Certain dietary changes, such as limiting sodium and excess fluids, may help reduce fluid buildup caused by heart failure.

Congestive heart failure (CHF) occurs when extra fluid builds up and affects your heart’s ability to pump blood effectively.

Read on to learn tips on how to limit sodium and fluids, and how to eat with CHF.

As a first-line treatment, doctors usually recommend making dietary changes to reduce extra fluid. This generally involves reducing your sodium consumption and restricting your fluid intake.

Too much sodium can cause fluid retention. Drinking too many fluids can also impair your heart’s ability to pump blood properly.

Research from 2020 suggests reducing the amount of sodium you consume could help you decrease fluid retention.

However, additional 2022 research also found that restricting sodium too much may actually lead to additional problems in people with heart disease.

The findings in this area are not consistent, so more research is necessary. That said, most doctors and nurses will still recommend you choose lower sodium foods.

When it comes to reducing fluid, while the amount of fluid restriction varies from person to person, doctors often recommend people with CHF aim for 1.5–2 liters a day. This is equivalent to up to 2 quarts of fluid.

In addition, there’s research suggesting that following the DASH diet has benefits for people with CHF. For example, in a 2021 study with 412 participants, following the DASH diet alongside reducing salt intake lowered certain heart disease markers by 20–23%.

While it’s unclear whether people with existing heart failure would experience similar benefits, many doctors believe such dietary changes are still beneficial.

Your body constantly tries to strike the perfect balance between electrolytes, including sodium, and water. When you consume a lot of sodium, your body hangs on to extra water to balance it. For most people, this results in some bloating and mild discomfort.

However, people with CHF already have extra fluid in their bodies. This makes fluid retention a more serious health concern.

How much salt can someone with congestive heart failure eat?

The first thing to do is to try to look for foods that contain the least amount of sodium.

Alternatively, if sodium is one of the first five ingredients listed, it’s probably best to avoid it.

What about foods labeled as “low sodium” or “reduced sodium”? Here’s what labels like this actually mean:

  • Light or reduced sodium: The food contains one-quarter less sodium than the food usually would.
  • Low sodium: The food contains 140 mg of sodium or less in one serving.
  • Very low sodium: The food contains 35 mg of sodium or less per serving.
  • Sodium-free: The food contains less than 5 mg of sodium in one serving.
  • Unsalted: The food might contain sodium but not any added salt.

In addition, there are several other things you can do to eliminate extra salt from your diet without sacrificing flavor:

  • Experiment with alternative seasonings: Salt is about 40% sodium. It might be one of the more common seasonings, but it’s definitely not the only one. Try swapping salt for savory herbs, such as parsley or basil. Pepper and lemon juice also add a good amount of flavor without any added salt.
  • Tell your waiter: When dining out, ask your server to limit the salt in your dish or advise you on low sodium options. You can also bring your own salt-free seasoning to use instead.
  • Avoid prepackaged foods: Prepackaged foods often contain high levels of sodium due to added salt. Even those labeled “light” or “reduced” are still above recommended amounts. But you don’t have to eliminate salt entirely. Here are low sodium frozen meals for the next time you’re in a time crunch.
  • Watch for hidden sodium sources: Salt is used to enhance flavor and texture in many foods, such as condiments like mustard, steak sauce, lemon pepper, and soy sauce. Salad dressings and prepared soups are also often high in sodium.
  • Get rid of the salt shaker: Simply getting rid of the salt shaker in your kitchen or on the dinner table can make a big impact. Since it’s difficult to gauge how much salt you’re putting on the food from the salt shaker, you risk coming close to your daily limit.

How much water should someone with congestive heart failure drink?

In addition to limiting sodium, a doctor may also recommend limiting fluids. This helps keep the heart from getting overloaded with fluids throughout the day.

When it comes to restricting fluid, make sure to account for anything that’s a fluid at room temperature. This includes things like soups, gelatin, and ice cream.

You can follow these suggestions:

  • Find alternative thirst quenchers: The next time you’re tempted to drink some water, try to just swish water around your mouth and spit it out. You can also suck on sugar-free candy, chew sugar-free gum, or roll a small ice cube around the inside of your mouth.
  • Track how much you drink: Keeping a daily log of your fluid intake can be a big help. You might be surprised by how quickly fluids add up. With a few weeks of diligent tracking, you can start making more accurate estimates about your fluid intake and ease up on the constant tracking.
  • Portion your fluids: Budget the recommended 2 liters, or 2,000 milliliters (mL), throughout your day. For example, have 500 mL for breakfast, lunch, and dinner. This leaves room for two 250-mL drinks between meals. Work with your doctor to determine how much you need to restrict your fluid intake.
  • Eat water-heavy or frozen fruit: Fruits high in water, such as citrus or watermelon, are a great snack that can quench your thirst, plus they’re sodium-free. You can also try freezing grapes for a cooling treat.
  • Track your weight: Call your doctor if you gain more than 3 pounds in a day or consistently gain a pound a day. This could be a sign you may need to take other measures to reduce your fluid intake.

In addition to managing your salt and fluid intake, following the DASH diet may help you manage some of the symptoms of CHF by reducing certain inflammatory markers and giving you the right amount of macronutrients.

With the DASH diet, you focus on eating foods such as:

  • whole grains
  • fruits and vegetables
  • low fat dairy
  • lean red meat
  • fish
  • poultry
  • nuts and seeds
  • legumes

On the other hand, you want to limit sugar as well as saturated and trans fats, which are found in processed foods, high fat dairy, red meats, and desserts.

You can also consider following a Mediterranean or vegetarian diet, which are also good alternatives. However, they are not as well studied for CHF as the DASH diet.

What should you not drink with congestive heart failure?

You should avoid or significantly limit both alcohol and beverages containing caffeine.

What helps congestive heart failure naturally?

Other than dietary changes, things that can help include quitting smoking, exercising as suggested by your doctor, reducing stress, and getting enough sleep.

What is the best fruit for congestive heart failure?

Heart-healthy fruits include mangoes, guava, papaya, citrus fruit, apples, and bananas. This also includes savory fruits like avocado and tomatoes.

CHF involves a buildup of fluid that makes it hard for your heart to work efficiently. Reducing the amount of fluid in your body is an important aspect of any CHF treatment plan.

Work with your doctor to determine your ideal fluid intake. When it comes to sodium, try to stay under 140 mg per serving unless your doctor recommends a different amount.

You and your doctor can work together to determine the diet that’s best for you.