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Background: Multidisciplinary heart failure (HF) programs reduce hospital readmission and improve clinical outcomes. Although dietitians are often members of such teams, no randomized studies have demonstrated the independent benefit of dietitian-administered dietary counseling for patients with HF. The purpose of this study was to evaluate the effect of dietitian education on adherence to a sodium-restricted diet in ambulatory patients with stable HF., Methods: Patients with HF (left ventricular ejection fraction < 35%) were randomized into a dietitian education group (n = 23) or a usual care group (n = 24), then observed for 3 months. Both groups received a 2 g/d dietary sodium prescription. The usual care group received nutrition advice by way of self-help literature, whereas the dietitian education group returned for 2 counseling sessions with a dietitian., Results: Dietitian education resulted in a significant decrease in sodium intake at 3 months (2.80 +/- 0.30 to 2.14 +/- 0.23 g/d, P < .05). In contrast, there was no change in sodium intake in the usual care group (3.00 +/- 0.31 to 2.74 +/- 0.35 g/d, P = ns)., Conclusions: Dietitian-administered counseling was more effective than providing literature in reducing dietary sodium intake in patients with stable HF.