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Barley, buckwheat (kasha), bulgur, cornmeal, couscous, white flour. |
Avoid: |
Bread, bagels, and rolls made with whole grain, 100% whole wheat, or dark rye |
Other cereals (bran, whole grain, granola, shredded wheat, those with dried fruit and nuts) |
Whole wheat pasta |
Brown rice |
Quinoa. |
DAIRY |
Although non-chocolate dairy has less potassium than their chocolate versions, dairy is considered a high potassium food choice. Please limit to ½-1 cup (125-250 ml) per day or as per the recommendation of your Dietitian or Healthcare Team. |
Choose: |
Fresh milk |
Pudding |
Ice cream |
Yogurt |
Avoid: |
Chocolate milk |
Ice cream and yogurt containing chocolate and/or nuts. |
ADDITIONAL ITEMS |
Choose: |
Coffee or tea |
Butter, margarine, oil, or mayonnaise |
White sugar, sugar substitutes, honey, jam, pancake syrup |
Non-cola beverages |
Herbs and spices, pepper, herb mixes |
Unprocessed meat, fish, poultry, and cheese |
Popcorn, pretzels, corn chips (low sodium options) |
Nut butter, but limited to 1 tbsp per day. |
Avoid: |
Specialty coffees (cappuccino, Turkish coffee, espresso) |
Canned coconut milk |
Chocolate |
Potato chips |
Nuts and seeds |
Colas |
Brown sugar |
Maple syrup |
Salt-free cheese or processed meats with potassium added |
Salt substitutes containing potassium chlorides (Nu Salt®, No Salt® and Half Salt®) |
Avoid foods that list potassium or the chemical symbols (K, KCl or K+) as an ingredient on the label. |
PREVENTING HEART FAILURE |
A healthy lifestyle and behaviours help reduce the risks of heart failure and related heart conditions. Making healthy choices and taking action on these risk factors can help prevent or reduce the chance of developing heart failure. |
Quit or do not start smoking. Smoking is a significant contributor to coronary artery disease, which can lead to heart failure. Avoid inhaling secondhand smoke as well. |
Maintain a healthy weight. Physical activity in addition to a healthy diet can help you achieve this goal. |
Consume heart-healthy foods. Foods that are low in saturated fat, trans fat, sugar, and sodium are beneficial to your health. Incorporate fruits and vegetables, low-fat dairy, lean protein like skinless chicken, and “healthy” fats like those found in olive oil, salmon, and avocadoes into your diet. |
Treat any related heart conditions promptly and properly. This includes managing high blood pressure, controlling diabetes, and maintaining healthy cholesterol levels. |
Take heart protective medications as prescribed by your physician. |
RADIATION THERAPY |
Radiation therapy is a key component in cancer care to help reduce the risk of recurrence and death. It is used to treat several cancers, including breast, lung, esophagus, and Hodgkin’s lymphoma. |
Most radiation therapy is administered by a local external beam of high-energy particles (such as protons, electrons, and photons) designed to destroy cancer cells. Sometimes radiation therapy is given by brachytherapy. Brachytherapy is a sealed source of radiation inserted in the body next to the target cells. Ultimately, radiation destroys the DNA in cancer cells and prevents them from growing and dividing normally, causing them to die. |
RADIATION-THERAPY INDUCED CARDIOTOXICITY |
Radiation can affect the arteries and veins that supply the heart muscle, causing the structures of the heart to become inflamed, thickened, or scarred (fibrosis). Radiotherapy-induced cardiotoxicity (RICT) is recognized as a contributor to abnormal heart function years after radiation therapy is completed. |
Effects of radiation on the heart include: |
Pericarditis (inflammation of the sac around the heart) |
Pericardial effusion (fluid collection in the sac around the heart) |
Myocarditis (inflammation of the heart muscle) |
Cardiomyopathy (enlarged heart/decreased pumping function/stiffness of the heart walls) |
Damage of the valves of the heart |
Premature narrowing/injury of the heart blood vessels (coronary artery disease) |
Injury to electrical system of the heart leading to arrhythmias (abnormal heart rhythms) |
Autonomic dysfunction (nerve injury, changes in heart rate and blood pressure with exercise) |
RICT generally occurs many years after radiation therapy is completed. Those at greatest risk of RICT include: |
People who had heart disease or risk factors for heart/carotid artery disease (smoking, diabetes, high blood pressure, high cholesterol, obesity) before their cancer diagnosis |
Those receiving concomitant chemotherapy (chemotherapy given to increase the sensitivity of tumour cells to radiation therapy) |
Those receiving anthracycline chemotherapy or trastuzumab |
Patients receiving left sided chest radiation |
Those receiving a radiation heart dose greater than 35 Gy |
Those who are/were a younger age when receiving radiation. |
REDUCING THE RISK OF RICT |
Recent improvements in radiotherapy reduce cardiac radiation exposure: |
Increased use of technology to plan and target radiation therapy allows more precise doses of radiation while limiting radiation exposure to the neck, chest, and heart. |
Daily dosing of radiation therapy means smaller doses of radiation are given more frequently, decreasing the risk of RICT associated with higher daily doses. |
Use of chemotherapy to decrease the amount of radiation required. |
Your overall health also helps reduce risk of heart disease. Healthy behaviours such as not smoking, maintaining a healthy weight, preventing/controlling diabetes, engaging in regular exercise, and maintaining healthy blood pressure and cholesterol levels all contribute to reducing risk. |
Tell your health care team if you develop symptoms of chest pain, shortness of breath, increasing difficulty with physical activity, and swelling in your feet/legs. These may be signs of heart injury, which can occur many years after radiation therapy. If you develop these symptoms and have had radiation therapy to the chest/neck in the past, you may require tests to determine if you have heart disease. |
HEART FUNCTION AND RELATED CONDITIONS |
Heart failure rarely occurs on its own. Various conditions can make the heart work harder than it should, exacerbating your heart failure symptoms. Heart failure can also lead to additional complications, such as kidney or liver disease or heart valve difficulties. |
As part of confirming your diagnosis, your doctor will likely order blood tests and other testing to examine what’s wrong with your heart and to rule out any other diseases. |
CORONARY ARTERY DISEASE |
Coronary artery disease is the most common cause of heart failure in Canada. It occurs when cholesterol deposits in the walls of the coronary arteries, causing them to become narrowed or blocked. This deposit of cholesterol plaques is called atherosclerosis. Over time, coronary arteries may become too narrow and impede blood flow to the heart muscle. This may result in chest pain (called angina), cause a heart attack, and weakened heart muscle. A heart attack, or ‘myocardial infarction’ occurs when the cholesterol plaques spontaneously rupture, causing a blood clot to form within the artery. This results in a sudden lack of blood flow and oxygen to the heart muscle. It is not entirely clear what causes certain cholesterol plaques to rupture. Coronary disease is typically diagnosed through different types of stress tests. The stress may either be exercise on a treadmill or bicycle, or a ‘pharmacologic stress’ brought on by medication. Risk factors for cholesterol plaques include: high blood pressure, high cholesterol, diabetes, smoking, older age, inactivity, obesity, family history of heart disease. |
ATRIAL FIBRILLATION |
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