Patient-reported barriers to dietary adherence in heart failure: a qualitative substudy of the Pro-HEART trial.
Andrew T Reyes, Angelina Nguyen, Alona D Angosta and 4 others
PMID 41911329WHAT IT FOUND
People with heart failure and diabetes or metabolic syndrome said strict diet plans felt culturally foreign, socially isolating, and emotionally stressful.
Tracking food and weigh-ins increased stress, and motivation declined without consistent support or flexibility.
Key findings
01Many felt anxious or guilty when they did not strictly follow the diet, and small lapses felt like failure.
02Food tracking and rigid digital tools felt burdensome, especially when travelling, eating out, or recalling meals.
03Participants said the diet did not fit their cultural foods, family traditions, or shared meals, making it feel foreign and isolating.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 24 participants from one parent trial site were interviewed, so the themes may not cover all patients. Interviews included people who stayed in the study, so participants who dropped out may have had different or stronger barriers. Participants may have been influenced by recall bias or by wanting to give socially acceptable answers to study staff. This is a qualitative substudy, so it does not measure whether the diet plans worked or whether flexible, culturally tailored support improves adherence.
Declared interests
The authors declared no competing interests.
The easy way to misread this
Do not read this as proof that either high-protein or standard-protein diets fail, or that flexible culturally tailored counselling improves adherence. It reports experiences of 24 participants who remained in the trial, not measured outcomes.