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Heart failure

Eating, drinking and exercise

People with heart failure may well be given different advice about diet and exercise according to individual circumstances. Some described how they had been advised to cut down on salt, fried food, gravy, butter and cheese, cakes, sweets, chocolate and alcohol. Others whose appetites were not as good as before and who had lost weight had been advised by medical staff to eat more.

People who were very overweight had often been advised to change their diet to lose weight. Those who had succeeded usually said they felt better for it, but changes to diet were often hard to make and sustain. A man who had been referred to a dietician said he was sometimes disheartened that he was not losing weight, but thought this was because of water retention. Someone else wondered if the 'Atkins Diet' (a high fat-low carbohydrate diet) was a safe way for people with heart disease to lose weight.

 

Describes how his fluid retention keeps his weight high even though his diet has completely changed.

Describes how his fluid retention keeps his weight high even though his diet has completely changed.

Age at interview: 49
Sex: Male
Age at diagnosis: 44
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Yeah, I've always been heavy-built. I've tried numerous diets, the doctors tried me on this that and the next thing, I'm under the dietician just now, I'm actually due back next week. 

Fluid retention is a big thing with me because the heart's not pumping right it's..I get a lot of fluid retention. I'm on frusemide tablets but it doesn't keep the fluid away. It'll build up and build up and build up. So I can go to bed at night time and I'll be say 22 stone, I can wake up the next morning and I'm 22 1/2 stone and I swear it works with me. I take my tablets and I take the extra tablet which is bendrofluazide, and I'll be weeing all the day, and I'll go to my bed at night time and the half stone's away again! It's just fluid, just constant fluid. So that makes you tired as well, carrying that extra bit of weight and you feel it, you know it. I mean I'll get up in the morning and I'll say to my wife, 'The fluid's back,' and she'll say, 'How do you know before I've even set the scales?' - I stand on the scales every morning, and it's annoying, I can't stand it, I hate it because it goes up and down, and up and down. 

One night you'll say to yourself 'oh great I'm away back down again', you get up the next morning and 'no, I've half a stone back on again' and it's really annoying but you've got to do it, you've got to stand on the scales every morning and get yourself weighed and check your weight because it's the only way I know for sure that the fluid's back again. 

Is there anything you can do to lower your own weight, I mean can you do?

I've been dieting for at least the last 6 months pretty rigorously. I used to be bad for the likes of Mr Kipling cakes - I loved them - but now I just, I get myself a treat of the weekend of one or two but that's it!  During the week I try and stay off the pastry, I don't eat a lot of potatoes. Fry-ups - we used to have a fry-up every second or third day and now basically if I have one, it's once a week. The deep fat fryer's hardly ever used because, myself and the kids don't eat a lot of chips now.  

I've changed my way of eating a lot but my weight's not getting down and psychologically it's terrible because when I go back to see a dietician next week I'm going to say to her 'What's the point? I've given up this, that, this, that and it's probably helped me giving them up, but to me it's not!'  I've still got the same weight as I started off with.

Most people who had tried to improve their diet described how they had cut down on red meat and dairy produce and generally ate less fried food. Many people said they knew they should eat more fresh fruit and vegetables though some found this harder to do than others particularly if they didn't like the taste. Several also said they didn't like to eat salad too often. People tried to eat smaller portions at meals and said that home-cooked food was better for you than ready-prepared meals. People often missed favourite foods such as bacon and eggs, fry-ups, chips and cream cakes, though some people still enjoyed these occasionally as a treat. Restricting fluid intake, including in foods, had sometimes been advised, and Philip was avoiding caffeine to prevent his heart from racing, which could activate his implanted defibrillator.

 

Says that he tries to control his weight by eating mainly salad and fish.

Says that he tries to control his weight by eating mainly salad and fish.

Age at interview: 81
Sex: Male
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All the food I eat is doing as best I can to keep off calories and, you know, cholesterol and stuff like that. My food consists mainly of salad or fish, greens, fruit, mainly. We do have a, we do go mad a little while now and again you know - might have a nice pudding or something like that which I'm not supposed to have, or cream cakes, stuff like that. But that don't happen very often, I don't think it's going to make a great deal of difference. But generally speaking, the food I have is not excessive but it's quite enough and I think I'm taking the right things, even the butter, milk, low cholesterol milk and all the rest of it, low-fat milk. That's what we have, so... I can't do much more in that line to help myself.

 

He eats less fruit than he should but generally his diet has greatly improved.

He eats less fruit than he should but generally his diet has greatly improved.

Age at interview: 49
Sex: Male
Age at diagnosis: 44
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What's she made you give up?

Cakes, biscuits, crisps. Don't eat a lot of cheese, I used to eat cheese terrible, something terrible, now I'm on a quarter pound a week, that's all the cheese want, so it's not a lot I don't know what kilograms, I can't work those things! Juice, I used to drink an awful lot of juice. I've been tested for diabetes and things like that, but it's all came back okay, but I drink a lot of juice, a 2-litre bottle. I've seen me drink that in a day, so I've started going on to diet just water. We buy a lot of bottled water now where 6 months' ago we would never think of it, we'd say why are people buying bottled water for when you've got a tap there? And now of course, no, the bottled water is a good thing for me, for diluting juice rather than fizzy juice.

