Date of Award

Winter 12-14-2011

Degree Type


Degree Name

Master of Science (MS)



First Advisor

Dr. Anita M. Nucci, PhD, RD, LD

Second Advisor

Jennifer Frediani, MS, RD, LD

Third Advisor

Barbara Hopkins, MMSc, RD, LD

Fourth Advisor

Dr. Sandra Dunbar, RN, DSN, FAAN, FAHA


Background: Heart failure and diabetes are common coexisting diseases. Elevated levels of glucose in the blood caused by insulin resistance can damage blood vessels and nerves, and eventually lead to heart disease. A poor diet and obesity can also contribute to the progression of diabetes and heart disease.

Objective: The purpose of this study was to determine if diet and lifestyle factors between adult heart failure patients with and without diabetes who are participating in the EducatioN, and Supportive Partners Improving Self-CaRE (ENSPIRE) study are associated with comorbidities such as diabetes, and if so then how current dietary recommendations in this population should be modified based on diabetes status.

Methods: Using data collected from the EducatioN and Supportive Partners Improving Self-CaRE (ENSPIRE) study from 2006 to 2009 which was a prospective, randomized, controlled clinical trial, a secondary data analysis was conducted. Daily dietary intake of calories, sodium, carbohydrate, fat, sugar, and fiber was assessed via a 3-day food record. Differences in anthropometric measures, smoking history, education level and health literacy score between the two groups were also assessed. 117 heart failure patients were included in the analysis. Of these, 39% had diabetes.

Statistical analysis: Statistical analyses included the t-test, Chi-square analysis, and Mann Whitney U test used to compare anthropometric data, lifestyle factors, and disease states.

Results: Weight was higher in heart failure patients with vs. without diabetes (104.9 vs. 92.6 kg, respectively; P

Conclusion: Weight was significantly higher in heart failure patients with diabetes and they consumed fewer carbohydrates than their non-diabetic counterparts. We recommend encouraging these individuals to closely monitor their macronutrient intake, specifically limiting fat in the diet. Meeting with a dietitian to ensure adequate nutrient intake is strongly recommended.