DIET AFTER HEART TRANSPLANT

Transplantation requires a change of lifestyle. Maintaining good nutritional health while undergoing and continuing this change of lifestyle is important. Many of the medications and procedures experienced by transplant patients can alter sense of taste or inhibit the desire to eat.

After surgery, your appetite may be slow in returning. It should improve with time. Remember however, that during your recovery, your body needs enough calories and protein to heal. Thus, eating is important. Some helpful tips to remember as you begin eating again:

• You may feel more comfortable eating smaller frequent meals.
• You may wish to add extra foods on your menu , which may include snacks such as milkshakes and juices.
• If you feel you just cannot eat enough, discuss this with the dietician. She may recommend a nutritional supplement, but try “real” food first.

Diet and Immunosuppressive Medications

Diet is a very important part of your life after transplantation. The drugs used to prevent rejection have several side effects that make a good diet necessary.

The immunosuppressive drugs:

• Cause the body to lose potassium
• Cause the body to hold water and salt.
• Can hunger and cause weight gain due to overeating.
• May increase the amount of cholesterol, fats and sugar in the blood.
• May speed up the thickening and narrowing process of the blood vessels of the heart.

Diet is important even if you did not have weight problems or thickening of the blood vessels of your heart before the transplant surgery.

Caloric Restrictions

Your total calories can be changed to decrease, increase or maintain your weight as necessary. Being overweight increases your heart’s work. Your drug therapy may make you hungry, you may eat more and gain weight. Therefore, it is extremely important for you to pay attention to the total amount of food you consume. Apart from adding to the work of your heart, being overweight is linked to high levels of Triglycerides (fats) in the blood stream. Having a lot of fats in your blood raises the possibility of thickening of the blood vessels of your heart.

Cholesterol and Saturated Fat Restriction

Cholesterol is an essential fatty substance found in our body including many animal foods. Fats are concentrated sources of energy that come in three forms; monounsaturated, polyunsaturated and saturated. Cholesterol and the saturated fats in our blood may gather along the walls of the blood vessels causing them to narrow. If this narrowing becomes severe in the blood vessels of your heart, the blood supply to your heart will be compromised.

Apart from your diet, your medications may also raise the level of fats in your blood. Therefore, in order to prevent coronary artery disease, the overall fat intake after your surgery must be restricted to not more than 30 percent of your total calories every day. Increasing the proportion of polyunsaturated and monounsaturated fat in your diet and reducing your total saturated fat intake to less than 10% of your total fat intake will actually help in lowering cholesterol and saturated fat levels in your blood.

Foods high in cholesterol & saturated fats

• Animal products: Liver and organ meats, egg yolks, whole milk, butter, cream, and whole milk cheeses.
• Vegetables high in saturated fats: Coconut, cocoa and palm.
• Other: Fried foods.

Note: Instead of frying the foods, try to boil, bake or steam while preparing foods.

Foods high in mono-saturated and polyunsaturated fats

• Meats as well as other protein foods: Low fat dairy products, lean meats and fatty fish (salmon, trout, tuna, bluefish)
• Vegetable fats: Olive oil, soybean oil, corn oil, sesame oil, groundnut oil sunflower oil and rice bran oil.

Concentrated Carbohydrate Restrictions

You may be asked to cut down on the amount of sugar and concentrated sweets in your diet as well. Carbohydrates add to calories and large amounts of the same can contribute to an increase in Triglycerides on the blood.

Dietary Changes

Changes in your diet may be necessary because of your transplant surgery and because of the medications you are on to prevent rejection. Keep in mind that your diet will be changed in the following ways:

• Fluid and sodium restriction
• Caloric restriction
• Concentrated carbohydrate restrictions
• Protein intake
• Cholesterol and saturated fat restriction
• Caffeine restriction
• High soluble fiber intake
• Alcohol restriction

Fluid and Sodium Restriction

Salt is made up of two minerals; Chloride (C) and Sodium (Na+). It is the sodium part of the salt that is a matter of concern in your diet. Sodium should be restricted in your diet as it causes the body to hold fluids.

You must control your sodium as well as the fluid intake as well since Prednisone causes the body to hold both of these. As a result of holding fluid and sodium, extra fluid builds up in the veins and arteries. To avoid this sodium and fluid buildup, you have to cut down on both.

To reduce fluids, stick to solid foods instead of liquids. For instance, eat fruit instead of drinking juice. You doctor may also prescribe you a sodium-restricted diet to cut down on salt. Your doctor may also prescribe a pill to help get the sodium and fluid out of your system.

FOODS HIGH IN SODIUM (NA+) CONTENT

• Meat and Other protein foods: Canned meats, Ham, smoked salmon, canned fish, cheese, and regular peanut butter
• Vegetables: Vegetables prepared in olives, brine, pickles, vegetables packed with seasonings or sauces, tomato sauce or paste, frozen peas, and lima beans.
• Breads & cereals: Bread and rolls with salt toppings, corn chips, potato chips, salted popcorn, and other salted snack foods.
• Fats: Bacon fat, olives, salted nuts, spreads, dips and sauces
• Soups: Canned broth soups, commercially prepared stews, and instant or dried soups.
• Be mindful of monosodium glutamate (MSG) used in Chinese foods. When you have Chinese food, you should request that it be prepared without MSG.

OTHER DIETARY RESTRICTIONS

• Caffeine restriction: Use of caffeine containing products like coffee, tea, chocolate, and dark sodas may be limited.
• High soluble fiber intake: Foods high in soluble fiber help to lower the level of cholesterol in your blood. Thus, encourage yourself to eat more amount of fiber. Foods high in soluble fiber include: fenugreek, oats, beans and barley.
• Alcohol restriction: You should not drink any alcohol after transplant. Alcohol can increase the level of Triglycerides (fats) in your blood, and alcohol can reduce liver function. Increase of Triglycerides puts you at risk for coronary artery disease.

PROTEIN INTAKE

The day after surgery, you may be given a diet rich in high biological value protein sources. This will help to heal your surgical wounds and improve your overall nutrition. However, the amount of protein you are given may be altered depending on how well your kidneys are working right after transplant surgery. Once you have recovered from surgery, a high protein diet will no longer be needed.