The committee was more interested in the impact on symptoms and hospitalisation. For the comparison of low sodium diet programme versus moderate sodium diet programme, the only evidence reported in a complete format enabling analysis was on quality of life and renal function. For the comparison of fluid restriction programme versus advice on fluid restriction, the only evidence was on quality of life and oedema. There was no evidence for any comparison on hospitalisation, change in weight, change in sodium level for patients with low baseline sodium, or hyperkalaemia. Quality of the clinical evidence The committee noted the paucity of evidence in this area, which was limited to 2 very small pilot studies looking at different comparisons. Low sodium programme versus moderate sodium programme: The evidence for both quality of life and renal function was graded low quality due to risk of bias (selection bias and performance bias). Imprecision could not be formally assessed due to reporting of the outcomes as median and interquartile range (IQR), but the committee noted the small size of the study. Fluid restriction programme versus general advice on fluid restriction: Chronic Heart Failure Beta-blockers in heart failure and concomitant atrial fibrillation NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 Recommendations Do not routinely advise people with heart failure to restrict their sodium or fluid consumption. Ask about salt and fluid consumption and, if needed, advise as follows: restricting fluids for people with dilutional hyponatraemia reducing intake for people with high levels of salt and/or fluid consumption. Continue to review the need to restrict salt or fluid. 