It's changed, she's changed my way of eating, sweets, I used to be a big chocolate eater and now I can't, I'll have it at the weekend I must admit I have a bar at the weekend, but... no she's entirely changed my way of eating.

What about, I mean does the dietician say the normal thing which is you must have five portions of fruit, do you find that difficult?

I find that difficult. I'm eating a lot of tinned fruit and she said that's all right so long as it's in natural juice and not in sweetened juice. So the wife buys a lot of tinned fruit now - peaches, pears - fresh ones are alright, but I find they're not very nice just now so I don't eat them. Oranges - I love oranges! [laughs] Bananas I can't stand - and they tell you to eat a lot of bananas because of the fibre - but I can't stand them! So fresh-wise we eat a lot of fresh food now. The wife'll, if she's making things like stewed sausages she'll make them herself whereas 6 months' ago she'd go into the freezer cabinet and buy a packet and stick it in the microwave. So the dietician has told us that you're better cooking yourself.

Taking regular light exercise such as walking had helped many control their weight and improve health (see 'Sport, hobbies and activities'). Some had changed what form of exercise they took, for instance one man had stopped doing aerobic work-outs and concentrated more on stretching. Others with more severe heart failure found taking exercise increasingly difficult and were not sure if it did them good.

 

He does stretching exercises and sit-ups now rather than martial arts.

He does stretching exercises and sit-ups now rather than martial arts.

Age at interview: 46
Sex: Male
Age at diagnosis: 45
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I still do the skipping. The martial arts I've had to cut down because it's, I don't know, I can feel, whether it's my mind or conscience or whatever, but I can feel my heart when we're going through certain exercises. And I can feel it going [claps] and I don't think I'm supposed to feel it doing [claps]. You know, it's supposed to be [slow claps] so I've had to cut down, but I still do the stretch exercises and sit-ups and what have you because they still keep your upper body strengthened and your leg strength, you know what I mean. So it's still good for you.

Alcohol and tobacco habits had often changed. One man regretted no longer being able to drink wine, but knew that it interfered with his medication. Others continued to have a glass or two of wine, lager or whisky - one man said that wine at lunchtime helped him sleep better. Someone else was told by a nurse that there was no need for him to cut out alcohol altogether as he was only a moderate drinker. A few people whose heart failure was alcohol-related had been advised to give up drinking alcohol altogether.

 

Describes his daily diet and says he likes to have something alcoholic to help him sleep.

Describes his daily diet and says he likes to have something alcoholic to help him sleep.

Age at interview: 80
Sex: Male
Age at diagnosis: 75
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I make up my mind what to have for breakfast. Sometimes I'll have a cheese sandwich, other time I'll have egg and bacon, another time like this morning... jam on toast, you know I'm not fussy. Then lunch time I [coughs] usually I have a proper lunch, you know, meat, vegetables and what-not, usually have potatoes, at least two, two vegetables. I never eat sweet, sometimes I'll have a chocolate afterwards, and perhaps I shouldn't say this, but a couple of glasses of hock, helps it!  [laughs] That's my excuse anyway, helps it down! 

And then in the afternoon, if I have more than one glass I usually end up there for an hour! There you are, snoring! And then I've nothing else to eat at all until nine o'clock at night. And I have a friend I go to visit, and I usually have either three or four crispbreads with cheese or bully beef or something on, and a couple of snifters of brandy - medicine - and I usually come home about ten o'clock and, sometimes I get a call out in the kitchen, for the bottle and have another one before I go to bed. I'm a naughty boy really, but, well, what else is there at 80 years old! [laughs] Well you've got no other enjoyment! 

But I don't drink beer now hardly - but I prefer a little snifter, a smaller glass. And apart from that I'm fairly happy. 

 

Brian thinks it is lack of exercise rather than diet or alcohol intake that has caused his weight gain.

Brian thinks it is lack of exercise rather than diet or alcohol intake that has caused his weight gain.

Age at interview: 76
Sex: Male
Age at diagnosis: 70
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Although I’ve always had a healthy diet, I confess that I enjoy alcoholic drinks. I’m pretty healthy in that respect so I’m not going to call myself a heavy drinker but I drink enough to, I’m afraid, put on weight if I’m not getting the exercise. When I was playing five times a week, playing golf five times a week, that was enough exercise to match my calorie intake and I had a fighting weight, I refer back to my days playing rugby and boxing of about 12½ stone. Unfortunately I’ve put on about 1½ stone, I’m now 14 stone without any change in diet or drinking habits so it’s entirely down to lack of activity. I’ve thought about it a good deal because obviously being overweight is not a good characteristic if you have heart problems. But nevertheless I’m pushing on towards 77 and I’ve had a good innings and so to some extent, I look at the quality of my life and think, “Would I prefer to be tee-total?” and on a permanent diet, the answer is no, I wouldn’t prefer that, I’ll take a chance because I know that my kidneys and liver are all healthy because I have annual regular checks. My main health problem is lack of energy, breathlessness and because I don’t get physical activity.
Though many people had smoked during their lives most gave up when they first became ill (see 'Peoples ideas about causes of heart failure'). Several people said they still smoked and someone was about to start a course to help him stop smoking. Many people said they wished they had not started smoking. Some people we spoke to smoked cannabis as well as tobacco, one to relieve pain from another medical condition.

For more information on diet and exercise see the British Heart Foundation.

 

Last reviewed April 2016.
Last updated April 2016.

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