By Christopher Salgado RD, LDN

Prior to and following heart transplant, the nutritional goal ensures that your child reaches their age-related ideal bodyweight. It is important to not be underweight, due to the importance of maintaining adequate fat and protein reserves to protect against an infection or organ rejection. But in the same regard, it is important to avoid carrying excess weight as it can place added stress on the new organ. Below is a list of steps to follow to maintain a healthy heart lifestyle.

  1. Incorporate more fruits and vegetables in each meal. Vegetables and fruits are full of vitamins, minerals and contain fiber, which support your heart by helping to regulate cholesterol and blood sugar.
    1. Be mindful that canned vegetables may be high in sodium, therefore opt for lower-sodium or salt-free counterparts. Avoid fruits in syrup.
    2. Try different textures when cooking vegetables such as spiralized zucchini with pasta, peppers with fajitas or minced vegetables when making meatballs.
    3. When taking anti-rejection medication, avoid foods containing grapefruit.

Did you know? Rinsing canned fruits and veggies with water can help get rid of extra sodium/sugar content.


  1. Consume more fiber to replace concentrated sweets and highly processed foods. High blood glucose levels can indirectly increase triglycerides which can increase risk for heart disease.
    1. Choose fresh veggies and fresh fruit over fruit in syrup or dehydrated fruit.
    2. Choose whole grain or whole wheat bread in place of white bread.
    3. Choose brown, black rice, quinoa, or farro in place of white rice or pasta.
    4. Choose oatmeal or fibrous cereal – aim for less than 10g sugar per serving.

Did you know? Three grams of fiber per serving indicates the product is considered a good source of fiber in most cases.


  1. Not all fats are bad fats! However, when reading a nutritional label follow these steps for healthier cholesterol levels:
    1. Avoid trans fats; -they may be hidden under ingredients as partially hydrogenated oil, and limit saturated fats to under 6 percent of the of total fat intake.
    2. Aim for monounsaturated – good fat and polyunsaturated – better fat. I often recommend avocados, extra-virgin olive oil (lower-temperature cooking), canola oil (higher temperature cooking), flaxseed oil, almonds, natural nut butters in moderation, hemp seeds, chia seeds, salmon, grounded flax seeds etc.

Did you know? Fat free or 1% Greek yogurt is a great substitute for sour cream? You may also try it in place of mayonnaise. If it’s too tart, try adding a few drops of olive oil.


  1. Protein is important for recovery and growth! Amino acids that make up proteins not only help build strong bones, but also assist in building and strengthening healthy tissue such as your heart.
    1. Eat skinless chicken breast, eggs, lean cuts of beef or pork such as the tenderloin and fish such as fresh salmon. Beans, lentils and soy products are a great protein alternative as well. When choosing dairy products, opt for 0-1% milk fat.

Did you know? After cooking meats, let it sit for five minutes to help retain moisture.


  1. Limit sodium intake by reading the label. This is to help control high blood pressure and prevent fluid retention. Opt for salt free or lower- sodium options when available; under 150mg sodium/serving is a good rule of thumb.

Did you know? Cured meats and beef jerky contain a ton of sodium, opt for lower-sodium versions.


  1. Identify serving size. This will help in identifying how much actual sugar, fat, carbohydrates, fiber, and protein is being consumed per prepared plate.
    1. Example: If one serving is ½ cup and you eat 1 cup, then you double the specified macronutrients and calories.

It’s understandable that eliminating unhealthy foods isn’t always ideal. However, moderation is important for an overall lifestyle change versus a temporary diet. Try to follow an 80/20 rule, which means you dedicate 80 percent to healthier food choices and the remaining 20 percent to the foods and snacks that you love.

Follow the recommendations above and your child will be on their way to a heart healthy lifestyle.

Christopher Salgado RD, LDN, is a pediatric registered transplant dietitian at Holtz Children’s Hospital at the University of Miami/Jackson Memorial Medical Center.