{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:01:24Z","timestamp":1787029284091,"version":"build-2736575974"},"reference-count":114,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T00:00:00Z","timestamp":1726617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Longer Life Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Objectives: Heart failure (HF) is a global health concern with rising incidence and poor prognosis. While the essential role of nutritional and dietary strategies in HF patients is acknowledged in the existing scientific guidelines and clinical practice, there are no comprehensive nutritional recommendations for optimal dietary management of HF. Methods: In this review, we discuss results from recent studies on the obesity paradox and the effects of calorie restriction and weight loss, intermittent fasting, the Western diet, the Mediterranean diet, the ketogenic diet, and the DASH diet on HF progression. Results: Many of these strategies remain under clinical and basic investigation for their safety and efficacy, and there is considerable heterogeneity in the observed response, presumably because of heterogeneity in the pathogenesis of different types of HF. In addition, while specific aspects of cardiac metabolism, such as changes in ketone body utilization, might underlie the effects of certain dietary strategies on the heart, there is a critical divide between supplement strategies (i.e., with ketones) and dietary strategies that impact ketogenesis. Conclusion: This review aims to highlight this gap by exploring emerging evidence supporting the importance of personalized dietary strategies in preventing progression and improving outcomes in the context of HF.<\/jats:p>","DOI":"10.3390\/nu16183157","type":"journal-article","created":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T03:34:20Z","timestamp":1726716860000},"page":"3157","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Fueling the Heart: What Are the Optimal Dietary Strategies in Heart Failure?"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4426-4959","authenticated-orcid":false,"given":"Anahita","family":"Ataran","sequence":"first","affiliation":[{"name":"Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, MO 63110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Pompian","sequence":"additional","affiliation":[{"name":"Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, MO 63110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamidreza","family":"Hajirezaei","sequence":"additional","affiliation":[{"name":"Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, MO 63110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rehman","family":"Lodhi","sequence":"additional","affiliation":[{"name":"Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, MO 63110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Javaheri","sequence":"additional","affiliation":[{"name":"Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, MO 63110, USA"},{"name":"John Cochran VA Hospital, St. Louis, MO 63110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/j.jchf.2024.02.021","article-title":"Aging in Heart Failure","volume":"12","author":"Goyal","year":"2024","journal-title":"JACC Heart Fail."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2424","DOI":"10.1038\/s41591-023-02567-2","article-title":"Recent Successes in Heart Failure Treatment","volume":"29","author":"Lam","year":"2023","journal-title":"Nat. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.molmed.2019.01.002","article-title":"Macrophages in Heart Failure with Reduced versus Preserved Ejection Fraction","volume":"25","author":"DeBerge","year":"2019","journal-title":"Trends Mol. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1136\/heartjnl-2019-314770","article-title":"Complex Interaction of Obesity, Intentional Weight Loss and Heart Failure: A Systematic Review and Meta-Analysis","volume":"106","author":"Mahajan","year":"2020","journal-title":"Heart"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.ccep.2018.11.001","article-title":"The Many Faces of Heart Failure","volume":"11","author":"Snipelisky","year":"2019","journal-title":"Card. Electrophysiol. Clin."