A study on dietary diversification intervention for elderly patients with chronic heart failure who can eat by mouth.

Abstract

Conventional CHF nutrition counseling is often one-size-fits-all. We developed and tested a DDS-guided, tiered dietary diversification program for elderly CHF patients able to eat orally. A quasi-experimental study with a non-randomized, non-concurrent control design was used. Eighty-eight elderly oral-feeding CHF patients were selected from the Cardiovascular Department of a tertiary general hospital in Zunyi City (July-October 2022): the control group (July-August, n = 44) and the intervention group (September-October, n = 44). The control group received conventional dietary guidance, while the intervention group underwent personalized intervention based on the Dietary Diversity Score (DDS9) and nutritional status, with 2-month post-discharge follow-up. The Dietary Diversity Score (DDS9) and nutritional indicators (Heart Failure-Specific Mini Nutritional Assessment [MNA-HF], Body Mass Index BMI) were compared between the groups at baseline, 1 and 2 months post-intervention. There were no statistically significant differences in baseline data between groups ( p > 0.05). After 1 month, the intervention group showed significantly higher scores in Total DDS and specific food groups (fish, fruits, etc.) compared to the control group ( p < 0.05), with a large effect size for Total DDS. After 2 months, significant improvements were maintained for Total DDS (large effect size) and MNA-HF (medium effect size) ( p < 0.05). The intervention group exhibited a significantly greater upward trend in dietary diversity over time ( p < 0.001, large effect size). Although absolute BMI trends did not differ significantly, the increase in BMI at 2 months was significantly greater in the intervention group (medium effect size). A DDS-guided, tiered intervention improved dietary diversity and nutritional status over 2 months in elderly CHF patients, demonstrating practicality and scalability. Limitations include the non-randomized, single-center design and short follow-up; longer multicenter trials are needed to confirm durability and clinical impact.