Starving And Strokes: Is There A Link?

Eating a healthy, balanced diet is one of the most important factors in reducing your risk of stroke. Eating well can lower your blood pressure and blood cholesterol levels, which are two of the biggest contributors to stroke risk. A diet rich in fruits and vegetables, whole grains, and low-fat dairy can help to prevent strokes by keeping blood vessels clear and reducing the chances of clots forming. However, it is important to note that eating difficulties are common after a stroke, and loss of appetite can often occur due to changes in taste buds, emotional changes, and physical challenges with eating and swallowing.

Eating difficulties after a stroke

Eating difficulties are common after a stroke, with almost half of stroke survivors initially facing challenges with swallowing. This is known as dysphagia, which can cause food or drink to go down the wrong way and enter the lungs, leading to aspiration pneumonia. To prevent this, it is crucial to assess swallowing ability within four hours of hospital admission and refer to a speech and language therapist for further evaluation and treatment.

Signs of Swallowing Problems:

• Coughing or choking when eating or drinking
• Food or drink coming out through the nose
• Food or drink going down the wrong way
• Feeling of food stuck in the throat
• Difficulty retaining food or drink in the mouth
• Presence of leftover food or drink in the mouth after swallowing
• Inability to chew food properly
• Croaky or 'wet' sounding voice
• Saliva escaping from the mouth
• Prolonged time required to swallow or finish a meal
• Frequent throat clearing or excessive swallowing
• Shortness of breath during swallowing

Treatments for Swallowing Problems:

• Speech and language therapy: Therapists will assess swallowing ability and recommend techniques, exercises, and aids to improve swallowing function.
• Modified diet: Speech and language therapists may advise consuming softer, puréed, or liquidised foods, as well as thickened drinks, to facilitate safer swallowing.
• Tube feeding: In cases of severe dysphagia or long-term swallowing difficulties, tube feeding may be necessary to ensure adequate nutrition and hydration. This can be done through nasogastric (NG) tubes or percutaneous endoscopic gastrostomy (PEG) tubes.

In addition to swallowing problems, stroke survivors may experience a loss of appetite, taste changes, or difficulty using utensils due to muscle weakness. Here are some strategies to address these issues:

• Choose colourful and flavourful foods: Opt for foods like salmon, carrots, and dark green vegetables, which are not only visually appealing but also packed with nutrients that lower the risk of another stroke.
• High-calorie foods: Include high-calorie options in meals to boost energy intake.
• Liquid supplements: Consider liquid supplements to provide additional energy and nutrients if eating solid foods is challenging.
• Light exercise: Engage in light activities like walking to stimulate appetite.
• Address mental health: Post-stroke depression is common and can contribute to a loss of appetite. Seek medical advice for antidepressant medication or talk therapy to address mental health concerns.
• Adaptive utensils: Use flatware with larger, thicker handles or knives with curved blades to facilitate easier handling and one-handed use if muscle weakness is present.
• Plate guards and rubberised pads: Utilise plate guards to help with scooping food and rubberised pads to prevent plates or bowls from sliding.
• Adaptive kitchen equipment: Invest in easy-grip scissors, battery-powered peelers, and specialised cutting boards for one-handed food preparation.

Tips for Family and Friends:

• Check with the stroke team: Before bringing food or drinks, consult with the stroke team to ensure they are safe for the survivor to consume.
• Provide time and privacy: Allow the person to eat at their own pace in a private and comfortable space to reduce self-consciousness.
• Present food attractively: Separate food items on the plate and use food moulds to enhance the presentation of puréed foods.
• Offer drinks or snacks: Provide drinks or small snacks if the person feels tired or drowsy, as this can impact their ability to swallow.
• Be patient and encouraging: Understand that eating may be stressful, so offer encouragement and allow them to take their time.
• Seek help: If you feel overwhelmed or unsure how to help, reach out to healthcare professionals or support groups for guidance.

Loss of appetite

Additionally, depression is a frequent issue after a stroke, and it can cause a decrease in appetite. The physical and psychological symptoms of depression can include sudden mood changes, anxiety, feelings of hopelessness, sleeping problems, and trouble concentrating. It is crucial to address mental health concerns as they can significantly impact a person's recovery and quality of life.