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1097\/FJC.0000000000001421","article-title":"Effects of Sacubitril\u2013Valsartan in Patients with Various Types of Heart Failure: A Meta-Analysis","volume":"81","author":"Zhang","year":"2023","journal-title":"J. Cardiovasc. Pharmacol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e2231878","DOI":"10.1001\/jamanetworkopen.2022.31878","article-title":"Subclinical Risk Factors for Heart Failure with Preserved and Reduced Ejection Fraction among Black Adults","volume":"5","author":"Zhao","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_8","first-page":"104","article-title":"COVID-19 Patients May Present with Myocarditis: A Case Report Emphasizing the Cardiac Involvement of SARS-CoV-2","volume":"35","author":"Salavati","year":"2021","journal-title":"Med. J. Islam. Republ. Iran"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e008273","DOI":"10.1161\/CIRCHEARTFAILURE.120.008273","article-title":"SARS-CoV-2\u2013Associated Myocarditis: A Case of Direct Myocardial Injury","volume":"15","author":"Verma","year":"2022","journal-title":"Circ. Heart Fail."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1111\/bcpt.13426","article-title":"Ageing and Longevity Genes in Cardiovascular Diseases","volume":"127","author":"Liberale","year":"2020","journal-title":"Basic. Clin. Pharma Tox"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"9","DOI":"10.20517\/jca.2022.42","article-title":"The Dynamic Interplay between Cardiac Mitochondrial Health and Myocardial Structural Remodeling in Metabolic Heart Disease, Aging, and Heart Failure","volume":"3","author":"Werbner","year":"2023","journal-title":"J. Cardiovasc. Aging"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.jacc.2020.11.023","article-title":"Cardiovascular Aging and Longevity","volume":"77","author":"Pietri","year":"2021","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.1093\/eurheartj\/ehw118","article-title":"Cachexia and Right Ventricular Dysfunction in Chronic Heart Failure: What Is the Chicken and What the Egg?","volume":"37","author":"Bahls","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.cardfail.2019.03.007","article-title":"Nutrition, Obesity, and Cachexia in Patients with Heart Failure: A Consensus Statement from the Heart Failure Society of America Scientific Statements Committee","volume":"25","author":"Vest","year":"2019","journal-title":"J. Card. Fail."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1017\/S0029665115002438","article-title":"The Wasting Continuum in Heart Failure: From Sarcopenia to Cachexia","volume":"74","year":"2015","journal-title":"Proc. Nutr. Soc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.2147\/CIA.S273967","article-title":"Cardiac Cachexia: A Well-Known but Challenging Complication of Heart Failure","volume":"15","author":"Krysztofiak","year":"2020","journal-title":"CIA"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1161\/CIRCRESAHA.121.318241","article-title":"Cardiac Energy Metabolism in Heart Failure","volume":"128","author":"Lopaschuk","year":"2021","journal-title":"Circ. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1172\/JCI0214080","article-title":"The Cardiac Phenotype Induced by PPAR\u03b1 Overexpression Mimics that Caused by Diabetes Mellitus","volume":"109","author":"Finck","year":"2002","journal-title":"J. Clin. Investig."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1161\/CIRCRESAHA.113.300376","article-title":"Cardiac Metabolism in Heart Failure: Implications Beyond ATP Production","volume":"113","author":"Doenst","year":"2013","journal-title":"Circ. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3556","DOI":"10.1093\/cvr\/cvac166","article-title":"Cardiac Metabolism in HFpEF: From Fuel to Signalling","volume":"118","author":"Capone","year":"2023","journal-title":"Cardiovasc. Res."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Karwi, Q.G., Uddin, G.M., Ho, K.L., and Lopaschuk, G.D. (2018). Loss of Metabolic Flexibility in the Failing Heart. Front. Cardiovasc. Med., 5.","DOI":"10.3389\/fcvm.2018.00068"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1093\/eurjhf\/hfq121","article-title":"Epidemiology and Clinical Course of Heart Failure with Preserved Ejection Fraction","volume":"13","author":"Lam","year":"2011","journal-title":"Eur. J. Heart Fail."