Nutrition Assessment
HF: Nutrition Assessment
➤ The RDN should assess the following (Table 1) in adults with HF (NYHA Classes
I–IV/AHA Stages B, C and D), to formulate the nutrition care plan:
Table 1. Nutrition Assessment and Monitoring and Evaluation
New York Heart Association (NYHA) functional classification, which describes
the severity of symptoms and exercise intolerance as follows:
• Class I: No limitation of physical activity. Ordinary physical activity does not
cause undue fatigue, palpitation, dyspnea (shortness of breath).
• Class II: Slight limitation of physical activity. Comfortable at rest. Ordinary
physical activity results in fatigue, palpitation, dyspnea (shortness of breath).
• Class III: Marked limitation of physical activity. Comfortable at rest. Less than
ordinary activity causes fatigue, palpitation, or dyspnea.
• Class IV: Unable to carry on any physical activity without discomfort. Symptoms
of HF at rest. If any physical activity is undertaken, discomfort increases.
Biochemical data, medical tests and medication usage:
• Lipid profiles
• Blood pressure and/or Doppler blood pressure
• Echocardiogram (left ventricular ejection fraction 40% or less)
• Complete blood count, urinalysis, serum electrolytes (including calcium and
magnesium), blood urea nitrogen, serum creatinine, glucose, fasting lipid profile,
liver function tests, thyroid-stimulating hormone, brain natriuretic peptide (BNP)
or N-terminal pro-B-type natriuretic peptide (NT-proBNP)
• Use of medications, prescription and other over-the-counter medications, herbal
supplements and complementary or alternative medications.
Nutrition-focused physical findings:
• Height, weight, body mass index (BMI) and waist circumference
• Edema, congestion and shortness of breath
• Cachexia and muscle wasting
• Hand grip strength testing
