Strategies To Encourage Eating After A Stroke

Eating a healthy diet after a stroke is essential to nourish your body, reduce the risk of another stroke, and support neurological and physical healing. However, brain damage from a stroke can cause various challenges that make eating difficult, such as trouble swallowing, problems using utensils, loss of appetite, and fatigue. To overcome these obstacles, stroke patients can follow several strategies, including sticking to soft foods, thickening liquids, consulting a speech therapist, using adaptive kitchen equipment, choosing colourful and flavourful foods, and making breakfast the biggest meal of the day. Additionally, physical therapy plays a crucial role in stroke recovery, helping to restore movement, improve function, and address specific challenges such as hand rehabilitation and spasticity.

Eat Whole, Plant-Based Foods and Vegetables

Eating a healthy, balanced diet is crucial for stroke recovery and reducing the risk of another stroke. A plant-based diet, rich in whole foods, is recommended for stroke patients as it provides essential nutrients and antioxidants that support the brain and body. Here are some detailed instructions on how to eat whole, plant-based foods to aid in stroke recovery:

• Focus on Whole Foods: Whole foods are those that are minimally processed and closest to their natural state. This includes fruits, vegetables, nuts, seeds, beans, rice, and fish. When choosing vegetables, opt for leafy greens, asparagus, peppers, onions, carrots, and brussels sprouts.
• Limit Processed Foods: Processed foods, such as cereal, crackers, certain breads, chips, and processed meats, are high in sugar and salt, which can contribute to plaque buildup and increase the risk of stroke. It's best to minimise or avoid these foods.
• Include Healthy Fats: Incorporate fatty fish like salmon into your diet, as it contains omega-3 fatty acids, which are important for brain health. Avocados are another excellent source of healthy fats and provide oleic acid, which supports information processing in the brain.
• Choose Plant-Based Proteins: Legumes, including beans, lentils, and peas, are excellent plant-based sources of protein, vitamins, and minerals. They are also high in fibre and low in fat, making them a nutritious addition to your diet.
• Opt for Whole Grains: Whole grains, such as quinoa, provide complex carbohydrates and essential amino acids. Quinoa is a complete protein source, containing all the amino acids needed to form new proteins in the body.
• Prioritise Antioxidant-Rich Foods: Blueberries, pomegranates, citrus fruits, apples, and tomatoes are rich in antioxidants, which help protect the brain and body from damage caused by free radicals. These fruits also provide valuable nutrients like flavonoids and vitamin C.
• Consider a Mediterranean or DASH Diet: These diets are primarily plant-based and emphasise healthy fats, fruits, vegetables, and whole grains. They have been shown to reduce the risk of stroke and promote overall health.
• Consult a Dietitian: Before making significant dietary changes, it is essential to consult with a dietitian or doctor. They can provide guidance based on your unique medical history and help create a diet plan that meets your specific needs and preferences.

Avoid Processed Foods, Salt, and Sugar

After a stroke, it is important to eat well to nourish your body and give you the energy you need to stay active and do rehabilitative therapy. Eating a healthy diet can also help reduce the risk of having another stroke.

Processed foods, salt, and sugar should be avoided after a stroke. Processed foods are typically prepackaged and include options like cereal, crackers, certain breads, chips, and processed meats. They often contain high levels of sugar and salt, which may contribute to plaque buildup that can cause an ischemic stroke. One study found that women who consumed one or more sugary beverages per day were 20% more likely to have a stroke than those who rarely consumed sugary drinks. Excess sugar can also lead to weight gain and type 2 diabetes, both of which are risk factors for stroke.

To reduce sugar intake, it is recommended to limit sugary foods such as desserts and pastries and replace sugary drinks with water. Instead of processed foods, opt for whole foods that are in their natural state, such as fruits, vegetables, nuts, seeds, beans, rice, and fish.

Salt should also be limited as it is linked to high blood pressure, which is a risk factor for stroke. The American Heart Association recommends consuming no more than 2,300 milligrams of sodium per day. To reduce salt intake, opt for seasoning meals with herbs, spices, or citrus instead of salt. Be mindful of packaged foods labelled as "whole wheat" as they often contain additives, salt, and sugar.

In summary, it is important to avoid processed foods, salt, and sugar after a stroke to reduce the risk of another stroke and promote overall health. Opt for whole, unprocessed foods and use herbs and spices for flavour instead of salt.

Consume Foods That Promote Brain-Derived Neurotrophic Factor (BDNF)

Consuming foods that promote Brain-Derived Neurotrophic Factor (BDNF) is an important part of stroke recovery. BDNF is a protein that supports the growth of new brain cells and promotes neuronal connections within the brain. This process is known as neuroplasticity, which is the brain's ability to rewire itself after sustaining an injury.

Fatty Fish

Salmon and other fatty fish are rich sources of omega-3 fatty acids, which play a crucial role in maintaining brain health. Omega-3s help build and repair brain cells, improve mood, and protect against cognitive decline. They also increase blood flow in the brain, leading to better cognition and thinking abilities.

