How to Eat Healthy With ATTR-CM: 5 Tips

5 Healthy Eating Habits for ATTR-CM

5 Healthy Eating Habits for ATTR-CM
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There’s no official diet for the heart muscle disease transthyretin amyloid cardiomyopathy (ATTR-CM), but choosing certain foods can help you manage your symptoms and feel your best. That’s because making healthy food choices can help your body maintain the right fluid balance and support heart health overall, says Johanna Contreras, MD, a cardiologist at Mount Sinai Fuster Heart Hospital in New York City.

These five eating habits can help you get on track. Every person’s needs are different, so be sure to check with your cardiology team before making any major changes to your diet.

1. Eat Less Sodium

When you have ATTR-CM, your heart has to work harder to pump blood, and excess salt makes it even tougher. If your ATTR-CM has caused heart failure, you may need to keep your sodium intake to 1,500 to 2,300 milligrams per day. Sodium encourages your body to hold onto water, which can worsen heart failure symptoms like swelling and fluid buildup.

To keep a lid on your sodium consumption, read food labels carefully. When buying packaged foods, look for “low sodium,” “reduced sodium,” or “no-salt added” on labels, and scan the nutrition facts to confirm the numbers. Try to limit products that are notoriously salty, like processed and cured meat, as well as sauces, mixes, and instant products like flavored rice and ready-made pasta.

 Restaurant meals can be far higher in sodium than home-cooked food.

Replacing salty foods with more fresh fruits and vegetables, which are naturally low in sodium, can help lower your intake. So can cooking more of your meals at home, since “you can measure and can keep track of any salt that’s added,” says Alyssa Kwan, RD, an adjunct professor at the University of San Francisco and a clinical dietitian with Stanford Health Care. That’s especially true when you opt for salt-free flavor boosters like fresh herbs, spices, garlic, citrus juices, and vinegar.

2. Stay Hydrated

If you have ATTR-CM, you’ll want to strike a balance with fluid intake. It’s important to consume enough liquids to prevent dehydration, but it’s also important to avoid overhydrating. Depending on the degree of cardiomyopathy, some patients may need to limit how much water they consume in a day, says Dr. Contreras.

Your cardiologist will tell you how much fluid you should have each day. Some people with heart failure caused by ATTR-CM may need to restrict their fluids to between 6 and 9 cups per day.

Most of your fluids should come from water, since soda and sports drinks sometimes add unnecessary sugar and salt. “Water helps maintain hydration without placing additional strain on the heart,” Contreras says.

If your fluid intake is restricted and you’re feeling thirsty, limiting salty foods and caffeine may help. So can chewing gum, sucking on hard candies or mints, and eating chilled or frozen fruits like grapes or strawberries. Let your cardiologist know if you’re having symptoms of dehydration, like fatigue, dark urine, or dizziness.

3. Keep an Eye on Your Potassium Intake

Because ATTR-CM makes your heart stiff, doctors often use diuretics to help clear out extra fluid. This may cause your body’s potassium level to either drop too low or climb too high, potentially leading to heart rhythm issues.

Different types of diuretics affect the body’s potassium levels. Thiazide and loop diuretics make you pee out excess potassium, causing you to need more. Potassium-sparing diuretics, on the other hand, can make your body hang on to more potassium, causing your levels to get too high. You may need to eat more or less of the mineral to account for your meds.

If you’re not clear which type of diuretic you take, ask your cardiologist and also discuss how much potassium is right for you. If you need to increase your potassium intake, include more bananas, potatoes, sweet potatoes, oranges, and tomato sauce in your diet. If you need to limit your potassium intake, opt for lower-potassium fruits and vegetables like berries, plums, watermelon, cauliflower, and cabbage.

A registered dietitian who specializes in ATTR-CM can help you find other foods that meet your potassium needs.

4. Limit or Avoid Alcohol

Though some kinds of alcohol once had a reputation for being heart-healthy, medical experts are now rethinking that advice. The current school of thought is that even moderate alcohol consumption may be harmful for heart health.

“Alcohol can be particularly problematic for ATTR-CM because it can worsen those predisposed to arrhythmias or abnormal heart rhythms, and cause fluid balance disruptions,” says Kevin Shah, MD, a cardiologist and the program director for heart failure outreach at MemorialCare Heart & Vascular Institute at Long Beach Medical Center in California. “And because alcohol leads to additional urination, it can also lower blood pressure.”

Many alcoholic drinks also contain potassium, which could make it harder to limit your intake if you’ve been instructed to do so.

There’s no expert consensus on how much alcohol may be okay when you have ATTR-CM. The general thinking is that less is better — and none may be the best of all.

“I recommend minimizing alcohol consumption or eliminating altogether,” says Dr. Shah. “Every drink introduces risk that a structurally compromised heart may not be well equipped to handle.”

5. Choose Nutrient-Dense Foods and Limit Processed Ones

Eating meals that pack a nutritional punch is good for your heart and your body as a whole. What’s more, it may have a positive impact on ATTR-CM symptoms like heart palpitations and shortness of breath.

It’s especially important to make every bite count if ATTR-CM causes gastrointestinal symptoms that limit your appetite, since eating too little can lead to malnutrition.

Reach for the following foods:

  • Fruits and vegetables
  • Whole grains
  • Lean proteins like beans, tofu, seafood, and skinless poultry
  • Low-fat dairy
  • Nuts and seeds

Prioritizing whole foods also leaves less room for ultra-processed foods that are high in sugar, salt, and unhealthy fats, which Contreras says can worsen fluid retention, weight gain, and overall heart health. “Limiting these foods can help patients better manage symptoms and avoid additional strain on the heart,” she says.

The Takeaway

  • While there’s no official diet for ATTR-CM, adjusting what you eat can help manage symptoms by supporting heart health and maintaining proper fluid balance.
  • Managing fluids and key nutrients is key. People with ATTR-CM may need to balance hydration carefully and adjust potassium intake, depending on their diuretic medications, to avoid complications like dehydration and an irregular heart rhythm.
  • Focusing on nutrient-dense, minimally processed foods while limiting alcohol can help manage symptoms and prevent added strain on the heart.

Resources We Trust

EDITORIAL SOURCES
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Resources
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Chung Yoon, MD

Medical Reviewer
Chung Yoon, MD, is a noninvasive cardiologist with a passion for diagnosis, prevention, intervention, and treatment of a wide range of heart and cardiovascular disorders. He enjoys...
Marygrace Taylor

Marygrace Taylor

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Marygrace Taylor is an award-winning freelance health and wellness writer with more than 15 years of experience covering topics including women’s health, nutrition, chronic conditi...