evaluate adherence to recommended intake levels for energy, macronutrients (fat, carbohydrates, protein), and key micronutrients. Results: Among the 92 participants, 41% exceeded fat intake recommendations, 73% surpassed guidelines for saturated fat, and 95% consumed excessive sodium. Despite adequate caloric intake, many individuals failed to meet recommended levels for key micronutrients known to influence inflammation and metabolic regulation, including vitamin D, calcium, magnesium, and potassium. Conclusions: These findings suggest that overweight and obese individuals with HF, despite their excess body weight, exhibit dietary patterns that place them at risk of malnutrition. The results underscore the necessity of nutritional assessments and interventions in this population to address deficiencies that may contribute to the metabolic and inflammatory abnormalities associated with HF.