Stroke Patient Nutrition

By Kelly Greenstreet, RD

fruits-and-vegetables-heart-225Patients recovering from stroke, or any acute illness or condition, have an increased need for adequate nutrition. This includes calories, protein, and vitamins & minerals. It is imperative to maintain weight during recovery. If weight loss is necessary, it should be achieved after recovery, or at least once well on the way to recovery. The body generally does not recover from any illness as well or as fast if not receiving adequate nutrition.

A low fat, low cholesterol, low sodium diet is typically encouraged for all patients. This is the same diet prescribed for patients with heart disease and is usually referred to as a heart healthy diet or TLC (Therapeutic Lifestyle Change) diet. By reducing dietary fat and cholesterol intake to less than 30% of calories per day and sodium intake to less than 2000mg per day, one can hope to reduce blood cholesterol levels and blood pressure, respectively. For those with existing diabetes or pre-diabetes, blood sugar control is also a concern. Poor blood sugar control may also increase risk for heart attack and stroke.

To achieve the TLC diet, the following should be the goal of intake:

  1. Less than 30% of calorie intake from total fat, less than 7% of calories from saturated fat, and no trans fat. Example: for someone requiring 2000 calories per day, they should consume no more than 65 grams of total fat, and of those 65 grams, no more than 15 grams should be saturated fat.
  2. Limit sodium intake to less than 2000 mg per day. Avoid the salt shaker, choose fresh foods over processed foods to limit intake.
  3. Increase intake of complex carbohydrates, i.e. fruits, vegetables, beans/lentils, and whole grains. These food groups should account for the majority of the diet.
  4. Limit simple or refined carbohydrates: these can increase triglycerides and inflammation and may cause spikes in blood sugars for those with Diabetes or pre-diabetes. Examples: sugar, candy, honey, agave, white or refined breads, rice, pasta.
  5. Choose low- or non-fat dairy products or dairy alternatives such as almond milk, rice milk, or soy milk.
  6. Choose lean proteins such as beans/lentils, fish, boneless, skinless chicken breast or turkey, or tofu. Red meat (beef, pork, lamb) should be consumed less than 3 times per week.
  7. Choose low or non-fat cooking methods. Bake, broil, grill, or steam foods with as little excess fats and oils as is necessary. Avoid frying.
  8. Limit alcohol to no more than 1 drink/day for women and 2 drinks/day for men. Alcohol may have a protective effect on cholesterol, but only for the above listed servings. More than that, and the reverse is true.

Ideally, almost everyone (exceptions occur, of course) should eat at least 5 servings of fruits/vegetables each day for the vitamin, mineral, and fiber content and let the other food groups fill in as needed.

When requiring a texture modified diet, such as a pureed diet, there are foods commercially available. Several websites offer canned options for pureed diets, though these foods are far more expensive and not necessarily consistent with a TLC diet, as what can be prepared at home with a little time and know-how.

Thick-It Pureed Canned Products are roughly $6 per can when purchased individually, or approximately $4-6 per can when purchased in bulk. A 15 oz can is supposed to contain 5-8 servings depending on the food item (1/4 to 1/3 cup per serving) and contain stabilizers, preservatives, and sodium. A 1/3 cup serving of Salisbury Steak Pureed contains 9g of total fat, 1g of trans fat, and 310mg of sodium. In comparison, the polenta with chick peas and red pepper recipe contains only 3g of fat per serving, less than 0.5g of saturated fat, and no trans fat. Fresh, unprocessed foods typically have a higher nutrient content (vitamins and minerals) and a lower sodium content due to lack of processing and canning. Fresh is best!

Kelly Greenstreet, RD, has been working in the hospital setting since 2007. She earned her Bachelor’s degree in Dietetics from Olivet Nazarene University in Bourbonnais, IL in 2006 graduating Magna Cum Laude and completed her internship to become a Registered Dietician (RD) at St. Louis University in St. Louis, MO in 2007. She currently performs nutrition counseling and assessments in both inpatient and outpatient settings in Newport Beach, CA and counsels patients on a wide variety of different nutrition topics such as obesity and weight loss, diabetes, cardiovascular disease and stroke and Gastrointestinal conditions. She also teaches community education classes focusing on Heart Healthy Diets, Low Sodium Eating and Healthy Dining Out.


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