Heart-Healthy Meal Plan for Chronic Heart Failure: Step-by-Step Guide + 7-Day Menu

You want meals that help you breathe easier, keep swelling down, and still taste good. That’s doable. The trick is balancing sodium, fluids, and protein without starving your energy. You don’t need a chef or a lab scale-you need a tight set of rules, a repeatable shopping list, and a simple way to adjust when meds or labs change.

This guide is for people living with chronic heart failure (and their caregivers) who want a practical plan they can start this week. It blends what major guidelines recommend with what actually works in a real kitchen. I’ll show you how to set your sodium and fluid targets, hit your protein needs, read labels fast, and build a week of meals you’ll actually eat.

TL;DR: The fast rules that make a difference

- Aim for 1,500-2,000 mg sodium per day unless your clinician told you differently. Split it across meals: 500-600 mg per meal, 100-200 mg per snack.

- Fluids: Many people don’t need a hard cap. If you have low sodium (hyponatremia) or frequent fluid overload, your clinician may set 1.5-2.0 L/day. Count anything liquid at room temp.

- Protein matters. Target 1.1-1.4 g per kg body weight daily (older adults often do better near 1.2-1.4 g/kg). It helps prevent muscle loss and keeps you stronger.

- Fill the plate: half non-starchy vegetables, a palm-sized portion of lean protein, a fist of whole grains or starchy veg, plus fruit and healthy fats. Think “DASH meets Mediterranean,” but with stricter sodium.

- Label hack: per serving, 5% DV sodium (~115 mg) is low; 20% DV (~460 mg) is high. Watch servings per package.

Build your plan step by step

heart-healthy meal plan rules only work if they’re tailored to your meds, labs, and appetite. Here’s how to dial it in.

1) Set calorie and protein targets

• Calories: 25-30 kcal per kg body weight per day. If you’re trying to lose weight safely, use the lower end (25). If you’re underweight or fatigued, use the higher end (30), and talk with your clinician if weight is dropping.
• Protein: 1.1-1.4 g/kg/day (older adults and those with recent weight loss often need 1.2-1.4). Example: 80 kg person → 90-110 g protein/day. Spread across meals to help appetite and muscle.
• Fiber: 25-35 g/day from vegetables, fruit, beans, oats, barley, and seeds. Fiber helps blood pressure, gut health, and satiety.

Why this matters: Heart failure often comes with muscle loss and low appetite. Higher protein for your size helps you stay strong. These targets are consistent with nutrition guidance used in cardiology and clinical nutrition practice.

2) Sodium: pick a realistic daily limit

• Most people do well aiming for 2,000 mg/day unless your cardiology team set a different limit. Some clinics still use 1,500 mg/day. If you try 1,500 and your meals feel impossible, 2,000 mg is a practical step that still cuts fluid retention for many.
• Why not go ultra-low? The SODIUM-HF randomized trial (Lancet, 2022) didn’t show fewer hospitalizations with very low sodium targets vs. usual advice, but people did feel better. The bottom line: choose a limit you can sustain and reassess with your clinician.
• Distribute it: 500-600 mg per main meal and 100-200 mg per snack. This keeps you from “blowing the budget” at dinner.

3) Fluids: do you need a cap?

• If you have low blood sodium (hyponatremia), frequent swelling, or your clinician said to restrict, use 1.5-2.0 L/day.
• If not, drink to thirst with intention (mostly water). Many feel better with 1.8-2.2 L/day plus low sodium. Your team may tailor this during hot weather or if you exercise.
• Count as fluids: water, coffee/tea, milk, broth, smoothies, ice, gelatin, popsicles, and watery foods like soup. If it melts into liquid at room temp, count it.

4) Potassium strategy (depends on meds and labs)

• If you take an ACE inhibitor/ARB/ARNI (like sacubitril/valsartan) or a mineralocorticoid receptor antagonist (spironolactone/eplerenone), your potassium can run high. Be careful with salt substitutes that use potassium chloride, and don’t overdo very high-potassium foods (large servings of bananas, OJ, potatoes, or coconut water) unless your clinician says it’s okay.
• If you’re on a loop diuretic (furosemide, bumetanide, torsemide) without those potassium-raising meds, you may need more potassium-rich foods or a prescribed supplement. This depends on labs-ask for your potassium goal (often 4.0-5.0 mmol/L).
• Good potassium sources that are easier to portion: berries, leafy greens, tomatoes, beans, yogurt, and winter squash. Use modest servings and rotate.

