A review of new evidence published after 2010 was carried out in order to determine whether any changes to current recommendations where likely to be required. The decision on which topics to include in the update of the guideline was made following consultation of the scope. This section, with the exception of salt and fluid restriction, was not within the scope of the update. For more information on the following aspects of lifestyle please refer to appendix R in the 2003 guideline: vaccinations, sexual activity, air travel, driving For guidance on alcohol and smoking cessation see 6.1.2. 6.1.1 Salt and fluid restriction Information provided to patients with heart failure usually includes advice to restrict salt and fluid intake. Patients often find this difficult to adhere to, and little is known as to whether or not adherence affects their overall condition, and helps prevent episodes of decompensation. There is a concern that advising fluid restriction in the elderly, whose fluid intake is often low, could potentially be harmful. There is currently variation in practice on what advice patients are given by health professionals and consequently confusion and uncertainty among patients about whether salt and fluid restriction is beneficial. Stakeholders identified this as a priority area for the guideline update, and the committee regarded this as an important aspect of patient care and education that required clarification. 6.1.1.2 Review question: What is the clinical and cost effectiveness of salt and/or fluid restriction in people with heart failure? For full details see review protocol in Appendix A. Chronic Heart Failure Treating Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. 