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A study on dietary diversification intervention for elderly patients with chronic heart failure who can eat by mouth
Wenlin Zhou1,2, Longya Si3, Yumei Deng1,2
1Department of Nursing, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
Introduction:
Conventional CHF nutrition counseling is often one-size-fits-all. We developed and tested a DDS-guided, tiered dietary diversification program for elderly CHF patients able to eat orally.
Method:
A quasi-experimental study with a non-randomized, non-concurrent control design was used. Eighty-eight elderly oral-feeding CHF patients were selected from the Cardiovascular Department of a tertiary general hospital in Zunyi City (July-October 2022): the control group (July-August, n = 44) and the intervention group (September-October, n = 44). The control group received conventional dietary guidance, while the intervention group underwent personalized intervention based on the Dietary Diversity Score (DDS9) and nutritional status, with 2-month post-discharge follow-up. The Dietary Diversity Score (DDS9) and nutritional indicators (Heart Failure-Specific Mini Nutritional Assessment [MNA-HF], Body Mass Index BMI) were compared between the groups at baseline, 1 and 2 months post-intervention.
Results:
There were no statistically significant differences in baseline data between groups (p > 0.05). After 1 month, the intervention group showed significantly higher scores in Total DDS and specific food groups (fish, fruits, etc.) compared to the control group (p < 0.05), with a large effect size for Total DDS. After 2 months, significant improvements were maintained for Total DDS (large effect size) and MNA-HF (medium effect size) (p < 0.05). The intervention group exhibited a significantly greater upward trend in dietary diversity over time (p < 0.001, large effect size). Although absolute BMI trends did not differ significantly, the increase in BMI at 2 months was significantly greater in the intervention group (medium effect size).
Discussion:
A DDS-guided, tiered intervention improved dietary diversity and nutritional status over 2 months in elderly CHF patients, demonstrating practicality and scalability. Limitations include the non-randomized, single-center design and short follow-up; longer multicenter trials are needed to confirm durability and clinical impact.
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