Development and testing of the feasibility and acceptability of a tailored dietary intervention in patients with heart failure.

PURPOSE: The aim of this study was to describe how to develop a theory-based tailored dietary intervention (TADI) and test its feasibility and acceptability in patients with heart failure (HF). METHODS: The development team consisted of experts in HF, nutrition, and clinical trials. Four patients with HF and 3 additional experts reviewed intervention materials and provided feedback. The 5-session TADI was developed from this feedback and tested in 5 patients with HF (60% women; mean age, 55 years). Participation and intervention completion rates were collected for feasibility test. In addition, data on dietary adherence and the factors affecting dietary adherence were collected at baseline and after the intervention for feasibility test. Data on patient acceptability were collected at the end of sessions. RESULTS: Sixty percent of patients we approached expressed interest in this study. Five patients completed all of the sessions and follow-up data collection. Mean dietary sodium consumption decreased from 2.38 to 1.30 g/d. Among the factors affecting dietary adherence, skills showed the greatest increase. Patient acceptability scores for sessions 1, 2, 3, and 4 were 98%, 97%, 100%, and 100% of 100%, respectively. CONCLUSION: The TADI is ready for testing in larger sample studies to manage sodium intake.

Nutritional considerations in heart failure.

There are a number of factors related to heart failure pathophysiology and treatment that influence nutrient requirements for patients. These include catabolism, inflammation, oxidative stress, diuretic use, and presence of comorbidities. On the other hand, there is evidence that specific nutrients can alter heart failure pathophysiology. This article reviews the current evidence for nutritional recommendations regarding sodium and fluid restriction, macro- and micronutrient intake, and dietary changes required by the presence of common comorbidities.

Qualification of oil-spill treatment products - Adopting the Baffled Flask Test for testing of dispersant efficacy in the UK.

The UK Marine Management Organisation (MMO) tasked the Centre for Environment, Fisheries & Aquaculture Science (Cefas) with reviewing the current UK dispersant efficacy testing procedures. The aim was to identify possibilities to increase standardisation, improve health and safety performance and explore harmonisation possibilities with international dispersant efficacy testing procedures. The US EPA 'Baffled Flask Test' (BFT) was adopted, implemented and validated as a new standard method in the UK. The outputs from this study suggest that dispersant efficacy results from the adopted BFT test and the currently used protocol are in a similar range and results presented by the US EPA. As a result, the transition to the adopted BFT test will require minimal changes in the assessment of the results or reporting and increase harmonisation between tests used in the UK and North America.

Higher dietary lycopene intake is associated with longer cardiac event-free survival in patients with heart failure.

BACKGROUND: The antioxidant lycopene may be beneficial for patients with heart failure (HF). Processed tomato products are a major source of lycopene, although they are also high in sodium. Increased sodium intake may counter the positive antioxidant effect of lycopene. METHODS: This was a prospective study of 212 patients with HF. Dietary intake of lycopene and sodium was obtained from weighted 4-day food diaries. Patients were grouped by the median split of lycopene of 2471 µg/day and stratified by daily sodium levels above and below 3 g/day. Patients were followed for 1 year to collect survival and hospitalization data. Cox proportional hazards modeling was used to compare cardiac event-free survival between lycopene groups within each stratum of sodium intake. RESULTS: Higher lycopene intake was associated with longer cardiac event-free survival compared with lower lycopene intake (p = 0.003). The worst cardiac event-free survival was observed in the low lycopene intake group regardless of sodium intake (> 3 g/day HR = 3.01; p = 0.027 and ≤ 3 g/day HR= 3.34; p = 0.023). CONCLUSION: These findings suggest that increased lycopene intake has the potential to improve cardiac event-free survival in patients with HF independent of sodium intake.