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1056\/NEJMoa1908655","article-title":"Angiotensin\u2013Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction","volume":"381","author":"Solomon","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1016\/j.hlc.2020.10.012","article-title":"The Effect of Sacubitril-Valsartan in Heart Failure Patients with Mid-Range and Preserved Ejection Fraction: A Meta-Analysis","volume":"30","author":"Nie","year":"2021","journal-title":"Heart Lung Circ."},{"key":"ref_25","unstructured":"Golla, M.S.G., Hajouli, S., and Ludhwani, D. (2024). Heart Failure and Ejection Fraction. StatPearls, StatPearls Publishing."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.pcad.2024.01.001","article-title":"Prioritizing the Primary Prevention of Heart Failure: Measuring, Modifying and Monitoring Risk","volume":"82","author":"Patel","year":"2024","journal-title":"Progress. Cardiovasc. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1056\/NEJM199704173361601","article-title":"A Clinical Trial of the Effects of Dietary Patterns on Blood Pressure","volume":"336","author":"Appel","year":"1997","journal-title":"N. Engl. J. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1097\/00045415-199909000-00013","article-title":"The Dietary Approaches to Stop Hypertension (DASH) Clinical Trial Implications for Lifestyle Modifications in the Treatment of Hypertensive Patients","volume":"7","author":"Conlin","year":"1999","journal-title":"Cardiol. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1056\/NEJM200101043440101","article-title":"Effects on Blood Pressure of Reduced Dietary Sodium and the Dietary Approaches to Stop Hypertension (DASH) Diet","volume":"344","author":"Sacks","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1007\/s11906-010-0168-5","article-title":"The DASH Diet and Insulin Sensitivity","volume":"13","author":"Hinderliter","year":"2011","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"569","DOI":"10.34067\/KID.0000000000000390","article-title":"Effects of Reduced Dietary Sodium and the DASH Diet on GFR: The DASH-Sodium Trial","volume":"5","author":"Nissaisorakarn","year":"2024","journal-title":"Kidney360"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Wallace, T.C., Cowan, A.E., and Bailey, R.L. (2019). Current Sodium Intakes in the United States and the Modelling of Glutamate\u2019s Incorporation into Select Savory Products. Nutrients, 11.","DOI":"10.3390\/nu11112691"},{"key":"ref_33","unstructured":"(2024, June 27). National Heart, Lung, and Blood Institute, Available online: https:\/\/www.nhlbi.nih.gov\/education\/dash-eating-plan."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/j.jchf.2015.02.009","article-title":"Contribution of Major Lifestyle Risk Factors for Incident Heart Failure in Older Adults","volume":"3","author":"Kalantarian","year":"2015","journal-title":"JACC Heart Fail."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.pcad.2020.08.004","article-title":"The Role of Diet and Nutrition in Heart Failure: A State-of-the-Art Narrative Review","volume":"63","author":"Billingsley","year":"2020","journal-title":"Progress. Cardiovasc. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.amjmed.2019.07.034","article-title":"Salt, No Salt, or Less Salt for Patients with Heart Failure?","volume":"133","author":"Khan","year":"2020","journal-title":"Am. J. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"F505","DOI":"10.1152\/ajprenal.00587.2012","article-title":"Activation of the Renin-Angiotensin System by a Low-Salt Diet Does Not Augment Intratubular Angiotensinogen and Angiotensin II in Rats","volume":"304","author":"Shao","year":"2013","journal-title":"Am. J. Physiol. Ren. Physiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1841","DOI":"10.1016\/j.numecd.2022.04.018","article-title":"Adherence to the Dietary Approaches to Stop Hypertension (DASH) Diet Is Associated with Low Levels of Insulin Resistance among Heart Failure Patients","volume":"32","author":"Ishikawa","year":"2022","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/j.cardfail.2021.01.011","article-title":"The Dietary Approaches to Stop Hypertension (DASH) Diet Pattern and Incident Heart Failure","volume":"27","author":"Goyal","year":"2021","journal-title":"J. Card. Fail."