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Stroke Prevention
A well balanced diet including protein, carbohydrates, vegetables and fruit is a vital part of stroke risk reduction. Healthy eating habits may help lower blood pressure rates, cholesterol levels and reduce complications from diabetes.

Eat your vegetables
A recent Harvard University study concluded that eating five daily servings of fruits and vegetables might lower your risk for a clot-caused stroke by 30 percent. Citrus fruits and vegetables such as broccoli or brussel sprouts are particularly beneficial. Their higher concentrations of folic acid, fiber and potassium, may be a key to reducing heart disease and stroke risk

Unfortunately, most individuals eat only half of the recommended servings. Increasing your intake can be easy. For example:
  • Drink a glass of orange or vegetable juice
  • Buy pre-sliced vegetables or fruit for easy snacking or cooking
  • For flavor, use a variety of herbs and spices on vegetables. Add basil or dill to green beans or tomatoes
  • Add grated vegetables to casseroles, spaghetti sauces or meat patties

Eat a low fat diet
Eating and cooking in a low-fat manner reduces your waistline and decreases stroke and heart attack risk. Taking a few minutes to think through your food choices and how you cook them can make a difference.

For instance, grilling a piece of chicken instead of frying it reduces your fat intake significantly Adding the following foods to your regular diet may also help:
 

  • fruits and vegetables
  • lean meats such as chicken, turkey and fish
  • lean cuts of beef (round or sirloin steak) or pork (pork chops, pork loin)
  • low-fat dairy products (skim milk, 2% fat cottage cheese)
  • egg substitutes or a maximum of four egg yolks per week
  • fiber, including whole grain breads, cereal products or dried beans

 

Watch your homocysteine levels

Homocysteine is an amino acid (a building block of protein) that is produced naturally in the body and then changed into other amino acids for the body's use. Researchers recently found that too much homocysteine in the blood may increase a person's chance of developing heart disease, stroke or other blood flow disorders.

Homocysteine levels are determined by two key factors: genetics and lifestyle. Genetic factors affect the speed homocysteine is processed in your body. Lifestyle factors, such as diet, effect homocysteine levels in another manner. For example, people with a high homocysteine level may have a low dietary intake of vitamins B6, B12, and folic acid. Replacing these vitamins helps levels return to normal. Low thyroid hormone levels, kidney disease, psoriasis or some medications may also cause abnormally high homocysteine levels.

Folic acid is another part of the homocysteine puzzle. Most Americans do not get enough folic acid from their diets. Eating more fruits and vegetables including lentils, chickpeas and asparagus increases folic acid levels and decreases health risks. Grain products, including ready-to-eat cereals and enriched products such as bread, pasta and rice are also good sources of folic acid.

Vitamins B6 and B12 are essential in controlling homocysteine levels and maintaining good health. As a person's body ages, the ability to absorb B12 is reduced. This may cause a variety of health problems including an increased risk for heart disease. Eating more foods containing vitamin B12 such as cereals, low-fat meat, fish, poultry, milk or milk products may help. In some instances of vitamin B12 deficiency, more proactive steps may be needed, including B12 injections.

Additional B6 can be easily added to your diet by eating fortified cereals and grains, bananas, baked potatoes, watermelon, meats, fish and poultry.

Adjusting your diet may not be enough to lower your homocysteine to a desirable level. Vitamins may also be needed. Speak with your healthcare provider before starting any vitamin regiment. Taking high doses of vitamins is not generally recommended. Rechecking your homocysteine levels after you've taken vitamins is essential. If your homocysteine remains high, your doctor will modify your treatment

Drink alcohol only in moderation
Recent studies indicate that drinking a daily four ounce glass of wine or a 12 oz can of beer or one drink made with spirits or liquor (1 1/4 oz), may lower your risk for stroke (provided that there is no other medical reason you should avoid alcohol). Remember that alcohol is a drug and can interact with other drugs you are taking. It is harmful if taken in large doses. Speak with your physician before consuming alcoholic beverages on a regular basis. If you don't drink, don't start.

Post-Stroke Nutrition to Help Restore Health

Normal nutritional requirements are altered with any trauma or illness. After a stroke, modifying your diet may be necessary. The focus in early treatment and throughout rehabilitation is to meet daily energy needs and basic nutritional demands.

Although each individual has specific needs, stroke survivors may have additional considerations including:

Ability to Eat
Chewing or swallowing difficulties will interfere with adequate intake. Often a stroke patient's is the same easy-to-eat foods repeatedly (mashed potatoes, pudding, etc.) A registered dietitian can help ensure that a variety of foods meet daily nutrition requirements.

Poor Appetite
Food and eating may become unappealing after a stroke for many reasons including: lack of desire for food, lack of taste sensation, fear of choking due to swallowing and chewing problems, mouth discomfort from ill-fitting dentures and/or medication. Constant encouragement may help increase the desire to eat and improve health.

Visual Perception
Vision problems that may occur after stroke can effect food intake. For instance, food items on a plate or tray may be out of the field of vision and may not be eaten. Special assistance during meals may teach survivors to finish their meals and "look" for all the food.

Length of Time
Eating may take more time after a stroke. If assistance is not always available, smaller, more frequent feedings should be used with a focus on foods high in nutritional value.

Medical Considerations
High blood pressure, diabetes, bowel and bladder function and other medical complications will also require dietary modification.
 
Diet in Rehabilitation
Being aware of the following nutritional needs will enhance the recovery/rehabilitation process:
  • Malnourishment - Survivors who demonstrate low motivation, apathy, or excessive fatigue may not be getting the nourishment they need. Increased monitoring of food intake may help.
  • Overweight/Obesity - Reducing calorie intake, but maintaining daily nutrients is essential for stroke survivors who are overweight or obese. It is possible to be overweight and be malnourished. Statements such as, "It's all right that she hasn't eaten for five days, she needs to lose weight," are inaccurate. A registered dietician can help create a balanced diet and weight-loss plan.


Nutritional Care
Dietary management is an essential part of care giving, whether performed by the dietician, nurse or family members. A nutritional care plan should include the following components:
 

  • Individual Needs - No standard menu or diet will apply to everyone.
  • Relevant Background Information - Many social/cultural factors affect eating habits. Consider adapting the diet to the survivor's preference.
  • Intake Monitoring- Observe and record the survivor's acceptance and tolerance of food items.
  • Diet instruction - Teach the survivor how to follow the diet, makes compliance easier.

Copyright © 2000, North Carolina Stroke Association