Stroke

Why is nutrition important for individuals after a stroke?

Nutrition is very important for those after a stroke in order to improve their outcomes and also to help prevent a further stroke in the future. Malnutrition can occur when a person cannot get all the nutrients they need from what they eat and/or drink. This can lead to complications such as dehydration, weight loss, reduced stamina, and poor physical and psychological recovery. Individuals who are malnourished with a stroke show higher rates of pressure ulcers and urinary tract and respiratory infections, and have longer hospital stays. Strokes can cause loss of muscle and fat mass which may lead to reduced rehabilitation potential and a poorer outcome for those that are malnourished.

What symptoms are associated with strokes that can cause reduced dietary intake?

Multiple factors may cause reduced dietary intake after a stroke including physical, social, and psychological issues. A lot of people who have had a stroke experience dysphagia (difficulty with swallowing) which can lead to reduced dietary intake. Many people experience problems using an arm or hand, making it difficult to eat and drink, and can affect the amount and type of food can be eaten. Individuals may also experience communication or cognition problems (memory, attention, perception) or the absence of teeth/dentures may lead to patients not being able to eat enough. Quality of life may also have been affected, for example, it may be difficult to go out to buy food, prepare meals, or to feed themselves. Fatigue/anxiety and depression can also affect the appetite.

How to help prevent and/or manage malnutrition following a stroke?

An early and accurate assessment of nutritional status by a registered dietitian, who will give individually tailored nutritional management plan is key. It is very important as part of the stroke therapy to prevent or manage malnutrition. The dietitian will consider the person’s current oral intake versus individually calculated nutritional requirements, and may then offer advise on how to boost their dietary intake if required. This may include high calorie/protein snacks/drinks, food fortification, oral nutritional support supplements (including pre thickened drinks) or enteral feeding if it's not possible for the individual to meet their nutritional requirements via oral diet alone. A plan is produced as agreed with the patient, with a person's taste preference in mind to ensure that they are meeting their requirements.
 

Ways to use Pro-Cal™ powder and/or Pro-Cal shot™ to increase nutritional intake?

• Make fluids more nourishing by adding Pro-Cal powder to them e.g. soup/ smoothies/milkshakes.
• Add Pro-Cal shot to desserts, pancakes, yoghurts, puddings, ice-cream, fruit, smoothies, or porridge.
• Drink Pro-Cal shot as prescribed in small volumes
• Add Pro-Cal powder to a pint of milk and use throughout the day e.g. in tea/coffee, making soup, sauces or desserts.

Top Tips to aid dietary intake in stroke patients:

• Choose high protein foods at least twice daily (meat, chicken, fish, eggs, cheese, beans lentils).
• If a smaller meal is eaten it is important to take snacks between meals and at supper time.
• Have some easy to prepare /store cupboard foods available for when you do not feel up to cooking.
• Take oral nutritional supplements (when prescribed) between meals so that they do not fill you up.
• Ensure you get enough fluid (thickened to correct consistency) to remain hydrated and to prevent constipation.

This piece was written in conjunction with a specialist stroke dietitian from Ireland.

Pro-Cal shot and Pro-Cal powder are Foods for Special Medical Purposes and must be used under strict medical supervision. Suitable from 3 years of age onwards. Pro-Cal shot contains Milk (Milk Protein, Lactose) and Soya (Soya Lecithin). Pro-Cal powder contains Milk (Milk protein, lactose)