Nutrition And Eating After A Stroke: What Patients Should Know

Eating a healthy diet is crucial for stroke recovery and can help prevent another stroke. A nutritious diet can provide the energy needed to stay active, undergo rehabilitative therapy, and resume daily activities. However, brain damage from a stroke can cause various challenges, such as difficulty swallowing, loss of appetite, and problems with using utensils. To overcome these obstacles, stroke patients may need to adopt new strategies, such as opting for soft foods, thickening liquids, and consulting with speech therapists and dietitians. Additionally, changing dietary habits by reducing processed foods, salt, and sugar, while increasing the consumption of whole foods, fruits, and vegetables, can promote overall health and lower the risk of another stroke.

Characteristics of eating after a stroke

Eating difficulties: Brain damage can cause trouble swallowing, loss of appetite, and problems using utensils

Eating and drinking are essential for nourishment and hydration, but they can become challenging after a stroke. Brain damage can cause trouble swallowing, loss of appetite, and problems using utensils. Here are some ways to manage these difficulties:

Trouble Swallowing

Dysphagia, or difficulty swallowing, is a common issue after a stroke. It can cause choking, coughing, or gagging while eating or drinking. It may also result in liquid coming out of the nose when swallowing. This issue often improves over time, but the following strategies can help:

• Stick to soft foods: Opt for foods that are naturally soft or cooked until soft, such as cooked cereal, mashed potatoes, soup, cottage cheese, and applesauce. If you want to try harder foods, cut them into small pieces or blend them to make them easier to chew.
• Thicken your liquids: While staying hydrated is important, water and other thin liquids can pose a choking hazard. Consult your doctor about thickening drinks with tapioca, matzo meal, cornstarch, or banana or potato flakes.
• See a speech therapist: Speech therapists can guide you through exercises to strengthen the muscles involved in swallowing, such as the tongue, lips, throat, and mouth muscles. They may also recommend neuromuscular electrical stimulation or prescribe muscle relaxers to open up the throat and ease swallowing.

Loss of Appetite

Brain damage from a stroke can affect your appetite and moods. You may not feel as hungry as you used to, or the stroke may have impacted the part of your brain that controls your senses, including taste and smell. Here are some tips to enhance your appetite:

• Choose flavourful and colourful foods: Opt for foods with strong, low-saturated fat, and low-salt flavours, such as citrus fruits, herbs, and spices. Colourful foods like salmon, carrots, and dark green vegetables are not only appetising but also packed with heart-healthy nutrients that lower the risk of another stroke.
• Prioritise high-calorie foods: If you're not feeling hungry, focus on eating high-calorie foods first to ensure you're getting enough energy and nutrients. Additionally, consider liquid supplements for added nutrition and energy.
• Exercise lightly: Light physical activity, such as walking, can help increase your appetite.
• Address dental issues: If you wear dentures, ensure they fit properly. Ill-fitting dentures can cause discomfort and reduce your desire to eat.
• Prioritise mental health: Depression is common after a stroke and can affect your appetite. Consult your doctor about antidepressants or consider talk therapy with a therapist or counsellor.

Problems Using Utensils

Weakness in the arms or hands after a stroke can make it challenging to use utensils properly. Consider the following adaptations:

• Use adaptive flatware: Opt for flatware with larger, thicker handles that are easier to grip. Curved blades can also help you cut food with one hand.
• Plate guards: These guards help you scoop food against the side of the plate when eating with one hand.
• Rubberised pads: Placing a rubberised pad under your plate or bowl can prevent it from sliding.
• Adaptive kitchen equipment: Invest in special tools to aid one-handed food preparation, such as easy-grip scissors, battery-powered peelers, and specialised cutting boards.

Healthy diet: Eating well can reduce the risk of another stroke and support recovery

Eating a healthy diet after a stroke is essential for reducing the risk of another stroke and supporting recovery. Here are some dietary guidelines and recommendations to achieve this:

Understand the importance of a healthy diet

Firstly, understand that dietary changes are crucial for stroke recovery and preventing another stroke. A healthy diet provides the necessary nutrients to support neurological and physical healing. It also helps manage risk factors such as high blood pressure, high cholesterol, and type 2 diabetes.

Consult with experts

It is important to consult with a dietitian or doctor to tailor a specific plan that considers your unique medical history and pre-existing health conditions. They can provide guidance on which foods to eat or avoid and suggest simple, heart-healthy diets like the Mediterranean diet or the DASH diet.

Choose whole, plant-based foods

Prioritize whole foods that are in their natural state, such as fruits, vegetables, nuts, seeds, beans, rice, and fish. Opt for more leafy greens, asparagus, peppers, onions, carrots, and other non-starchy vegetables. Legumes, including beans, lentils, and peas, are excellent sources of protein, vitamins, and minerals.

Avoid processed and high-sugar foods

Processed foods, such as baked goods, refined carbohydrates, sugary foods and drinks, fried foods, and fast food, are often loaded with sodium, unhealthy fats, and added sugars. These can contribute to plaque buildup, weight gain, and type 2 diabetes, increasing the risk of stroke.

Reduce salt and saturated fat intake

Limit your consumption of foods high in salt and saturated fats, such as red meat, processed meats, commercial burgers, pizza, fried foods, potato chips, and other savory snacks. Choose unsaturated fats found in fish, avocados, nuts, and seeds, which are better for heart health.

