How to Diet for Stroke Victims

Three Parts:Modifying A Stroke Victim's DietOvercoming Eating DifficultiesHelping a Loved One in Public

The risk factors that arise from having a stroke include increased blood pressure, obesity, high cholesterol and diabetes, thus giving nutrition a vital role in recovery. Concentrating your diet on foods that are low in fats, sugars and salt will keep these risk factors at bay, limiting the potential of a stroke to happen again. What's more, a healthy diet can improve your health overall, making everyday life a bit easier.

Part 1
Modifying A Stroke Victim's Diet

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    Reduce intake of saturated fat to 8-10% of calories consumed. The primary goal of a healthy diet for a stroke victim should be to reduce consumption of saturated fat – it should be limited to 8-10% of total caloric intake.[1] In most cases, there are many saturated fats that the body is not able to break down and just stores as fatty, adipose tissues, leading to high blood pressure. To cut down on saturated fat:
    • Drink non-fat milk or skimmed milk instead of whole milk
    • Cut down intake of butter and fatty cheeses
    • Eat white meat (turkey, chicken, fish) instead of red meat, without the skin
      • As fat is deposited and accumulated in the blood vessels, it will cause them to narrow. Because of this, the heart needs to pump harder just to supply the same amount of blood leading to high blood pressure. Where there is less blood, there is also less oxygen and nutrition that can go to the brain leading to death of cells and eventually stroke.
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    Decrease cholesterol to 300 mg daily.[2] Like fat, cholesterol can lead to the blockage of blood vessels. That being said, there are two types of cholesterol: low density and high density cholesterol. Among these two, high density cholesterol (HDL) is known to be the good cholesterol. To up HDL and lower LDL levels:
    • Stroke victims should reduce their intake of dairy products and meat and aim to eat more vegetables and fruits. Dairy products, like milk and yogurt, are okay if they are low-fat and low-cholesterol.
    • Egg yolks should be avoided, but egg whites are perfectly healthy.
      • Cholesterol causes the formation of fat deposits that may occlude the arteries that supply oxygenated blood to the brain. The brain needs oxygen and nutrients to be able to function well. Therefore, when there is a destruction of blood supply to the brain, its function is impaired, thus causing stroke.
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    Cut back on salt. There is a good reason doctors warn their patients to stop eating salty food: Salt is hydrophilic, meaning it loves and attracts water. As you eat salty food, some of this salt goes around your blood vessels and because it loves water, it attracts more water to the blood vessels. As water or fluid increases inside the blood vessel, more blood volume accumulates. When there is more blood volume, more force is needed to pump blood to the systemic system leading to increased blood pressure.
    • Limit the intake of salt to 1600 milligrams daily.[3] Use other methods that are salt free to season food, like spices, herbs, and fruit juices like orange and lemon.
    • Make sure the stroke victim avoids eating processed foods as they usually have high levels of salt. This includes processed meat, snacks and brine foods.
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    Eat plenty of fruits and vegetables. Aside from the obvious fact that this food group doesn’t contain much fat, eating more fruits and vegetables will help you boost the immune system and aid in digestion and elimination.
    • All people, including stroke victims, should aim for five servings of vegetables and two servings of fruit every day.[4] Those rich in potassium like potatoes, spinach, sweet potatoes, tomatoes, spinach, banana, zucchini and broccoli are especially healthy as potassium is known to reduce and control blood pressure.
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    Eat wholegrain breads and cereals for fiber. This food group contains a high level of fiber, vitamins, and folate. Fiber is known to reduce fat and cholesterol because it acts as an absorber.[5] It is a great medium of attracting fat and cholesterol from the body and since fiber is easily eliminated by the body, then these harmful substances will be eliminated as well. Eat plenty of brown rice, wholemeal pasta, and porridge to get your fiber fix.
    • Cauliflower, broccoli, cabbage, berries, lettuce, celery, squash, beans, mushrooms, and oranges are all great sources of fiber.
    • Fiber can also lead to feelings of satiation (fullness) leading to decreased eating.
    • Folate is known to improve the health of red blood cells which carry vital oxygen to the brain. Healthy red blood cells will efficiently carry more oxygen. Furthermore, folate helps in maintaining the integrity of nerves.
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    Eat meat products in moderation. Stroke victims should limit their meat intake to only 65-100g of cooked chicken or red meat or 80-120g of cooked fish.[6] Choose only lean cuts with little or no fat at all.
    • If you see fatty food on the stroke victim's plate, trim it off. Take the skin off from the chicken too. It's not the meat that's unhealthy – it's the skin.
    • Eat fish rich in omega-3s, like salmon, mackerel, trout, sardines, tuna, and herring. This type of fat can actually be helpful for the heart and brain. Omega-3s can reduce inflammation and damage of the blood vessels.[7]
    • If the stroke victim doesn't eat much meat, make sure that the protein need is still met by eating two boiled eggs per week. And if they're vegan, make sure they eat plenty of beans and almonds to make up the deficit.
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    Cut down on white bread, biscuits, pastries, pasta, cakes, and white rice. These foods are rich in calories which get stored in the body as fat when not used. This fat accumulates in the bloodstream, too, making the heart pump harder and making it more difficult for the brain to receive oxygen.
    • The recommended amount of sugar should only be 60g per day, the equivalent of 12 teaspoons.[8]
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    Avoid drinking alcohol. There is good chance that medications taken after a stroke will interact with alcohol, thereby altering their desired effects. In addition to this, alcohol is known to increase blood pressure. For these two reasons, it should be avoided.
    • It is recommended that stroke victims limit themselves to only two glasses of alcoholic beverages per night maximum. Less is even better. A doctor should be consulted before taking medication and drinking as undesirable side effects like nausea and vomiting could be experience.
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    Boost your energy with supplements. Nutrition supplements as snacks are an easy way to boost energy levels. Popular supplements are Ensure and Nutrishake. These can be snacked on two or three times per day if needed.
    • Look into taking supplements that can help in the prevention of stroke if the stroke victim's doctor gives the okay. Often, this includes omega 3 and omega 6 fatty acids.
    • However, all supplements should be limited as overdosing can actually make stroke more likely. Because of this adverse side effect if not taken carefully, consult a doctor before taking any vitamin or supplement.

