Introduction <p>Heart failure (HF) is a complex clinical syndrome associated with high morbidity and mortality, substantially impairing patients’ quality of life and imposing a significant burden on the Brazilian Unified Health System. Among the non-pharmacological strategies, nutrition plays a pivotal role in HF management by fostering healthy lifestyle habits. However, the impact of recommended dietary patterns — and others such as plant-based, ketogenic, low-sodium diets, and intermittent fasting — on cardiovascular outcomes in patients with HF remains insufficiently elucidated.</p> Objective <p>This review aims to analyze current evidence regarding the effects of these dietary approaches on clinical and cardiovascular outcomes in HF and to assess their alignment with Brazilian heart failure guidelines and national recommendations for healthy eating.</p> Methods <p>A narrative review of the literature was conducted in April 2025, using the databases of the Virtual Health Library and PubMed. The search strategy used the term “heart failure” combined with terms related to diet and eating habits. Open-access articles published from 2020 onwards, in Portuguese or English, were included. Subsequently, using the Rayyan tool, review articles of any type that were considered relevant to the objectives were selected.</p> Results <p>Eighteen studies were selected, indicating benefits of adopting dietary patterns such as the DASH (Dietary Approaches to Stop Hypertension) and the Mediterranean diet for patients with HF. The most frequently cited approaches were the DASH (<i>n</i> = 11), Mediterranean (<i>n</i> = 10) and the sodium restriction (<i>n</i> = 15), other dietary patterns identified included the ketogenic diet (<i>n</i> = 4), plant-based diets (<i>n</i> = 8), intermittent fasting (<i>n</i> = 2), paleolithic diet (<i>n</i> = 1), and HEART diet (<i>n</i> = 1). Recommendations to restrict sodium and fluids were also addressed, but this remains a controversial and debatable topic. When comparing this evidence with national guidelines, it was observed that, despite the value placed on healthy eating, there are gaps regarding the specificity of nutritional guidelines aimed at HF. In particular, the absence of detailed recommendations on dietary patterns adapted to the needs of these patients was noted.</p> Discussion <p>There is evidence supporting dietary patterns such as the Mediterranean and DASH diets, but Brazilian HF guidelines still lack more detailed recommendations. Adapting or including Brazilian dietary recommendations made for the general population could improve cultural relevance and adherence among patients with HF.</p> Conclusion <p>The Brazilian guidelines need to be updated to address more detailed information on diets recommended for the non-pharmacological management of patients with HF. The information from the Dietary Guidelines for the Brazilian Population could be adapted and used to promote more consistent and contextualized dietary guidelines for nutritional management in HF, with a view to favorably impacting disease progression.</p>