Flaxseeds

Flaxseeds are an excellent source of alpha-linolenic acid (ALA), an omega-3 fatty acid that cannot be produced by the body and must be obtained through diet. ALA boosts BDNF levels, neuroprotection, and neuroplasticity, making it crucial for stroke patients who are at a higher risk of having another stroke.

Nuts and Seeds

Nuts and seeds are rich in vitamin E, which is associated with lowering the risk of cognitive decline. Vitamin E also has antioxidant properties that protect the brain cells from damage. Additionally, vitamin E helps improve cognitive function.

Avocados

Avocados contain oleic acid, which is essential for optimal performance in the areas of the brain responsible for processing information. Avocados are also a great source of antioxidants, which may act as effective neuroprotective agents.

Eggs

Eggs are a good source of protein and can be cooked in various ways, making them easily consumable for those with swallowing difficulties. According to research, consuming one egg per day can help reduce the risk of stroke by 12%.

In addition to these specific foods, it is important to follow a healthy and balanced diet that includes a variety of whole foods, such as fruits, vegetables, nuts, seeds, beans, and fish. This will ensure that the body receives the necessary nutrients to support recovery and reduce the risk of another stroke.

Manage Loss of Appetite

Loss of appetite is a common issue after a stroke, and it can be caused by various factors, such as depression, damage to the part of the brain that controls senses, or difficulty with chewing and swallowing. Here are some strategies to help manage loss of appetite and ensure proper nutrition:

• Choose flavourful and colourful foods: Opt for foods with strong flavours and colours, such as citrus fruits, herbs, spices, and salmon. These foods not only stimulate the appetite but also provide heart-healthy nutrients that lower the risk of another stroke.
• Prioritise high-calorie foods: Encourage the consumption of high-calorie, nutrient-dense foods first during meals. This ensures that even if the patient has a small appetite, they are still getting the necessary nutrients and energy.
• Light exercise: Encourage light physical activities, such as walking, to help increase appetite.
• Check dentures: If the patient wears dentures, ensure they fit well. Ill-fitting dentures can cause discomfort and reduce the desire to eat. Regular dental check-ups are important.
• Address mental health: Depression is common after a stroke and can lead to a loss of appetite. Encourage the patient to seek support from a therapist or counsellor, and consider consulting a doctor about antidepressant medication.
• Set specific meal times: Establish a routine by setting specific times for meals. Sharing mealtimes with loved ones can also make the experience more enjoyable and social.
• Serve meals when energy levels are highest: Typically, energy levels are higher earlier in the day, so try to serve larger meals during breakfast or lunch.
• Consider liquid meal substitutes: For patients who struggle with chewing and swallowing, consider liquid meal substitutes such as protein shakes or smoothies. Ensure that these supplements are approved by a healthcare professional and do not contain added sugars, especially if the patient has diabetes.
• Speech therapy: A speech therapist can guide the patient through exercises to strengthen the tongue, lips, throat, and mouth muscles, improving swallowing function.
• Nutritional supplements: Consult a doctor or dietitian about nutritional supplements that may be beneficial during stroke recovery, such as potassium, Omega-3 fatty acids, Vitamin B3, and Coenzyme Q10. However, be cautious about potential interactions with medications.

Consult a Speech Therapist for Swallowing Difficulties

Swallowing difficulties, or dysphagia, can occur during any of the three stages of the swallowing process: the oral phase, the pharyngeal phase, and the esophageal phase. If you are experiencing trouble swallowing, it is important to consult a speech therapist or speech-language pathologist (SLP), who can guide you through exercises to strengthen the relevant muscles and improve your ability to swallow.

Signs and Symptoms of Swallowing Disorders

• Coughing or throat clearing during or after eating or drinking
• Wet or gurgly voice during or after eating or drinking
• Needing extra time or effort to chew or swallow
• Food or liquid leaking from the mouth or getting stuck in the mouth
• Recurring pneumonia or chest congestion after eating
• Weight loss or dehydration due to insufficient food or fluid intake

Speech Therapy Treatment Options

If you are experiencing any of the above symptoms, a speech therapist can help by providing:

• Exercises to improve the range of motion, coordination, and strength of the muscles involved in swallowing, including the jaw, lips, tongue, throat, and mouth muscles.
• Guidance on positioning strategies and swallowing maneuvers to redirect the movement of food or liquid and improve control of the swallow, protecting the airway and reducing the risk of aspiration.
• Recommendations for modifying the consistency of food and liquids, such as thickening liquids or softening solid foods, to make swallowing easier and safer.
• Neuromuscular electrical stimulation, which uses electrical impulses to strengthen the swallowing muscles.
• Prescription medications, such as muscle relaxants, to open the throat and facilitate swallowing.

Benefits of Speech Therapy for Swallowing Difficulties

With the help of a speech therapist, individuals with swallowing difficulties can improve their ability to eat and drink safely, reducing the risk of aspiration and maintaining their quality of life. This can lead to improved nutrition, hydration, and overall health outcomes.

Frequently asked questions