Diet and Lifestyle Changes fo... Video Transcript

Participants

Ainat Beniaminov MD, Simon Maybaum MD, Paul J. Moniz , Sumit Verma MD

Summary

CHF is a serious disease that will usually require medical treatment. But diet and exercise can play a crucial role in slowing the progression of the disease and improving one's quality of life. Our panel of experts will discuss the latest recommendations.

Webcast Transcript

PAUL J. MONIZ: I'm Paul Moniz. Thanks so much for joining us on this webcast. Today's we're talking about congestive heart failure and how dietary and exercise changes can actually slow the progression of this very debilitating condition. Catching it early can mean the difference between a debilitating life, and one that you can lead with some comfort.

We have two specialists here to talk about that. They are both cardiologists. To my left is Dr. Simon Maybaum. He is an attending cardiologist at the Heart Failure and Cardiac Transplant Program at New York Presbyterian Hospital. Thanks for joining us.

SIMON MAYBAUM, MD: Thank you.

PAUL J. MONIZ: Next to him, we have Dr. Ainat Benjaminovitz, who is a cardiologist at the same hospital, and whose name is getting slightly easier after saying it a few times.

Doctor, let's begin with you. Why is salt so dangerous for someone who has congestive heart failure?

AINAT BENJAMINOVITZ, MD: In the state of congestive heart failure, the body avidly absorbs water. That's one of the compensations that it does to help the failing heart. And although it's a short-end compensation, in the long-term it's very deleterious because you have too much water on board and then you get the signs and symptoms of congestive heart failure.

Since the body is already in a fluid retaining state, you have to always keep your salt level in your body constant. You can't have too much salt. So, if you have just a little bit of salt, you draw in a lot of fluid with it. A lot of water, so you don't get too salty inside. Since the body is already avidly holding on to water, any extra salt will make it hold on to that much more water. That can really mean the difference, like you said, between a comfortable lifestyle of not having to breathe heavily with every little step you take versus one where you're very congested and feeling miserable because you have too much water.

PAUL J. MONIZ: We should point out again that congestive heart failure refers to the heart not pumping efficiently enough, and as a result fluid is then backed up into the heart, the lungs and the other organs, which causes problems; fatigue, shortness of breath.

Doctor, you have some interesting stories about what lengths to which your patients will go to get salt. Share for us how difficult it is to get even patients with congestive heart failure off the salt habit.

SIMON MAYBAUM, MD: I think that it's not easy to adhere to a low salt diet. We understand that, but there are some patients who find it particularly difficult. We both have stories and memories of policing the floors at the Heart Failure Center and Cardiac Transplant program watching what patients are eating. We would often see a patient the next morning with decompensated heart failure who has had a pastrami sandwich or a hot dog.

AINAT BENJAMINOVITZ, MD: Or pizza.

SIMON MAYBAUM, MD: Who has ordered in Chinese food.

PAUL J. MONIZ: What are we talking about? Contraband food? Salty foods on the floors?

SIMON MAYBAUM, MD: Correct. This would be smuggled in and we would only find out the next day when we had to increase the diuretic,or the water removing dose, to try and compensate for the night's discretion.

PAUL J. MONIZ: We're joking about this now, but this can really have a serious effect on the body, even a small amount, which is surprising to most people. Most people, no matter what condition they have, they really think everything in moderation is okay, but in this case, it really isn't.

AINAT BENJAMINOVITZ, MD: Absolutely not.