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1093\/eurjpc\/zwac003","article-title":"The DASH Diet Is Associated with a Lower Risk of Heart Failure: A Cohort Study","volume":"29","author":"Ibsen","year":"2022","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_41","first-page":"1116","article-title":"Mediterranean and DASH Diet Scores and Mortality in Women with Heart Failure: The Women\u2019s Health Initiative","volume":"6","author":"Levitan","year":"2013","journal-title":"Circ: Heart Fail."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e020718","DOI":"10.1161\/JAHA.120.020718","article-title":"Plant-Centered Diet and Risk of Incident Cardiovascular Disease during Young to Middle Adulthood","volume":"10","author":"Choi","year":"2021","journal-title":"JAHA"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1161\/CIRCULATIONAHA.123.065551","article-title":"Portfolio Diet Score and Risk of Cardiovascular Disease: Findings From 3 Prospective Cohort Studies","volume":"148","author":"Glenn","year":"2023","journal-title":"Circulation"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Laffond, A., Rivera-Pic\u00f3n, C., Rodr\u00edguez-Mu\u00f1oz, P.M., Ju\u00e1rez-Vela, R., Ruiz De Vi\u00f1aspre-Hern\u00e1ndez, R., Navas-Echazarreta, N., and S\u00e1nchez-Gonz\u00e1lez, J.L. (2023). Mediterranean Diet for Primary and Secondary Prevention of Cardiovascular Disease and Mortality: An Updated Systematic Review. Nutrients, 15.","DOI":"10.3390\/nu15153356"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1161\/CIRCRESAHA.118.313348","article-title":"The Mediterranean Diet and Cardiovascular Health: A Critical Review","volume":"124","author":"Gea","year":"2019","journal-title":"Circ. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.amjmed.2014.10.014","article-title":"The Mediterranean Diet, Its Components, and Cardiovascular Disease","volume":"128","author":"Widmer","year":"2015","journal-title":"Am. J. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.recesp.2024.01.013","article-title":"Effect of the Mediterranean Diet in Cardiovascular Prevention","volume":"77","year":"2024","journal-title":"Rev. Espa\u00f1ola Cardiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.atherosclerosis.2015.08.039","article-title":"A Mediterranean Diet and Risk of Myocardial Infarction, Heart Failure and Stroke: A Population-Based Cohort Study","volume":"243","author":"Tektonidis","year":"2015","journal-title":"Atherosclerosis"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Oppedisano, F., Mollace, R., Tavernese, A., Gliozzi, M., Musolino, V., Macr\u00ec, R., Carresi, C., Maiuolo, J., Serra, M., and Cardamone, A. (2021). PUFA Supplementation and Heart Failure: Effects on Fibrosis and Cardiac Remodeling. Nutrients, 13.","DOI":"10.3390\/nu13092965"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Xia, M., Zhong, Y., Peng, Y., and Qian, C. (2022). Olive Oil Consumption and Risk of Cardiovascular Disease and All-Cause Mortality: A Meta-Analysis of Prospective Cohort Studies. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.1041203"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Sacks, F.M., Lichtenstein, A.H., Wu, J.H.Y., Appel, L.J., Creager, M.A., Kris-Etherton, P.M., Miller, M., Rimm, E.B., Rudel, L.L., and Robinson, J.G. (2017). Dietary Fats and Cardiovascular Disease: A Presidential Advisory from the American Heart Association. Circulation, 136.","DOI":"10.1161\/CIR.0000000000000510"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1016\/j.jacc.2015.07.055","article-title":"Saturated Fats Compared with Unsaturated Fats and Sources of Carbohydrates in Relation to Risk of Coronary Heart Disease","volume":"66","author":"Li","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1161\/STROKEAHA.121.037314","article-title":"Can Dietary Patterns that Support Planetary Health Benefit Population Health?","volume":"53","author":"Carcel","year":"2022","journal-title":"Stroke"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1016\/j.jchf.2024.02.017","article-title":"The EAT-Lancet Diet Index, Plasma Proteins, and Risk of Heart Failure in a Population-Based Cohort","volume":"12","author":"Zhang","year":"2024","journal-title":"JACC Heart Fail."