Self-Care Behaviors and Dietary Habits Among Patients with Heart Failure: A Cross-Sectional Study

Background: Self-care and healthy dietary habits are fundamental components of heart failure (HF) management, yet the relationship between dietary quality and self-care remains insufficiently explored. This study investigated the association between dietary habits and self-care behaviors among patients with HF. Methods: A cross-sectional study was conducted among 137 adults with HF attending outpatient clinics in Greece. Self-care behaviors were assessed using the Hippocratic Heart Failure Self-Care Scale (HHFSCS), whereas dietary quality was evaluated using the validated Greek version of the Cardiovascular Diet Questionnaire-2 (CDQ-2). Associations between demographic characteristics, dietary quality, and self-care were initially examined using non-parametric tests. Two multivariable General Linear Models (GLMs) were subsequently performed to identify independent predictors of self-care. Results: The mean HHFSCS score was 41.0 ± 11.3, indicating a moderate level of self-care. Medication adherence and attendance at scheduled appointments showed the highest scores, whereas exercise, smoking-related behaviors, alcohol-related behaviors, and symptom monitoring demonstrated lower adherence. The mean total CDQ-2 score was −5.9 ± 3.9. In the multivariable analysis, overall dietary quality remained independently associated with self-care after adjustment for age, sex, marital status, educational level, and employment status (β = −0.511, p = 0.020). Among the individual dietary domains, only saturated fat intake remained independently associated with self-care (p = 0.015), whereas fruit consumption and unsaturated fatty acid intake were not significant predictors. Employment status also remained independently associated with self-care (p < 0.001). Conclusions: Better dietary quality, particularly lower saturated fat intake, was independently associated with improved self-care among patients with HF. These findings support integrating comprehensive nutritional assessment and individualized dietary counseling into routine HF management. Dietary behavior may serve as a practical marker of patients' overall self-management capacity and could assist healthcare professionals in identifying individuals who require additional educational and behavioral support.