Stroke is one of the major causes of long-term disability in adults. Individuals who have a history of stroke are at a 43% higher risk of recurrence for the next 10 years. Certain risk factors are associated with a history of stroke, including sarcopenia, anemia, and osteoporosis. In addition, poor nutritional status in this population may aggravate impairments related to cognition, motor function, and mood disorders, such as depression. Malnutrition in the post-stroke population may be caused by trouble swallowing or other physiological or structural abnormalities, digestive disorders, or deteriorations in the individual's condition, and this may increase the risk of complications, such as infections, electrolyte disturbances, osteoporosis, and anemia.
Researchers of a clinical trial involving 178 individuals with post-stroke status suggest an association between improvement in nutritional status and activities of daily living. A recently published review highlights certain nutrients to support neural health and a healthy response to oxidative stress and inflammation in individuals with post-stroke status.
For post-stroke individuals with sarcopenia, supplementation with branched-chain amino acids (BCAAs), such as leucine, has been studied for its potential support of muscle mass and function. A controlled trial of individuals with sarcopenia were randomized to a low-intensity resistance training program as part of an 8-week rehabilitation program. The treatment arm received leucine-enriched amino acids. Although both groups exhibited improvements in recovery indices, such as the Functional Independence Measure (FIM), skeletal muscle mass index (SMI), and handgrip strength, the intervention group receiving supplementation showed statistically significant improvements.
Supplementation with vitamin D may also support health in individuals with post-stroke status. One randomized, placebo-controlled, clinical trial explored the potential impact of 50,000 IU of vitamin D weekly for 4 to 12 weeks on markers related to motor function and ambulation. At the end of the study, the treatment group showed greater improvements in scores for functional ambulation classification (FAC) and Brunnstrom recovery staging (BRS).
Another trial assessed rehabilitation outcomes on hemiplegic post-stroke individuals related to high-dose vitamin D supplementation. After 3 months of treatment, BRS, FAC, and other test scales showed improvements for the treatment arm, with some individuals showing statistically significant improvements.
Other research highlighted in the same review article point toward dietary interventions, such as the Mediterranean Diet and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet as potentially neuroprotective. Both have shown improvements in cognitive function and memory in clinical trials. In one trial, the potential effect of the MIND diet for more than 100 individuals were assessed for nearly 6 years. Based on those results, it was suggested that the MIND diet may have slowed global cognitive decline and attenuated semantic memory and perceptual speed declines.
Post-stroke rehabilitation may involve the consideration of nutritional status and nutrient intake. Supplementation with micronutrients targeted to individual needs, such as BCAAs or vitamin D, along with dietary interventions, such as the MIND diet, may provide support for cognitive function, muscle mass, and overall recovery.
By Colleen Ambrose, ND, MA
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