Dear Dietitian,

My husband was recently in the hospital and was diagnosed with congestive heart failure. He has been instructed to follow a 1500 mg sodium diet.  He’s trying to follow the diet, but it’s tough.  I’m afraid he will get frustrated and give up. Any words of wisdom?

Elsie

Dear Elsie,

A low sodium diet is a major adjustment for just about any person, and a 1,500 mg sodium diet is not easy to follow. To put that in perspective, Americans consume more than 3,400 mg of salt each day. For readers who are not familiar with congestive heart failure (CHF), it’s a chronic condition where fluid builds up around the heart, causing it to pump inefficiently. Salt draws water, so it is restricted in the CHF patient’s diet to decrease fluid retention.  

Behavior change is a process that takes time; it is not an event. Following are the stages of change as described by Prochaska and DiClemente:

1. Precontemplation – The person does not have any plans to change in the near future. The positives of using salt outweigh any negatives associated with not using it.
2. Contemplation. – People in this stage may consider the cutting down on salt, but may be indecisive about taking the first step.
3. Preparation- The person sees the ‘cons’ of continuing behavior as outweighing the ‘pros’ and are more willing to take the first step.
4. Action- People have changed their behavior and plan to move forward. There is still ambivalence about change, and relapse is possible.
5. Maintenance- The patient is able to avoid temptations to return to using salt. He may have slips, but doesn’t see this as failure.

There are several things you can do to support your husband in his lifestyle change. First, you can educate yourself on a low salt diet. Most hospitals offer Cardiac Rehabilitation classes where diet and exercise are taught. You may have already attended these classes with your husband.

Although patients are educated on their diet while in the hospital, it is a lot of information to process when you are not well. I strongly recommend an outpatient appointment with a Registered Dietitian Nutritionist (RDN) and attend the session with your husband. The environment is much more relaxed than in the hospital, and at this time, the patient usually feels better, so it’s easier to learn. Most insurances will cover the cost.  Also, interview the dietitian over the phone to see if it’s a good fit before making an appointment. Any dietitian will have the information to teach you, but styles and attitudes vary.

If you are the cook, prepare tasty meals that use herbs for seasoning instead of salt. There are numerous recipes on the internet.

Finally, compliance is a choice that the patient has to make. No one else can make it for them. Don’t expect to see significant changes for at least six weeks. Try to be patient; it’s a virtue.

Until next time, be healthy!

Dear Dietitian