5) Fats, carbs, and sugar

• Fats: prefer olive oil, nuts, seeds, avocado, and fatty fish. Keep saturated fat low (under ~10% of calories). Avoid trans fat entirely.
• Carbs: choose intact grains (oats, barley, brown rice), beans, lentils, and starchy vegetables. Limit refined sweets to rare treats-sugar pulls you away from nutrient-dense foods.
• If you also have diabetes, pair carbs with protein and fiber to avoid spikes; consider a certified diabetes educator for fine-tuning.

6) Label reading and restaurant moves

• Per serving, 5% DV sodium (~115 mg) is low; 20% DV (~460 mg) is high. Check servings per package.
• “Reduced sodium” can still be salty. Compare brands. Aim for soups under 140 mg per serving or make your own.
• Eating out: ask for no salt added; sauces and dressings on the side; choose grilled, roasted, or steamed options; skip brined meats, pickles, broth-based starters, and soy-heavy dishes unless they have low-sodium options.

7) Flavor without salt

• Use acid: lemon, lime, vinegar.
• Use aromatics: garlic, onion, ginger, scallions.
• Use umami: mushrooms, tomato paste (no-salt-added), nutritional yeast.
• Use herb blends that don’t contain potassium chloride (check the label).

8) Special notes with meds

• Salt substitutes: avoid those with potassium chloride unless your clinician okays them.
• Warfarin: keep vitamin K steady, not low. If you eat greens, eat about the same amount daily.
• Grapefruit: can interact with some statins and other drugs-ask your pharmacist.

Evidence and guidance sources referenced in this section include AHA/ACC/HFSA Heart Failure guidelines (2022) and clinical nutrition guidance (ESPEN 2021). Use your care team’s advice first.

7-day menu, recipes, and a smart grocery list

Use this as a template. Portions are examples for a 75-85 kg adult. Adjust up or down based on your calorie and protein targets. Sodium numbers are ballparks-brands and cooking technique change totals.

Daily targets (example): 2,000 mg sodium; 1.9-2.2 L fluids; 100 g protein; 2,200 kcal. Split sodium roughly 600 mg breakfast, 600 mg lunch, 600 mg dinner, 200 mg snacks.

Breakfast options (300-500 kcal; 20-30 g protein; ~300-400 mg sodium)

• Protein oatmeal: 1/2 cup dry oats cooked in milk (or fortified soy milk), 1 scoop unflavored whey/plant protein, 1/2 cup blueberries, 1 tbsp walnuts, cinnamon. Sodium ~200-300 mg depending on protein powder.
• Greek yogurt bowl: 1 cup plain 2% Greek yogurt, 1/2 cup sliced strawberries, 1 tbsp chia seeds, 1 tbsp almond butter, drizzle honey. Sodium ~100-150 mg.
• Veggie scramble: 2-3 eggs or egg + egg whites, sautéed peppers, onions, spinach in olive oil; side of 1 slice low-sodium whole-grain toast. Sodium ~350-450 mg (check bread).

Lunch options (450-650 kcal; 25-35 g protein; ~400-600 mg sodium)

• Quinoa bowl: 1 cup cooked quinoa, 3/4 cup no-salt-rinsed chickpeas, cherry tomatoes, cucumber, parsley, lemon-olive oil dressing; feta optional (adds sodium). Sodium ~350-550 mg.
• Chicken and farro salad: 4 oz grilled chicken, 3/4 cup cooked farro, mixed greens, roasted carrots, vinaigrette; pumpkin seeds on top. Sodium ~400-500 mg.
• Tuna salad wrap: 1 pouch no-salt-added tuna, 1-2 tbsp plain yogurt + mustard, celery, dill, whole-wheat low-sodium wrap; side of grapes. Sodium varies ~350-600 mg.

Dinner options (500-750 kcal; 30-40 g protein; ~500-700 mg sodium)

• Salmon tray bake: 5 oz salmon, roasted green beans and baby potatoes, lemon and dill. Sodium ~150-250 mg, plus any seasoning blends.
• Turkey chili (homemade): 93% lean ground turkey, no-salt-added tomatoes, kidney beans (rinsed), onion, bell pepper, chili spices; serve over brown rice. Sodium ~400-600 mg per bowl.
• Tofu stir-fry: extra-firm tofu, broccoli, mushrooms, carrots; sauce from low-sodium soy sauce or coconut aminos, garlic, ginger, and lime; serve over barley. Sodium ~500-700 mg depending on sauce amount.