Part 2
Overcoming Eating Difficulties

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    Know that stroke victims should eat their biggest meal in the morning. It is a good idea for stroke victims to eat their heaviest meal in the morning while you have increased energy. This will provide them with the necessary energy that is needed for rehabilitation therapy. Dinner can be something simple like a sandwich or wholegrain cereal.
    • If a large meal isn't possible, eat small meals at different times of the day. Aim for six small meals a day instead of three.
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    For those who have difficulty in swallowing, cut the food into small bits. Dysphagia, or difficulty swallowing, is a very common side effect of stroke. To make foods more easily chewable, cut them into small bits before placing them into the mouth. This is important especially for hard, thick foods like meat.
    • When possible, eat soft foods like mashed potatoes, mashed bananas, eggs and cereals. These foods are easier to swallow naturally and quite tasty.
    • Blend foods, when necessary, so that the texture is like that of baby food, making the food easier to swallow.
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    Stick to thick liquids. It's a good idea for stroke victims to only drink thick liquids instead of lighter ones that can easily go down the wrong pipe and lead to choking. There are different natural thickeners that can be used that don't detract from food's natural flavors. Consider using any of the following:
    • Oats
    • Matzo meal
    • Flour
    • Potato flakes
    • Tapioca
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    Have eating aids and silverware that is large or has straps available. Many stroke victims have difficulty grasping silverware. To overcome this, flatware that has a larger handle or straps that patient can easily grasp can be used.
    • Knives that have curved blades can be used easily to cut food using one hand.
    • Plate guards can be used to keep the food on the plate when the patient is using one hand to eat.
    • Rubberized pads can be placed under the plate and this helps to keep the plate from sliding.

Part 3
Helping a Loved One in Public

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    Choose restaurants that are accommodating. It's a good idea to go to restaurants where one is known or where the staff are aware of your condition. In addition to seeing friendly faces, it will make the whole eating experience easier from being sat to ordering to enjoying a nice meal in a nice atmosphere.
    • If you've never been somewhere before and are itching to go, call beforehand to know whether they are able to cater for patients that are in wheelchairs and to inquire about what food they offer. This helps in ensuring that your party is catered for well while eating out and that all your needs are met.
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    Call ahead for a quiet corner. It's wise to call before you go out for a quiet corner to be reserved for you. This can be a table where the stroke victim can sit facing the wall while sitting across from the other people in their party. This helps to reduce stigma where the patient might feel uncomfortable when they feel like other people are watching them.
    • To get that quiet corner, it may be easier to go during less busy hours, like after the lunch rush. This reduces the stigma that most stroke patients have, reduces distraction, and also reduces the chance of developing depression.
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    Talk to the staff. When the patient is eating in a new place, it is advisable for them to go with a relative or to inform the staff of his/her condition. This makes it easier for the stroke patient to adjust in a new place. It also makes it clear to the staff what they have to do to ensure you have a good experience at their restaurant.
    • In short, restaurants want your business. Do not think of this as an inconvenience or an obstacle – any good restaurant will be more than happy to help you.
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    Help the patient rehearse what they want to order. To avoid forgetting, patients are advised to rehearse mentally what they want to order. You may want to avoid giving them a menu if it will just be distracting.
    • You can also order their food ahead of time while making the reservation if it's easier. Just remind the staff upon your arrival that you've already ordered and they should be able to take care of it from there.
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    Help them figure out other ways to order. If the patient can't verbally order their food, there are other easy ways around the issue without you having to do the work for them. Here are two ideas:
    • The patient can use pictures or point using their fingers. This helps them feel more independent and autonomous.
    • The patient can bring a card that explains their condition and the meal that they want to eat. The card should be given to the hostess upon seating to make everything easier from the get-go.

Sources and Citations

  1. Corrigan, M. L., Escuro, A. A., & Kirby, D. (2013). Handbook of clinical nutrition and stroke. New York: Humana Press
  2. Hoffman, J., & Hoffman, Joyce. (2012). The tales of a stroke patient. United States: Xlibris Co.
  3. Stanfield, P., & Hui, Y. H. (2009). Nutrition and diet therapy: Self-instructional modules. Sudbury, Mass: Jones and Bartlett.

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Categories: Maintaining Diets