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e540","DOI":"10.1016\/j.orcp.2013.12.005","article-title":"Mechanisms of Heart Failure in Obesity","volume":"8","author":"Ebong","year":"2014","journal-title":"Obes. Res. Clin. Pract."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1056\/NEJMoa020245","article-title":"Obesity and the Risk of Heart Failure","volume":"347","author":"Kenchaiah","year":"2002","journal-title":"N. Engl. J. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1016\/S2213-8587(19)30249-9","article-title":"Cardiovascular, Mortality, and Kidney Outcomes with GLP-1 Receptor Agonists in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Cardiovascular Outcome Trials","volume":"7","author":"Kristensen","year":"2019","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1955","DOI":"10.1093\/eurheartj\/ehac071","article-title":"Bariatric Surgery and Cardiovascular Disease: A Systematic Review and Meta-Analysis","volume":"43","author":"Gorter","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"89","DOI":"10.2147\/VHRM.S168946","article-title":"Obesity Paradox in Cardiovascular Disease: Where Do We Stand?","volume":"15","author":"Carbone","year":"2019","journal-title":"Vasc. Health Risk Manag."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.hfc.2019.08.008","article-title":"The Impact of Obesity in Heart Failure","volume":"16","author":"Carbone","year":"2020","journal-title":"Heart Fail. Clin."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1016\/j.jacc.2014.01.022","article-title":"Obesity and Cardiovascular Diseases","volume":"63","author":"Lavie","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1016\/j.jacc.2012.04.047","article-title":"Human Cardiac Progenitor Cells Engineered with Pim-I Kinase Enhance Myocardial Repair","volume":"60","author":"Mohsin","year":"2012","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1210\/clinem\/dgad398","article-title":"Glucagon-Like Peptide-1 Receptor Agonists Across the Spectrum of Heart Failure","volume":"109","author":"Ferreira","year":"2023","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1056\/NEJMoa2306963","article-title":"Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity","volume":"389","author":"Kosiborod","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"e010453","DOI":"10.1161\/CIRCHEARTFAILURE.122.010453","article-title":"Trends and Outcomes Associated with Bariatric Surgery and Pharmacotherapies with Weight Loss Effects Among Patients with Heart Failure and Obesity","volume":"17","author":"Mentias","year":"2024","journal-title":"Circ Heart Fail."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"104893","DOI":"10.1016\/j.nurpra.2023.104893","article-title":"Intermittent Fasting: Exploring Approaches, Benefits, and Implications for Health and Weight Management","volume":"20","author":"Nye","year":"2024","journal-title":"J. Nurse Pract."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1016\/j.cjca.2024.02.004","article-title":"Risks and Benefits of Intermittent Fasting for the Aging Cardiovascular System","volume":"40","author":"Ozcan","year":"2024","journal-title":"Can. J. Cardiol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1007\/s11357-021-00335-z","article-title":"Intermittent Fasting: From Calories to Time Restriction","volume":"43","author":"Duregon","year":"2021","journal-title":"GeroScience"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"e010936","DOI":"10.1161\/CIRCHEARTFAILURE.123.010936","article-title":"Intermittent Fasting after ST-Segment\u2013Elevation Myocardial Infarction Improves Left Ventricular Function: The Randomized Controlled INTERFAST-MI Trial","volume":"17","author":"Dutzmann","year":"2024","journal-title":"Circ Heart Fail."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1016\/j.cmet.2023.02.006","article-title":"Sustained Alternate-Day Fasting Potentiates Doxorubicin Cardiotoxicity","volume":"35","author":"Ozcan","year":"2023","journal-title":"Cell Metab."