Post-Stroke Appetite Loss: Can Patients Recover Their Hunger?

Post-stroke, patients may experience a loss of appetite, which can be distressing for them and their caregivers. This loss of appetite can be attributed to brain damage impairing muscle movement and affecting moods and senses of taste and smell. Other factors contributing to poor nutrition include problems with memory, swallowing, and using utensils. To help stroke patients recover their appetite, caregivers can serve their favourite foods, set specific mealtimes, and encourage the consumption of nutrient-dense foods. Additionally, pureed fruits and vegetables, yogurt, custard, porridge, and soft scrambled eggs are recommended for their ease of consumption and nutritional value. Ensuring adequate nutrition is vital for stroke recovery, and speech pathologists and dietitians can provide valuable guidance in this area.

Pureed fruits and vegetables are easy to eat and can be nutritionally dense

Pureed fruits and vegetables are an excellent way to ensure post-stroke patients get the nutrients they need. The soft, pudding-like consistency of pureed foods makes them easier to swallow and digest, reducing the risk of choking or digestive issues. This is especially important for those with swallowing difficulties, a common issue after a stroke.

Pureed fruits and vegetables can be a good source of vitamins, minerals, and nutrients, helping to prevent malnutrition and ensuring adequate nutrition. They can also be made more palatable by adding herbs and spices, and by using food molds to improve their appearance.

Preparing pureed foods is simple and can be done with a blender or food processor. It is important to cook fruits and vegetables until they are soft before pureeing, and to add liquids such as water, broth, or milk to achieve the desired consistency.

Pureed fruits and vegetables can be a nutritious and safe option for post-stroke patients, providing the nutrients needed to support the recovery process. They can be easily incorporated into the diet and customized to meet individual needs and preferences.

Loss of appetite after a stroke is rare but can be caused by damage to the part of the brain that controls senses

Loss of Appetite After a Stroke

Loss of appetite after a stroke is a rare condition , but it can occur due to damage to the part of the brain that controls senses, affecting the sense of taste or smell. This can lead to a decreased interest in food and a lack of appetite. Brain damage can also cause difficulties with chewing, swallowing, and moving muscles, further impacting the ability to eat.

Strategies to Improve Appetite

• Choose flavourful and colourful foods: Opt for foods with strong flavours and colours, such as citrus fruits, herbs, spices, salmon, carrots, and dark green vegetables. These foods not only look and taste appealing but also provide essential nutrients for recovery.
• Prioritize high-calorie foods: Encourage the consumption of high-calorie, nutrient-dense foods first in the meal. This ensures adequate energy intake even if the person eats a smaller portion.
• Thicken liquids: Thicken drinks with tapioca, matzo meal, cornstarch, or banana or potato flakes to make them easier to swallow and reduce the risk of aspiration.
• See a speech therapist: Speech therapy can help strengthen the tongue, lips, throat, and mouth muscles, improving swallowing function.
• Modify utensils and kitchen equipment: Use flatware with larger, thicker handles, knives with curved blades for one-handed use, plate guards, rubberized pads, and adaptive kitchen tools to facilitate independent eating and cooking.
• Address mental health concerns: Depression is common after a stroke and can contribute to loss of appetite. Seeking treatment for depression, such as antidepressant medication or talk therapy, may help improve appetite.
• Exercise lightly: Light physical activity, such as walking, can help increase appetite and promote a healthy recovery.
• Ensure proper denture fit: Ill-fitting dentures can cause discomfort and make eating difficult. Regular dental check-ups are important to maintain oral health and appetite.
• Create a routine: Set specific times for meals to establish a routine. Eating with loved ones can also make mealtimes more enjoyable and social.
• Choose soft and pureed foods: Opt for soft, easy-to-chew foods such as cooked cereal, mashed potatoes, soup, cottage cheese, and applesauce. Pureeing fruits and vegetables with milk can make them easier to eat and add nutritional value.
• Consider nutritional supplements: If eating enough food is challenging, consider liquid nutritional supplements to ensure adequate energy and nutrient intake.

Speech pathologists can recommend strategies to help stroke patients eat and drink safely

Speech pathologists can play a crucial role in helping stroke patients recover their ability to eat and drink safely. They can provide guidance on exercises to strengthen the tongue, lips, throat, and mouth muscles, which will help with swallowing. In some cases, they may recommend neuromuscular electrical stimulation, which involves sending electrical impulses to the nerves in the throat to strengthen the swallowing muscles.

Additionally, speech pathologists can advise on modifying the consistency of food and drinks. They may suggest sticking to soft foods or blending tougher foods to make them easier to chew and swallow. They can also provide recommendations on thickening liquids to avoid dehydration while reducing the risk of liquids going down the wrong pipe.

Speech pathologists also play a significant role in screening, assessment, and management of communication disorders associated with stroke, such as aphasia, motor speech disorders, and cognitive communication disorders. They can provide strategies and environmental adaptations to enhance communication effectiveness and maximize the patient's participation in the rehabilitation process.

Furthermore, speech pathologists can offer techniques for neuromuscular re-education of the swallowing muscles and cognitive-language exercises to restore or adapt language understanding and communication skills. They work closely with the patient and their caregiving team to develop an individualized treatment plan, focusing on achieving the highest level of communication and language function possible.

Overall, speech pathologists are essential in helping stroke patients regain their ability to eat and drink safely, as well as improving their communication skills and enhancing their overall recovery process.

Stroke patients may experience swallowing problems, also known as dysphagia

Dysphagia affects more than 50% of stroke survivors, and it is important to identify and manage this condition to prevent poor nutrition, pneumonia, dehydration, and disability. While most patients recover swallowing function within a week, about 11-13% still experience dysphagia after six months.

There are various diagnostic modalities available for investigating dysphagia, including video fluoroscopic examination, fibreoptic endoscopic evaluation of swallowing, and pharyngeal manometry. Treatment options include compensatory and rehabilitative approaches, such as modifying food consistency, posture adjustments, and speech therapy to strengthen the tongue, lips, throat, and mouth muscles.

It is crucial to seek professional help and follow recommended precautions to ensure safe swallowing and adequate nutrition during the recovery process.

High-calorie foods can be eaten first if the patient is not very hungry

If a post-stroke patient is not very hungry, it is recommended that they eat high-calorie foods first. This can be an effective way to ensure they are getting the energy and nutrients they need to support their recovery.

High-calorie foods

High-calorie foods that are recommended for stroke patients include:

• Nut butters
• High-calorie smoothies or shakes
• Full-fat dairy products
• Avocados
• Eggs
• Olive oil
• Quinoa
• Greek yogurt
• Lean meats
• Oily fish

Other tips to increase appetite

If a stroke patient is experiencing a loss of appetite, there are several other things they can try:

• Choose foods with strong flavours
• Opt for colourful foods
• Exercise lightly
• Check their dentures
• Seek help for depression

Frequently asked questions