Manage blood pressure and cholesterol

To manage blood pressure and cholesterol, incorporate more fruits and vegetables into your diet, as they contain antioxidants, potassium, and fiber. Opt for low-fat or reduced-fat dairy products, and choose lean meats and poultry. Legumes are also excellent for controlling blood pressure and cholesterol.

Consider swallowing difficulties

If you experience dysphagia (difficulty swallowing) after a stroke, modify your food consistencies accordingly. Puree foods, mince and moisten them, or cut them into soft, bite-sized pieces. Cook vegetables in water to soften them, and cook meat until it is very tender.

Prevent weight loss

To prevent weight loss, consume nutrient-dense and high-calorie foods such as nut or seed butters, high-calorie smoothies, and shakes. Add extra oil to your meals, use full-fat dairy products (if advised by a doctor), and consider smaller, more frequent meals.

Nutritional advice: Speech pathologists, dietitians, and occupational therapists can help with nutritional advice and strategies for eating and drinking

Nutritional advice and strategies for eating and drinking are essential for stroke patients to aid their recovery and prevent further strokes. Speech pathologists, dietitians, and occupational therapists can provide guidance and support in this area. Here are some recommendations and strategies:

• Speech pathologists can guide patients through exercises to strengthen the tongue, lips, throat, and mouth muscles, improving their swallowing ability. They may also suggest neuromuscular electrical stimulation, which uses electrical impulses to strengthen the swallowing muscles. Additionally, they can recommend prescription medications, such as muscle relaxers, to open the throat and make swallowing easier.
• Dietitians can advise on specific diets and food consistencies suitable for stroke patients. For example, the Mediterranean diet, which includes fresh produce, lean protein, and healthy fats like olive oil, is recommended for stroke prevention. Dietitians can also suggest texture-modified diets and thickened fluids to prevent aspiration in patients with dysphagia. They can help patients identify safe textures and consistencies for swallowing and ensure adequate nutrient and fluid intake.
• Occupational therapists can assist patients with day-to-day activities, including eating and food preparation. They may suggest adaptive kitchen equipment, such as easy-grip scissors, battery-powered peelers, and specialised cutting boards, to make food preparation easier. They can also provide advice on modifying recipes to accommodate different food consistencies, such as pureeing food or mincing and moistening food to reduce the need for chewing.

It is important to work with these professionals to develop a personalised plan that considers the patient's specific needs and severity of symptoms. This multidisciplinary approach can help ensure adequate nutrition and a smoother recovery process for stroke patients.

Food types: Whole foods, plant-based foods, and foods rich in fibre are recommended

Eating a healthy diet after a stroke is crucial for several reasons. Firstly, it helps to ensure your body gets the nourishment it needs to support the healing process and gives you the energy to stay active and engage in rehabilitative therapy. Secondly, it can reduce the risk of having another stroke.

Whole Foods

Whole foods are those that are minimally processed and as close to their natural state as possible. Examples include fruits, vegetables, nuts, seeds, beans, rice, and fish. When choosing vegetables, opt for leafy greens, asparagus, peppers, onions, carrots, brussels sprouts, and other non-starchy options. If you're having trouble chewing or swallowing, focus on softer whole foods like cooked cereals, mashed potatoes, cottage cheese, and applesauce. You can also blend tougher foods to make them easier to consume.

Plant-Based Foods

A plant-based diet has been shown to reduce the risk of heart disease and stroke. This includes whole grains, fruits, vegetables, nuts, seeds, legumes, and plant-based proteins like tofu. For example, quinoa is a whole grain that is rich in fibre and contains all the essential amino acids. Legumes, such as beans, lentils, and peas, are excellent sources of protein, vitamins, and minerals while being low in fat.

Foods Rich in Fibre

Fibre is an essential component of a healthy diet, and you can find it in abundance in plant-based foods. Legumes, in particular, are a great source of fibre, as well as potassium, iron, and protein. They are versatile and can be used in burgers, soups, and stews. Additionally, avocados are a good source of fibre and healthy fats, which are beneficial for brain health.

Food to avoid: Processed foods, salt, and sugar should be limited

After a stroke, it is important to eat a healthy diet to support your body's recovery and prevent another stroke. This involves limiting your intake of processed foods, salt, and sugar.

Processed foods are typically altered to include lots of fats, starches, sugars, and hydrogenated oils, which can increase your cholesterol, blood pressure, and stroke risk. These include processed meats like bacon and salami, refined carbohydrates like white bread and crackers, sugary foods and drinks, fried foods, and fast food. Instead, opt for whole foods, which are the opposite of processed foods. Examples include fish, whole grains, legumes, fruits, and vegetables.

Salt, or sodium, is also linked to high blood pressure, a major risk factor for stroke. The American Heart Association recommends consuming no more than 2,300 milligrams of sodium per day, which is about a teaspoon of salt. To reduce your salt intake, eliminate any added salt from your food and choose lower-salt options. Instead of salt, use herbs and spices to add flavour to your meals.

Sugar can damage blood vessels and increase your risk of stroke, as well as cause weight gain and type 2 diabetes, both of which are stroke risk factors. Limit your intake of sugary foods and drinks, including desserts, pastries, candies, and soda. Choose lower-sugar options and satisfy your sweet tooth with fruits, which provide natural sugars and essential nutrients.

Frequently asked questions