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1952","DOI":"10.1080\/15548627.2017.1368596","article-title":"Intermittent Fasting Preserves Beta-Cell Mass in Obesity-Induced Diabetes via the Autophagy-Lysosome Pathway","volume":"13","author":"Liu","year":"2017","journal-title":"Autophagy"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"e010866","DOI":"10.1161\/JAHA.118.010866","article-title":"Transcription Factor EB Activation Rescues Advanced \u03b1B-Crystallin Mutation-Induced Cardiomyopathy by Normalizing Desmin Localization","volume":"8","author":"Ma","year":"2019","journal-title":"JAHA"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"3115","DOI":"10.1161\/CIRCULATIONAHA.105.563817","article-title":"Cardioprotection by Intermittent Fasting in Rats","volume":"112","author":"Ahmet","year":"2005","journal-title":"Circulation"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1017\/S0007114517003890","article-title":"Intermittent v. Continuous Energy Restriction: Differential Effects on Postprandial Glucose and Lipid Metabolism Following Matched Weight Loss in Overweight\/Obese Participants","volume":"119","author":"Antoni","year":"2018","journal-title":"Br. J. Nutr."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Wang, J., Wang, F., Chen, H., Liu, L., Zhang, S., Luo, W., Wang, G., and Hu, X. (2022). Comparison of the Effects of Intermittent Energy Restriction and Continuous Energy Restriction among Adults with Overweight or Obesity: An Overview of Systematic Reviews and Meta-Analyses. Nutrients, 14.","DOI":"10.3390\/nu14112315"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"eabd8034","DOI":"10.1126\/scitranslmed.abd8034","article-title":"A Randomized Controlled Trial to Isolate the Effects of Fasting and Energy Restriction on Weight Loss and Metabolic Health in Lean Adults","volume":"13","author":"Templeman","year":"2021","journal-title":"Sci. Transl. Med."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1007\/s11357-021-00509-9","article-title":"Evaluation of a Blood-Based Geroscience Biomarker Index in a Randomized Trial of Caloric Restriction and Exercise in Older Adults with Heart Failure with Preserved Ejection Fraction","volume":"44","author":"Justice","year":"2022","journal-title":"GeroScience"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1001\/jama.2015.17346","article-title":"Effect of Caloric Restriction or Aerobic Exercise Training on Peak Oxygen Consumption and Quality of Life in Obese Older Patients with Heart Failure with Preserved Ejection Fraction: A Randomized Clinical Trial","volume":"315","author":"Kitzman","year":"2016","journal-title":"JAMA"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1016\/j.jchf.2020.04.004","article-title":"Insufficient Calorie Intake Worsens Post-Discharge Quality of Life and Increases Readmission Burden in Heart Failure","volume":"8","author":"Bilgen","year":"2020","journal-title":"JACC Heart Fail."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"2641","DOI":"10.1093\/eurheartj\/ehn420","article-title":"Weight Loss and Mortality Risk in Patients with Chronic Heart Failure in the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) Programme","volume":"29","author":"Pocock","year":"2008","journal-title":"Eur. Heart J."},{"key":"ref_81","first-page":"e010161","article-title":"A Randomized, Controlled Trial of Resistance Training Added to Caloric Restriction Plus Aerobic Exercise Training in Obese Heart Failure with Preserved Ejection Fraction","volume":"16","author":"Brubaker","year":"2023","journal-title":"Circ Heart Fail."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.jacbts.2022.10.009","article-title":"Western Diet Causes Heart Failure with Reduced Ejection Fraction and Metabolic Shifts after Diastolic Dysfunction and Novel Cardiac Lipid Derangements","volume":"8","author":"Maurya","year":"2023","journal-title":"JACC Basic. Transl. Sci."