Nutritional Interventions in Heart Failure: A Systematic Review of the Literature
Authors: Johana R Almansa
Abby Cummings
Diana Baptiste
Martha J Andrews
Jingzhi Xu
Martha Abshire
Cheryl Dennison Himmelfarb
Jiayun Xu
Journal: Journal of cardiac failure (2015)
Discipline: CLINICAL MEDICINE
Keywords: Diet; fluid restriction; sodium restriction.
Affiliations: Johns Hopkins University School of Nursing, Baltimore, Maryland. Electronic address: ., Johns Hopkins University School of Nursing, Baltimore, Maryland; College of Nursing, University of Utah, Salt Lake City, Utah., Department of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, Maryland., Heart Failure Bridge Clinic, Johns Hopkins Hospital, Baltimore, Maryland., Johns Hopkins University School of Nursing, Baltimore, Maryland., Academic Affairs, Johns Hopkins University School of Nursing, Baltimore, Maryland.

Abstract:  Background: Heart failure (HF) is a major health care burden and there is a growing need to develop strategies to maintain health and sustain quality of life in persons with HF. The purpose of this review is to critically appraise the components of nutrition interventions and to establish an evidence base for future advances in HF nutrition research and practice. Methods and results: Cinahl, Pubmed, and Embase were searched to identify articles published from 2005 to 2015. A total of 17 randomized controlled trials were included in this review. Results were divided into 2 categories of nutrition-related interventions: (1) educational and (2) prescriptive. Educational interventions improved patient outcomes such as adherence to dietary restriction in urine sodium levels and self-reported diet recall. Educational and prescriptive interventions resulted in decreased readmission rates and patient deterioration. Adherence measurement was subjective in many studies. Evidence showed that a normal-sodium diet and 1-liter fluid restriction along with high diuretic dosing enhanced B-type natriuretic peptide, aldosterone, tumor necrosis factor Œ±, and interleukin-6 markers. Conclusions: Educational nutrition interventions positively affect patient clinical outcomes. Although clinical practice guidelines support a low-sodium diet and fluid restriction, research findings have revealed that a low-sodium diet may be harmful. Future research should examine the role of macronutrients, food quality, and energy balance in HF nutrition. 

Retracted: No

PubPeer comments:
 Abshire et al cite and discuss findings from a 2008 paper by Paterna et al published in Clinical Science and a paper by the same author group published by Parrinnello 2009 in the Journal of Cardiac Failure. Both papers have been found to contain duplicated data. Data from both these studies were contained in a 2012 systematic review published in BMJ Heart journal that was later retracted (Aug 21, 2012) due to the inability of the study group to provide the original data to verify the duplicate data issues due to a u201ccomputer failureu201d. Importantly, the Parrinello 2009 paper is published in the same journal as the Abshire et al 2015 systematic review (Journal of Cardiac Failure). In 2013, the then Editor in Chief of this journal published a [notice of concern](http: www.sciencedirect.com science article pii S1071916413001644?via%3Dihub) outlining the duplicate data issue which cautioned the use of data from the Parrinello 2009 paper. However, the journal did not retract the paper. The fact that the editor(s) reviewers have allowed Abshire et al 2015 to cite the Parrinello 2009 paper in their review highlights that existing editor(s) of the journal a) do not pay attention to papers with a notice of concern in their own journal b) do not ensure submitting authors are aware of articles that contain a notice of concern and or c) do not enforce submitting authors to not cite articles from their own journal that contain a notice of concern. This is of some concern, especially given the following conclusion in the abstract of Abshire et al which is based predominantly on potentially fraudulent data from Parinnello 2009 (and Paterna 2008): While clinical practice guidelines support a low sodium diet and fluid restriction, research findings have revealed that a low sodium diet may be harmful. The review of Abshire et al should, therefore, be retracted and re-published once the data and conclusions have been corrected accordingly. Additional PubPeer posts for these two specific studies are available: https: pubpeer.com publications E03BB72DBAA939C61082F4608D558B https: pubpeer.com publications B24491C479E0C003418D1F1CBECE07 A complete blog of the story leading to retraction of the BMJ Heart systematic review is available here: https: www.cebm.net 2019 02 salt-reduction-in-heart-failure-where-has-the-uncertainty-come-from ,