To improve appetite after a stroke, it is recommended to choose foods with strong flavors, such as citrus fruits, herbs, and spices. Opting for colorful and nutritious foods like salmon, carrots, and dark green vegetables can also make meals more appealing. Eating high-calorie foods first and including liquid supplements can ensure adequate energy and nutrient intake. Light exercise, such as walking, can also help stimulate the appetite.

It is important to consult a healthcare professional for personalized advice and support. They may recommend seeing a speech therapist to address swallowing difficulties or a mental health professional to address any mental health concerns.

High blood pressure

There are several factors that can increase your risk of high blood pressure, including family history, age, lack of physical activity, poor diet, social determinants, gender-related risk patterns, obesity, and drinking too much alcohol. It is important to measure your blood pressure regularly and understand what your numbers mean.

To reduce high blood pressure, you should eat a healthy diet, including reducing salt intake, engage in regular physical activity, maintain a healthy weight, avoid tobacco smoke, take your medication as prescribed, and limit your alcohol consumption.

Diabetes

People with diabetes are twice as likely to have a stroke as people without diabetes. The risk of stroke is 1.5–2 times higher in people with diabetes compared to those without, and this risk increases with the duration of diabetes. Diabetes is a condition that causes blood sugar to rise, and a fasting blood glucose level of 126 mg/dL or higher is considered dangerous.

The connection between diabetes and stroke lies in how the body processes blood glucose for energy. During digestion, most foods are broken down into glucose, which enters the bloodstream and travels to cells throughout the body. For glucose to enter cells and provide energy, the body needs a hormone called insulin, which is produced by the pancreas. In people with type 1 diabetes, the pancreas does not produce insulin, while in type 2 diabetes, the pancreas either produces too little insulin or the body's muscles, liver, and fat do not use insulin correctly. As a result, untreated diabetes leads to high levels of glucose in the blood, leaving cells without enough energy. Over time, this can increase fatty deposits or clots in blood vessels, leading to a stroke.

People with prediabetes, or those at risk of developing type 2 diabetes, are also at an increased risk of stroke. Additionally, the risk of stroke in people with diabetes may differ according to sex, with a greater risk observed among women compared to men.

Steps to Reduce Stroke Risk in People with Diabetes

• Maintain a heart-healthy diet: Consume at least 14 grams of fiber daily for every 1,000 calories consumed, and keep cholesterol intake below 300 mg per day.
• Don't smoke or vape: Smoking increases the risk of heart disease, regardless of whether an individual has diabetes.
• Maintain a healthy weight: Making lifestyle changes can lead to a weight loss rate of 3-5%, which has health benefits when maintained over time.
• Engage in physical activity: Even light exercise, such as a brisk walk or swimming, can improve health and may reduce stroke risk. Be sure to consult a doctor before starting any new exercise program.
• Limit alcohol consumption: Women should have no more than one drink per day, and men should limit their intake to no more than two drinks per day.
• Manage stress: Stress can have lasting negative effects on health and well-being.
• Regular check-ups and medication: Get tested regularly and talk to your doctor about preventive measures and medication to manage diabetes and lower stroke risk.

High cholesterol

Eating a healthy, balanced diet is important for stroke prevention. While a person cannot directly suffer a stroke from not eating, a poor diet can increase the risk of having a stroke.

Cholesterol-lowering statins have been shown to reduce the overall risk of stroke by about 30%, but without reducing mortality from stroke. Patients under 75 recovering from a stroke with evidence of carotid atheroma as the cause, or with a history of coronary heart disease, should be considered for treatment with a statin to reduce the risk of recurrences.

To lower cholesterol and reduce stroke risk, it is recommended to reduce saturated fat intake and eat more foods containing healthy fats, such as salmon, sardines, and avocado. Unsaturated fats found in fish, nuts, seeds, and plant-based oils can help prevent blocked arteries and blood clots, which can cause strokes.

Frequently asked questions