Snack options (100-250 kcal; 8-15 g protein; ~50-150 mg sodium)

• Unsalted nuts (1 oz) + clementine
• Low-sodium cottage cheese (check label) with pineapple
• Apple + 2 tbsp peanut butter
• Protein shake with water or milk (check sodium in powder)

7-day sample menu

• Day 1: Protein oatmeal; Quinoa-chickpea bowl; Salmon tray bake; Nuts + clementine.
• Day 2: Veggie scramble; Chicken-farro salad; Turkey chili; Cottage cheese + pineapple.
• Day 3: Greek yogurt bowl; Tuna wrap; Tofu stir-fry; Apple + peanut butter.
• Day 4: Protein oatmeal; Lentil soup (homemade, low-sodium) + side salad; Baked cod with roasted zucchini and quinoa; Protein shake.
• Day 5: Yogurt bowl; Turkey-avocado low-sodium sandwich; Whole-wheat pasta with tomato-mushroom-spinach sauce (no-salt-added tomatoes) + parmesan sprinkle; Nuts.
• Day 6: Scramble; Leftover chili over baked sweet potato; Grilled chicken, brown rice, broccoli, olive oil-lemon; Fruit + yogurt.
• Day 7: Oatmeal; Big salad (greens, beans, tuna or tofu, seeds, vinaigrette); Shrimp and vegetable skewers with couscous (lightly salted during cooking only if budget allows); Dark chocolate square.

Three quick, low-sodium recipes

1) No-Salt House Vinaigrette

• 1/4 cup extra-virgin olive oil; 2 tbsp red wine vinegar; 1 tsp Dijon; 1 tsp honey; pepper, garlic, herbs.
• Whisk. Lasts 1 week in the fridge. ~10-20 mg sodium per serving (from mustard), depending on brand.

2) Sheet-Pan Lemon Herb Chicken

• 4 chicken thighs or 2 breasts (skinless), 1 lb baby potatoes, 12 oz green beans, 2 tbsp olive oil, zest/juice of 1 lemon, garlic, rosemary, pepper.
• Toss and roast at 425°F (220°C) for 25-35 min. Salt-free but bright and savory. Sodium ~90-150 mg/portion (from chicken).

3) High-Protein Overnight Oats

• 1/2 cup oats, 3/4 cup milk or soy milk, 1/2 scoop unflavored protein powder, 1/2 cup berries, 1 tbsp chia, vanilla, cinnamon.
• Mix, chill overnight. Sodium ~150-250 mg depending on ingredients.

Smart grocery list (low-sodium friendly)

• Proteins: skinless chicken, salmon, white fish, extra-lean ground turkey, firm tofu/tempeh, eggs, plain Greek yogurt, low-sodium cottage cheese, no-salt-added tuna packets, beans (dried or no-salt-added canned).
• Grains: old-fashioned oats, barley, brown rice, farro, quinoa, 100% whole-grain bread/wraps with ≤120 mg sodium/slice if possible, whole-wheat pasta.
• Produce: leafy greens, broccoli, green beans, peppers, onions, mushrooms, tomatoes, cucumbers, berries, apples, bananas (portion to labs), citrus, potatoes/sweet potatoes (watch portions if potassium is high).
• Pantry: no-salt-added tomatoes and tomato paste, low-sodium broth (or DIY), olive oil, vinegars, mustard, herbs/spices without potassium chloride, garlic, pepper, nutritional yeast.
• Snacks: unsalted nuts, seeds, fruit, popcorn kernels (air-popped), dark chocolate 70%.

Meal prep that fits heart failure life

• Batch cook once, eat twice: roast two proteins (chicken + tofu) and two grains (quinoa + brown rice) on Sunday. Mix and match with veggies all week.
• Rinse canned beans and veggies under water 30-60 seconds to drop sodium 20-40%.
• Keep “emergency” meals: frozen unsalted veggies, precooked frozen brown rice, no-salt-added beans, and canned no-salt tomatoes-15 minutes to dinner.
• Travel cups for fluids keep you honest. Mark the bottle with tape lines to pace intake if you’re on a fluid cap.

Checklists, FAQ, and what to do when things go sideways

Daily heart-failure food log (quick checklist)

• Weight this morning: ____ (call your team if up 2-3 lb overnight or 5 lb in a week)
• Sodium tally: Breakfast __ mg; Lunch __ mg; Dinner __ mg; Snacks __ mg; Total __ mg
• Fluids: Goal __ L; Actual __ L
• Protein target: __ g; Reached? Y/N
• Swelling, breathlessness, or sudden fatigue today? Notes: ____

Label-reading cheat sheet

• Low sodium = 140 mg or less per serving
• Very low = 35 mg or less
• No salt added = none added during processing (still check natural sodium)
• Watch serving size; packages often hide 2-3 servings

