The Importance of Good Nutrition with Fibre in Stroke Patient Management
Every hour, six Malaysians suffer a stroke1.
Stroke is a devastating illness that affects a staggering 15 million people globally, and an estimated 40,000 Malaysians each year2. It is the third leading cause of death in Malaysia and the leading cause of disability, often severely impacting the quality of life of the people it touches.
Two thirds will suffer from a disability, such as language, cognitive function, or motor skills impairment3. The type of disability corresponds to area of the brain that has been damaged.
Perhaps, one of the most concerning aspects about a stroke is that it can happen to anyone, anywhere and at anytime and often without warning.
Mark, fit, active, and in his late twenties, was arguably enjoying his prime years when he collapsed whilst jogging at his local park. Luckily for Mark, the first responder was the jogger behind him, a renowned cardiologist who performed CPR and saved his life.
When Mark finally woke from his coma, he was diagnosed having suffered from a massive stroke which had left him with a severe speech impediment and extensive memory loss. No longer able to function independently, Mark faced a long rehabilitation ahead.
As with 80%4 of stroke patients, Mark had suffered from an Ischaemic stroke which occurs as a result of a blockage within a blood vessel which cuts off a vital blood flow to the brain.
Good Nutrition for Stroke Patient Recovery
Diet and nutrition play a crucial role not only in preventing the risk factors that could lead to a stroke, but also in supporting a patient's recovery. Good nutrition provides essential nutrients and assists the body’s recovery from the negative effects of a stroke.
A lack of good nourishment can lead to further health complications and greater incidences of infection, pressure sores, malnutrition, dehydration, urinary and respiratory tract infections5. Such conditions may ultimately result in a longer hospital stay for patients and in some instances, an elevated risk of death.
With malnutrition affecting as many as three in five stroke patients5, dysphagia, a condition where patients are unable to adequately consume food due to difficulty in chewing and swallowing is a major risk for malnourished patients.
The condition creates challenges in ensuring patients are able to maintain a healthy diet and weight range. Stroke patients suffering from dysphagia are 2.4 times more likely to experience malnourishment6. As a result, a dysphagic patient’s total nutritional requirements is substantially reduced.
As a caregiver, it is important to be aware of the adverse effects of dysphagia and provide the necessary support and care to ensure stroke patients eat a nutritious healthy diet and regain any weight loss incurred during the critical rehabilitation period.
Malnutrition is a crucial factor in stroke patient management and can be prevented with the right nutritional intervention
Patients who are unable to swallow, may require parenteral feeding which entails delivery of nutrients into the bloodstream via a drip or enteral feeding commonly referred to as tube feeding, where nutrients are supplied via a nasogastric tube to the patient. These two methods are generally applied in a hospital or institutional setting.
In instances where eating is compromised, a special nutritionally balanced oral formula containing a blend of high quality protein e.g. whey protein and unique fibre blend i.e. combination of soluble and insoluble dietary fibre with prebiotics is often used to provide long-term nourishment to help meet the nutritional needs of stroke patients.
The Role of Fibre in Stroke Patient Management
If you have previously suffered a stroke, the probability of a reccurent stroke is high. Without treatment, medical intervention and lifestyle adjustments, the risk of suffering another stroke can increase by more than 40% within five years of the first stroke7. Recurrent strokes often have a higher rate of death and disability8.
Although a stroke can happen to anyone at any time, certain groups of people are at higher risk - the elderly, people with diabetes, smokers, those with a history of stroke, heart disease and hypertension.
To minimise the risk, eat a balanced diet that is low in fat and salt and increase your intake of fruits and vegetables. Importantly, cut back on foods high in saturated fats as they are associated with high cholesterol and an increased risk of cardiovascular disease.
Increase your Fibre Intake
The health benefits associated with a high dietary fibre intake has long been heralded for its role in reducing the risk factors which lead to a stroke9. Soluble fibre content has the ability to reduce cholesterol and regulate the body’s use of sugar to keep blood sugar levels in check, while insoluble fibre, adds bulk and softness to stools, thus, promoting bowel regularity and good gut health10.
The best sources of dietary fibre are qraw or cooked vegetables such as broccoli, carrots and green leafy vegetables, whole-grain products, and legumes (e.g., dried beans, lentils, split peas).
The National Health and Morbidity Survey (NHMS) 2015 results released by the Ministry of Health Malaysia shows that 94% of Malaysian adults11 fail to consume enough fresh fruits and vegetables. For those who lack an adequate fibre intake, there are fibre supplements, available in many forms, which allow people to increase the amount of fibre in their diet.
It all begins with good nutrition.
1. Krishnamoorthy M. Killer stroke: Six malaysians hit every hour. The Star. Retrieved from http://thestar.com.my/news/story.asp?file=/2007/4/24/nation/17524877&sec=nation.
2. Stroke in Malaysia, National Stroke Association of Malaysia. Retrieved from http://www.nasam.org/english/prevention-what_is_a_stroke.php
3. What is Stroke? National Stroke Association. Retrieved from http://www.stroke.org/understand-stroke/what-stroke
4. Ischemic Stroke, National Institute of Neurological Disorder and Stroke. Retrieved from http://www.ninds.nih.gov/disorders/stroke/detail_stroke.htm
6. Foley et al 2009b
7. Kirshner, H. S. (2009). Differentiating ischemic stroke subtypes: Risk factors and secondary prevention. Journal of the Neurological Sciences, 279(12): 1-8.
8. Secondary Stroke Fact Sheet. Retrieved from
9. Stroke. 2013;44:1360-1368; originally published online March 28, 2013;
Dietary Fiber Intake and Risk of First Stroke A Systematic Review and Meta-Analysis Diane E. Threapleton, MSc; Darren C. Greenwood, PhD; Charlotte E.L. Evans, PhD; Cristine L. Cleghorn, MSc; Camilla Nykjaer, MSc; Charlotte Woodhead, MSc; Janet E. Cade, PhD; Chris P. Gale, MBBS; Victoria J. Burley, PhD . Retrieved from http://stroke.ahajournals.org/content/44/5/1360.full.pdf
11. The National Health and Morbidity Survey 2015. Retrieved from http://www.iku.gov.my/index.php/research-eng/list-of-research-eng/iku-eng/nhms-eng/nhms-2015