AIMS: Eating a varied diet promotes adequate micronutrient intake. Poor appetite could decrease desire to eat a varied diet leading to dietary micronutrient insufficiencies. The interrelationships among appetite, diet variety, and dietary micronutrient intake has not been investigated in patients with heart failure. The purpose with the study was to determine whether the relationship between appetite and micronutrient insufficiency was mediated through diet variety.
METHODS AND RESULTS: A total of 238 patients with heart failure, mean age 61 ± 12.1; 68% male and 45% NYHA class III/IV were included in this secondary analysis. Data collection consisted of a four-day food diary and self-reported appetite on a 10-point visual analog scale. Micronutrient insufficiency was defined as the total number of 17 minerals and vitamins that were insufficient in the diet. Diet variety was calculated as the number of 23 food types consumed over the 4 days. Mediation analysis, controlling for co-variates age, gender, NYHA-class and body mass index showed that diet variety mediated the relationship between appetite and micronutrient insufficiencies (indirect effect = -.0828, 95% CI: -.1585 to -.0150). There was no direct effect of appetite on micronutrient insufficiency (c´ = -.1802; 95% CI = -.3715 to.0111).
CONCLUSIONS: Diet variety played a previously unrecognized role in the relationship between appetite and dietary micronutrient intake in patients with heart failure. More research is needed to validate these associations in patients with heart failure.