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Clemente-Su\u00e1rez, V.J., Beltr\u00e1n-Velasco, A.I., Redondo-Fl\u00f3rez, L., Mart\u00edn-Rodr\u00edguez, A., and Tornero-Aguilera, J.F. (2023). Global Impacts of Western Diet and Its Effects on Metabolism and Health: A Narrative Review. Nutrients, 15.","DOI":"10.3390\/nu15122749"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"2221","DOI":"10.2147\/DMSO.S216791","article-title":"How Western Diet and Lifestyle Drive the Pandemic of Obesity and Civilization Diseases","volume":"12","author":"Kopp","year":"2019","journal-title":"DMSO"},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Wali, J.A., Jarzebska, N., Raubenheimer, D., Simpson, S.J., Rodionov, R.N., and O\u2019Sullivan, J.F. (2020). Cardio-Metabolic Effects of High-Fat Diets and Their Underlying Mechanisms\u2014A Narrative Review. Nutrients, 12.","DOI":"10.3390\/nu12051505"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1161\/CIRCRESAHA.111.253104","article-title":"Dietary Fat and Heart Failure: Moving from Lipotoxicity to Lipoprotection","volume":"110","author":"Stanley","year":"2012","journal-title":"Circ. Res."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1111\/jcmm.12556","article-title":"High-fat Diet Induces Cardiac Remodelling and Dysfunction: Assessment of the Role Played by SIRT 3 Loss","volume":"19","author":"Zeng","year":"2015","journal-title":"J. Cell. Mol. Medi"},{"key":"ref_88","first-page":"e596","article-title":"2019 ACC\/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"140","author":"Arnett","year":"2019","journal-title":"Circulation"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1038\/s42255-020-00296-1","article-title":"Nutritional Modulation of Heart Failure in Mitochondrial Pyruvate Carrier\u2013Deficient Mice","volume":"2","author":"McCommis","year":"2020","journal-title":"Nat. Metab."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1002\/oby.23990","article-title":"Ketones with a Twist: Tipping the Heart\u2019s Hat to Fat","volume":"32","author":"Javaheri","year":"2024","journal-title":"Obesity"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1161\/CIRCULATIONAHA.115.017545","article-title":"Evidence for Intramyocardial Disruption of Lipid Metabolism and Increased Myocardial Ketone Utilization in Advanced Human Heart Failure","volume":"133","author":"Bedi","year":"2016","journal-title":"Circulation"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1161\/CIRCULATIONAHA.118.036459","article-title":"Cardiovascular Effects of Treatment with the Ketone Body 3-Hydroxybutyrate in Chronic Heart Failure Patients","volume":"139","author":"Nielsen","year":"2019","journal-title":"Circulation"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.cmet.2016.12.022","article-title":"Multi-Dimensional Roles of Ketone Bodies in Fuel Metabolism, Signaling, and Therapeutics","volume":"25","author":"Puchalska","year":"2017","journal-title":"Cell Metab."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"155608","DOI":"10.1016\/j.metabol.2023.155608","article-title":"Ketone Ester Supplementation Suppresses Cardiac Inflammation and Improves Cardiac Energetics in a Swine Model of Acute Myocardial Infarction","volume":"145","author":"Yurista","year":"2023","journal-title":"Metabolism"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.cmet.2016.07.010","article-title":"Nutritional Ketosis Alters Fuel Preference and Thereby Endurance Performance in Athletes","volume":"24","author":"Cox","year":"2016","journal-title":"Cell Metab."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1016\/S0735-1097(22)02030-7","article-title":"Ketone ester treatment increases cardiac ketone utilization and reduces cardiac inflammation in a porcine model of acute myocardial infarction","volume":"79","author":"Yurista","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Neudorf, H., and Little, J.P. (2024). Impact of Fasting & Ketogenic Interventions on the NLRP3 Inflammasome: A Narrative Review. Biomed. J., 47.","DOI":"10.1016\/j.bj.2023.100677"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1016\/j.jchf.2023.05.009","article-title":"Ketogenic Diet in Heart Failure","volume":"11","author":"Kodur","year":"2023","journal-title":"JACC Heart Fail."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"eado1463","DOI":"10.1126\/sciadv.ado1463","article-title":"Ketogenic Diet Induces P53-Dependent Cellular Senescence in Multiple Organs","volume":"10","author":"Wei","year":"2024","journal-title":"Sci. Adv."