Why the study?
Malnutrition worsens outcomes in heart failure, but evidence evaluating enhanced nutritional care combined with exercise therapy remains limited.
Does enhanced nutritional care alone or with exercise therapy improve clinical outcomes and physical function in patients with heart failure?
Does enhanced nutritional care alone or with exercise therapy improve clinical outcomes and physical function in patients with heart failure?
Enhanced nutritional care, particularly when combined with exercise therapy, may improve physical function and reduce cardiovascular events in heart failure patients, though large-scale trials are needed to confirm these preliminary findings.
Answers are grounded in this paper and cite their sources.
May support combined nutritional-exercise interventions for function in HF; leaves open large RCTs on mortality and events.
Background: Malnutrition worsens outcomes in heart failure (HF). Although nutritional therapy is important, evidence for enhanced nutritional care (ENC) combined with exercise therapy (ET) is limited. Methods and Results: This systematic review and meta-analysis evaluated ENC, alone or with ET, in HF. Randomized controlled trials (RCTs) published to March 31, 2023, were identified through comprehensive searches. Meta-analyses used a random-effects model with risk ratios (RRs) or mean differences (MDs) and 95% confidence intervals (CIs). Twenty-five RCTs were included: 20 assessed ENC alone and 5 assessed ENC+ET. ENC alone did not reduce all-cause mortality but was associated with fewer post hoc-defined cardiovascular events (RR 0.64; 95% CI 0.48-0.85), driven largely by 1 study and considered exploratory. ENC+ET improved 6-min walk distance (MD 39.85 m; 95% CI 13.05-66.65) and handgrip strength. Conclusions: ENC may reduce cardiovascular events and improve physical function in HF, particularly with ET, but evidence is preliminary and large-scale trials are warranted.
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Teramatsu et al. (2025) studied this question.
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