Encouraging Appetite And Nutrition After A Stroke

Eating a healthy diet after a stroke is crucial for recovery and can help prevent another stroke from occurring. However, eating may not be as simple as it was before, as brain damage can cause difficulties with chewing, swallowing, and appetite loss. To ensure adequate nutrition, it is important to consult with a dietitian and speech pathologist, who can recommend strategies and foods to make eating easier and more enjoyable. This may include soft foods, such as cooked cereal, mashed potatoes, and pureed fruits and vegetables, as well as high-calorie and nutrient-dense options. Additionally, certain supplements may aid in stroke recovery, such as potassium, omega-3 fatty acids, and vitamin B3.

Pureed fruits and vegetables

Some good vegetables to puree include:

• Peas
• Cauliflower
• Squash
• Broccoli
• Bell peppers
• Parsnips
• Sweet potatoes
• Eggplant
• Turnips
• Celery root

Fruits that are easy to puree include:

• Peaches
• Apples
• Tomatoes

Pureeing fruits and vegetables is a great way to ensure a post-stroke patient gets the nutrition they need to heal and recover. It is important to consult with a doctor or dietitian to ensure the patient's specific needs are being met and that any pre-existing conditions are not being exacerbated.

High-calorie foods

Following a stroke, it is important to maintain a healthy diet to aid in recovery and prevent further strokes. A dietitian can help ensure adequate nutrition, and a speech pathologist can recommend strategies for safe eating and drinking. Here are some tips for including high-calorie foods in a post-stroke diet:

• Include nutrient-dense foods that are high in calories, such as avocado, nut butters, and seed butters. Ensure that nut and seed butters are runny enough to swallow easily.
• Incorporate full-fat dairy products, such as whole milk and full-fat yoghurt, if advised by a doctor.
• Use extra oil, such as olive oil, when cooking or as a salad dressing.
• Add high-calorie ingredients to smoothies, such as nut powders or butters, pasteurised egg whites, and natural sweeteners like dates or honey.
• Increase calorie intake by having smaller, more frequent meals throughout the day.
• Try high-calorie, soft foods that are easy to chew and swallow, such as Greek yoghurt, eggs, and quinoa.
• Include healthy fats like olive oil, nuts, and avocados, which can help improve blood cholesterol levels and reduce inflammation.
• Consider high-calorie, plant-based foods like quinoa, which is rich in fibre and contains all the essential amino acids.
• Opt for lean protein sources like chicken, fish, and tofu, which provide essential nutrients and help build muscle and tissue.

Soft foods

Pureed Fruits and Vegetables

Fruits and vegetables can be pureed with milk, not only making them easier to swallow but also adding nutritional value. Blending them into smoothies is another great option.

Yogurt

Yogurt is an excellent source of protein and probiotics, which aid in digestive health. Its soft and creamy texture makes it a perfect choice for those with swallowing difficulties.

Custard or Jello

These sweet treats have high palatability, which may make eating easier for those with a diminished appetite.

Porridge with Milk

Warm porridges like oatmeal are softer and easier for stroke patients to consume than bread or rice. They also provide important nutrients and can be made with milk for added nutritional value.

Soft Scrambled Eggs

Eggs are a great source of protein and various beneficial nutrients, including choline, biotin, and vitamin B12. Scrambling them makes them softer and easier to chew and swallow.

Liquid Meal Substitutes

While whole foods are ideal, liquid meal substitutes such as protein shakes can be helpful for those who have difficulty chewing or preparing food.

Thickened Liquids

For those who have difficulty swallowing, it is important to thicken liquids with agents like tapioca, matzo meal, cornstarch, or banana or potato flakes. This helps to prevent aspiration and ensures adequate fluid intake.

Soft and Bite-Sized Foods

The International Dysphagia Diet Standardization Initiative (IDDSI) recommends Level 6 foods for those with mild swallowing difficulties. These foods are soft and bite-sized, allowing for safe chewing and swallowing. Examples include baked fish, minced meat, and root vegetables.

Stewed, Roasted, or Steamed Foods

Cooking methods such as stewing, roasting, or steaming can help soften foods, making them easier to chew and swallow. This technique can be applied to meats and vegetables.

Avoid Sticky and Dry Foods

Sticky and dry foods, such as peanut butter or rice, can be extremely difficult to swallow, even if they can be chewed. It is best to avoid these foods and opt for softer alternatives.

Speech Therapy and Neuromuscular Electrical Stimulation

In addition to dietary modifications, speech therapy can help improve swallowing function. Neuromuscular electrical stimulation uses electrical impulses to strengthen the swallowing muscles, making it easier to manage soft foods.

High-fibre foods

The recommended daily fibre intake for adults is about 30 grams, with one portion of fibre weighing about 7 grams. Here are some tips to include more high-fibre foods in your diet:

• Include plenty of whole grains, such as brown rice, whole-wheat bread, quinoa, brown pasta, wholewheat couscous, and oats. These foods are rich in fibre and other essential nutrients.
• Opt for high-fibre fruits such as apples, berries, plums, and avocados. A medium-sized apple, for example, provides about 4.4 grams of fibre.
• Eat a variety of vegetables, especially green leafy vegetables like spinach and kale. These are packed with fibre and other vital nutrients like folate.
• Legumes, including beans, lentils, and peas, are excellent sources of fibre. They are also low in fat and rich in protein, vitamins, and minerals.
• Nuts and seeds are good sources of fibre and healthy fats. Some nuts, like almonds, are also a good source of calcium.
• Choose high-fibre snacks like raw carrot sticks or a piece of fruit.

Remember to increase your fibre intake gradually and ensure you drink plenty of water to aid digestion. Additionally, if you are caring for a stroke patient, consult with their doctor or dietitian to ensure their diet is tailored to their specific needs and any existing medical conditions.

Whole foods

• Focus on eating plenty of fruits and vegetables. These are rich in antioxidants and flavonoids, which are great for stroke recovery. Some of the best fruits for stroke patients include blueberries, pomegranates, citrus fruits, apples, and tomatoes. Vegetables such as legumes are also excellent sources of potassium, iron, and protein.
• Include more whole grains in the diet, such as oats, barley, brown or wild rice, quinoa, and barley. These are good sources of fibre, which can help lower cholesterol.
• Choose lean proteins such as chicken, tofu, fish (especially oily fish like salmon), and eggs. These provide essential amino acids and can help with weight management.
• Opt for healthy fats like olive oil and avocado oil, which are good sources of unsaturated fats. Avocados, in particular, are a great source of oleic acid, which can help improve cognitive function.
• Dairy foods such as milk, yoghurt, and cheese are good sources of calcium and potassium, which can help control blood pressure. However, go for reduced-fat options and be mindful of portion sizes, as dairy can also be high in saturated fat.
• Limit processed foods, as these are often high in salt, sugar, and unhealthy fats. This includes foods like processed meats, baked goods, sugary drinks, and convenience foods.
• Be cautious with salt, sugar, and saturated fats. Excessive amounts can increase the risk of stroke and damage blood vessels. Instead, use herbs and spices to add flavour to your meals.
• Stay hydrated by drinking plenty of water.

Remember, it is important to consult with a doctor or dietitian to ensure that any dietary changes are safe and appropriate for the individual's needs.

Frequently asked questions