Hi everyone my name is Ryan Santanna-Hart and I am a Registered Dietitian for Northern California VA.
I have been with the VA for little under 2 years and have been working as a Dietitian for over 6 years. I am part of a team called Transition of Care. This dynamic team is made up of nursing case managers, pharmacy, and social work to ensure all aspects of a veterans needs upon d/c are being met.
My position is unique, because I am currently the only Dietitian in this role for Northern California. This means I have the privilege to work with veterans from all over Northern California.
We support veterans with safe discharge plans who have recently been admitted to community hospitals. I understand how hard it can be being in the hospital and then you get discharged home with so much information.
This can be overwhelming and may not be the easiest to understand all the recommendations and directions you have been given, especially when you are not feeling great.
This is why this whole series is called heart to home, we at the VA are here to take care our nations heroes and we want you to be at home and healthy.
My number one goals is to ensure veterans feel supported with their health once they have been discharged home and of course we do not veterans to end up back in the hospital. I love working with veterans and I get the opportunity to talk to many veterans throughout the day and week.
Heart health month is celebrated every year in February but heart health is important to focus on every day. Today on this episode I am going to focus on the veterans who are newly diagnosed with congestive heart failure (CHF) or those who are having issues with already existing CHF.
With CHF, your heart is not pumping blood as well as it should, causing blood to back up in the veins. You may feel short of breath, fatigued and have swelling called edema from fluid buildup around the heart, lungs, or legs .
Okay, so maybe you have been in the hospital with some of these symptoms and then you get sent home. Now what? Hopefully you have been set up to f/u with your PCP.
We hope you are aware that your local VA has a dietitian to review some lifestyle and diet changes that can help with heart health and help you feel better. But, most importantly help assist you in NOT making a return trip to the hospital because we all know that is no vacation…
So what are some things you can do to help manage your CHF? Let’s review a few lifestyle changes that may help you manage your CHF.
Limit your sodium: A high sodium diet may cause the body to retain water. In return it causes the heart to work harder to pump out the extra water. This may also raise your blood pressure.
A great way to do this is by managing your sodium intake by eating real foods and less processed foods. What is a real food? It is something that comes straight from the plant or animal as possible and can typically be found in nature.
These include protein sources such as poultry, fish, eggs, beef, pork, Greek yogurt, etc.; non-starchy vegetables, fruit, nuts and seeds, whole grains, etc.
Verses heavily processed foods such as fast food, TV dinners/frozen meals, boxed foods/meals, processed meats, snack cakes, potato chips, etc.
Typically when people are consuming too much sodium, it is because they are consuming too many heavily processed foods.
Using alternative seasonings instead of salt is one way to cut back on the salt you eat. Some examples that you could use are garlic powder, or seasoning specifically made with not salt that comes in different flavors and varieties. fresh herbs or dried spices, fresh lemon, and lime
You can even make your own spice blend.
For example for an Italian blend: Mix onion powder, garlic powder, oregano, and basil.
For a stir-fry blend: Mix onion powder, garlic powder, ground ginger, and black pepper.
You may find a new favorite seasoning or seasoning blend to use on your favorite foods!

By choosing unseasoned fresh or frozen meats or vegetables you are able to have more control of the types of seasonings you add to your food.
Steamer bags of vegetables can be a great, easy way to add in low sodium sources of veggies.
Throw them in the microwave (or cook via your preferred method), add some of your favorite seasonings and maybe some olive oil, and voila!
Keep canned foods at a minimum, but when you do use them look for cans that say “low-sodium” or “No salt added”
If you are eating out, see if food can be prepared without salt or cut back on how often you eat out. Small changes can add up to bigger health outcomes.
Nutrition labels are your friend and a great tool to use when deciding what foods to purchase.
Look for salt content of foods under “Sodium” which is in milligrams (mg). A trick is to look for foods that have less than 140 mg sodium per serving and avoid foods that have 300 or more mg of sodium.
Many physicians recommend limiting sodium to around 2000 mg when dealing with CHF.
The serving size will be important to ensure you are not eating more than you want.
If there are certain foods that you really enjoy, that happen to be high in sodium, just try to consume those foods in moderation and be mindful of it.
Some other tips that may help you manage CHF symptoms or catch issues is watching your weight.
Recording daily weights will be important to ensure you don’t have a lot of fluid retention. Call your doctor or CHF care team if you gain 3 lbs in one day or 5 lbs in one week.
If you feel like weight loss is something you’d like to pursue to reduce symptoms, just remember that we want to take a conservative approach and avoid the crash diets. A weight loss of 1-2% per week is reasonable for most. Your VA dietitian can help you to build a plan.

Physical activity (hat is any movement that you are able to do) is good movement and can help your heart stay strong.

Start slowly and make sure you talk to your doctor about how much activity is right for you.

Keep in mind that increasing your activity & exercise does not mean that you have to train for a marathon. The largest reductions in risk simply come from sitting less, and being less sedentary.

Find something that interests you, and take small steps towards including more of it into your lifestyle. Avoid overworking your heart with activities that cause you to feel dizzy, short of breath, or chest discomfort.
While talking to one of my fellow RDs she shared that a veteran she had been working with had started watching his fluid and sodium intake. He said it helped keep the swelling (edema) off and that has made him feel much better.
Keep in mind that small changes over time add up to big health benefits We have a great team of Registered Dietitians who can individualize a plan that is right for you and work to support you in reaching your health goals for improved quality of life.