Screening and Referral
➤ The registered dietitian nutritionist (RDN) plays an integral role in the
interdisciplinary healthcare team by designing the optimal nutrition
prescription that complements drug therapy, physical activity, and
behavioral therapy.
➤ Based on the client's treatment plan and comorbid conditions, other
nutrition practice guidelines may be needed in order to provide optimal
treatment.
HF: Medical Nutrition Therapy (MNT)
➤ For adults with heart failure (HF) (NYHA Classes I–IV/AHA Stages B, C and D),
the RDN should provide MNT to treat HF and contributing comorbidities,
such as hypertension, disorders of lipid metabolism, diabetes mellitus
and obesity. Every patient with HF should have a clear, detailed, and
evidence-based plan of care that ensures the achievement of guideline
determined medical therapy (GDMT) goals, effective management of
comorbid conditions, timely follow-up with the healthcare team, appropriate
dietary and physical activities, and compliance with secondary prevention
guidelines for cardiovascular disease. Research reports that MNT resulted
in a significant decrease in sodium intake and maintenance of body weight.
(Strong, Imperative)
HF: Frequency and Duration of MNT
➤ For adults with HF (NYHA Classes I–IV/AHA Stages B and C), the RDN should
provide an initial MNT encounter lasting 30–60 minutes, with a follow-up
encounter four to six weeks later, and determine if and when additional
MNT encounters are needed. Research reports that this frequency and
duration of MNT resulted in a significant decrease in sodium intake, as well as
maintenance of serum sodium levels and body weight. (Fair, Conditional)
HF: Frequency and Duration of MNT in Advanced HF
➤ For adults with advanced HF (NYHA Class IV/AHA Stage D), the RDN should
provide an initial MNT encounter and additional follow-up encounters
as often as every two weeks. Research reports that this frequency and
duration of MNT resulted in increased exercise tolerance, higher physical
component scores on quality of life measures and decreased anxiety, as well
as maintenance of body weight. (Fair, Conditional)