Pitfalls that spike sodium fast

• Deli meats, bacon/sausage
• Canned soups/ramen
• Pickles, olives, sauerkraut, kimchi (unless truly low-sodium versions)
• Soy sauce, teriyaki, bottled dressings-use low-sodium and measure
• Restaurant breads and buns; choose lower-sodium brands at home

Flavor swaps that work

• Instead of soy sauce: coconut aminos or low-sodium tamari, used lightly
• Instead of bouillon: homemade stock or low-sodium broth with herbs
• Instead of pickles: quick-pickle cucumbers in vinegar, garlic, and dill without salt

Mini-FAQ

• Do I need fluid restriction? Not always. It’s common for people with low blood sodium or repeat fluid overload. Many others do fine drinking to thirst when sodium is controlled. Your cardiology team decides based on labs and symptoms.
• Are salt substitutes safe? Avoid potassium chloride substitutes if you take ACEi/ARB/ARNI/spironolactone/eplerenone or if your potassium runs high. Use herb blends without potassium chloride.
• Is the DASH diet okay for heart failure? Yes, when tailored to your sodium target. Think DASH/Mediterranean patterns but with strict label reading.
• What about alcohol and caffeine? Alcohol can worsen heart failure; many do best with none. If allowed, cap at 1 drink/day and not daily. Moderate coffee or tea is usually okay; watch sugary add-ins and fluids if you have a cap.
• Can I fast for weight loss? Extended fasting can backfire with fatigue and fluid shifts. A steady calorie and protein plan works better. If you want time-restricted eating, run it by your clinician.
• Do I need supplements? Food first. Some people on high-dose diuretics need magnesium or thiamine, but only if labs/symptoms point that way. Ask your clinician before starting anything.
• How do I handle potassium if I’m on spironolactone? Keep portions of high-potassium foods moderate, avoid potassium salt substitutes, and get labs checked as scheduled.
• What if I also have kidney disease? Protein needs may shift, and potassium/phosphorus limits might apply. You’ll need a renal-aware, heart-failure-informed plan from a dietitian.

Next steps and troubleshooting

• If your weight jumps 2-3 lb overnight or 5 lb in a week: Double-check sodium sources in the last 48 hours (restaurant meals, bread, sauces). Tighten sodium to 1,500-2,000 mg today. If your clinician gave diuretic instructions, follow them and call as advised.
• If you’re exhausted and not eating enough: Raise protein density (Greek yogurt, eggs, fish, tofu, protein oatmeal). Use smoothies with measured fluid if needed. Switch to softer, easy-to-chew foods and small, frequent meals.
• If potassium is high on labs: Review salt substitutes; trim large servings of bananas, potatoes, OJ, coconut water; pick lower-potassium fruits (berries, apples, grapes) and veggies (green beans, cauliflower). Ask about meds that raise potassium.
• If potassium is low: If you’re on a loop diuretic, add potassium foods (beans, yogurt, tomatoes, spinach, bananas in modest portions) or ask about supplements. Always confirm with your care team.
• If sodium is low on labs (hyponatremia): Your team may reduce fluids to 1.5 L/day, adjust diuretics, and review meds. Keep dietary sodium steady; don’t self-increase salt.
• If eating out often: Pre-plan one entrée and two backup options at your usual spots. Ask for no-salt cooking, sauce on the side, and skip soups. Stick to grilled proteins, steamed veggies, and plain rice or baked potato (no skin if potassium is a problem).
• If budget is tight: Buy frozen vegetables and fruit; dried beans and lentils; whole grains in bulk; canned no-salt tomatoes; canned fish; eggs; in-season produce. Batch-cook and freeze in single portions.
• If you crave salt: Add acid (lemon, vinegar), use toasted spices, and build umami with mushrooms and tomato paste. Give it 1-2 weeks-your tongue adapts.

When to call your clinician

• Rapid weight gain as noted above
• Swelling, breathlessness at rest, waking at night short of breath
• New dizziness or fainting
• Persistent nausea, inability to keep food down, or poor appetite for several days
• Potassium problems on labs or heart rhythm concerns

Why you can trust this approach: It follows core ideas from AHA/ACC/HFSA heart failure guidelines (2022), the SODIUM-HF trial (Lancet, 2022), and nutrition guidance used in cardiac rehab and clinical dietetics: moderate sodium restriction you can live with, protein to protect muscle, smart fluids, and pattern-based eating (DASH/Mediterranean) tailored to heart failure meds and labs.

Start with the 7-day menu, keep the label cheat sheet on your phone, and track weight, sodium, and fluids for two weeks. Then review with your care team and tweak. This is a plan you can sustain-not just survive.