Nutrition After Stroke

Kristen M. Kinney, MA, RD, CNSC Swedish Medical Center Englewood, CO Subject Expert Kristen M. Kinney, MA, RD, CNSC Swedish Medical Center Englewood, CO

Objectives Common diet modifications after a stroke Nutritional information and guidelines Meat substitutes Loss of appetite Tips for dining out

Importance of Medical Nutritional Therapy Making healthy food choices decreases the risk of having a future stroke by reducing high blood pressure, high cholesterol and excess weight Appetite changes may have occurred Making nutrient-dense food choices is important Swallowing may have become a challenge so meeting nutritional needs may be an issue 4

Common Diet Modifications Controlling carbohydrates Lowering saturated fat and trans fat Reducing salt intake Modifying food consistency due to change in swallowing function 5

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Whole Grains: 1-2 Small Servings Per Meal Add nutrients and fiber that fill you up, for example: Small white or sweet potato skin Whole grain bread or brown rice Whole grain cereal Whole grain pasta or wild rice

Fruits and Vegetables: 5 Servings Per Day Provide nutrients, antioxidants and disease-fighting properties Ways to include them: Hot or cold cereal, smoothies, yogurt Homemade soups, salads and a variety of non-starchy vegetables Fresh, frozen or canned without salt

Protein: 2, 4-oz Servings Per Day Fatty fish such as salmon or tuna-2 times a week Broiled, baked or pan fried in a small amount of oil Eggs or egg substitutes 2-3 times a week In omelets, French toast or scrambled Lean beef, chicken and pork are healthy choices May need to be ground or chopped Can be served with gravy

Meat Substitutes If you choose not to eat meat or have lost your appetite for meat, then try: Cottage cheese or other low-fat cheese such as string cheese Peanut butter or nut butter Baked or cooked dried beans Meat substitutes: veggie burgers or soy crumbles used in place of ground meat

Dairy and Soy: 2-3, 8-oz Servings Per Day Low fat milk and yogurt provide calcium, protein and Vitamin D Soy milk is an excellent substitute if you cannot tolerate or don’t drink cow’s milk Check that soy or nut milks are fortified with calcium

Limit Salt to 1,500mg Per Day Eat fresh vegetables in season Use herbs, garlic or Mrs. Dash for flavoring Limit single items over 500 mg of sodium Aim for meals less than 800 mg of total sodium Use a salt substitute if your potassium level is normal Choose “no added salt” canned vegetables

Loss of Appetite Consider moving dinner time to earlier in the day, when you have more energy Choose colorful, nutrient dense foods, cut into small pieces to make them easier to chew Reduce distractions at meal times Ask your doctor if a glass of wine before your main meal is ok; it may help your appetite Eat 5-6 small meals throughout the day

Tips for Dining Out Request that no salt or seasoning salt be add to your food Ask for extra lemon wedges, a dash of Worcestershire or hot sauce Bring your own salt substitute

Additional Tips for Dining Out Avoid commercial soups, soy sauce and batter-fried items which will limit fat and salt intake Split an order with someone Ask for a take-home container before the meal arrives Before you begin eating, put half of your meal in the container and eat it at home as another meal

Eat More… Colorful fruits and vegetables Omega 3 fatty acids in fish, nuts and seeds Whole grains and legumes Lean fresh meats or meat substitutes

Eat Less…. Marbled meats and sausage products Deep fat fried foods Salty snacks Sugar-containing beverages and foods Limit these items to 100 calories per day for women and 150 calories per day for men.

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