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"e419","DOI":"10.1016\/S2468-2667(18)30135-X","article-title":"Dietary Carbohydrate Intake and Mortality: A Prospective Cohort Study and Meta-Analysis","volume":"3","author":"Seidelmann","year":"2018","journal-title":"Lancet Public. Health"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1097\/MCO.0000000000000946","article-title":"Effect of Dietary Carbohydrate Restriction on Cardiometabolic Function in Type 2 Diabetes: Weight Loss and Beyond","volume":"26","author":"Magkos","year":"2023","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"4253651","DOI":"10.1155\/2022\/4253651","article-title":"Alternate-Day Ketogenic Diet Feeding Protects against Heart Failure through Preservation of Ketogenesis in the Liver","volume":"2022","author":"Guo","year":"2022","journal-title":"Oxidative Med. Cell. Longev."},{"key":"ref_103","unstructured":"(2024, June 28). National Heart, Lung, and Blood Institute, Available online: https:\/\/clinicaltrials.gov\/study\/nct04442555."},{"key":"ref_104","unstructured":"(2024, June 28). National Heart, Lung, and Blood Institute, Available online: https:\/\/clinicaltrials.gov\/study\/nct04370600."},{"key":"ref_105","unstructured":"(2024, June 28). National Heart, Lung, and Blood Institute, Available online: https:\/\/clinicaltrials.gov\/study\/nct04443426."},{"key":"ref_106","unstructured":"(2024, June 28). National Heart, Lung, and Blood Institute, Available online: https:\/\/clinicaltrials.gov\/study\/nct04633460."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1177\/1535370214558024","article-title":"Beetroot Juice Reduces Infarct Size and Improves Cardiac Function Following Ischemia\u2013Reperfusion Injury: Possible Involvement of Endogenous H2S","volume":"240","author":"Salloum","year":"2015","journal-title":"Exp. Biol. Med."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/j.jchf.2015.12.013","article-title":"One Week of Daily Dosing with Beetroot Juice Improves Submaximal Endurance and Blood Pressure in Older Patients with Heart Failure and Preserved Ejection Fraction","volume":"4","author":"Eggebeen","year":"2016","journal-title":"JACC Heart Fail."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1764","DOI":"10.1001\/jama.2018.14852","article-title":"Effect of Inorganic Nitrite vs Placebo on Exercise Capacity Among Patients with Heart Failure with Preserved Ejection Fraction: The INDIE-HFpEF Randomized Clinical Trial","volume":"320","author":"Borlaug","year":"2018","journal-title":"JAMA"},{"key":"ref_110","unstructured":"(2024, June 28). National Heart, Lung, and Blood Institute, Available online: https:\/\/clinicaltrials.gov\/study\/nct03511248."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1536\/ihj.23-550","article-title":"Long-Term Maintenance of Normal Serum Vitamin B1 Levels Is Associated with Better Outcomes in Patients with Heart Failure","volume":"65","author":"Morimoto","year":"2024","journal-title":"Int. Heart J."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/S0002-9343(99)80349-0","article-title":"Improved Left Ventricular Function after Thiamine Supplementation in Patients with Congestive Heart Failure Receiving Long-Term Furosemide Therapy","volume":"98","author":"Shimon","year":"1995","journal-title":"Am. J. Med."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s00392-011-0376-2","article-title":"Thiamine Supplementation in Symptomatic Chronic Heart Failure: A Randomized, Double-Blind, Placebo-Controlled, Cross-over Pilot Study","volume":"101","author":"Schoenenberger","year":"2012","journal-title":"Clin. Res. Cardiol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1080\/10408398.2018.1540398","article-title":"Benefits of Multiple Micronutrient Supplementation in Heart Failure: A Comprehensive Review","volume":"59","author":"Dragan","year":"2019","journal-title":"Crit. Rev. Food Sci. Nutr."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/18\/3157\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:59:01Z","timestamp":1760111941000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/18\/3157"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,18]]},"references-count":114,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["nu16183157"],"URL":"https:\/\/doi.org\/10.3390\/nu16183157","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,18]]}}}