Rehab Insights

Hope through Rehabilitation & Research

Food for Thought: What to Eat to Help Lower Your Risk of Stroke

Posted on Tuesday, May 6th, 2014

17443_wpm_lowresHere’s some good news: Advancements in modern medicine have succeeded in dramatically lowering mortality after stroke. In fact, stroke has recently been surpassed by lung disease and is now the fourth common cause of death, after heart disease, cancer and lung disease.

But this increased survival rate means that more patients are now living with the disability from their stroke. Currently, stroke is the number one cause of disability in the US, with an estimated 700,000 people living with disability after stroke. And unfortunately, once a stroke has occurred, modern medicine has no “magic cure” to help with the resulting disability.

This reality makes stroke prevention even more important than ever.

There are a few risk factors of stroke that are non-modifiable and beyond our control: Age, gender, race and our genetic background are facts of life that we cannot change. There are, however, modifiable risk factors. These include high blood pressure, high cholesterol, smoking, being overweight, lack of exercise and diabetes. These important risk factors can very much be modified by our lifestyle choices. For example, dietary changes—like eating healthier—can help reduce high blood pressure and cholesterol.

General guidelines for healthy eating include:

  1. Consume a diet high in whole grains. The whole grain variety of rice, bread and pasta is beneficial because the body takes longer to digest the fiber content, thus leading to a slower release of carbohydrates into the body. The carbohydrate content in white rice, bread and pasta is easily digestible, leading to rapid absorption of these carbs into the body and a spike in blood sugar levels. Our body reacts with an increase in insulin levels trying to bring the blood sugar levels back to normal, and often leading to a subsequent drop in blood sugar, which causes us to feel hungry again. This can lead to a cycle of eatingàspike in blood sugarà spike in insulinà drop in blood sugar and second hunger attack—a cycle that often results in obesity. Consuming whole grains, on the other hand, causes a slow and steady release of carbohydrates into our blood stream, avoiding the ups and downs of insulin levels and a more steady feeling of satiety.
  1. Your mother was right: eat your fruits and veggies. Eating 5 servings per day can cut your risk of stroke by one third. Certain vegetables seem particularly beneficial in stroke prevention, including broccoli and cauliflower, citrus fruit, and green leafy vegetables (Note: if you are taking Coumadin, discuss any intake of green leafy veggies with your doctor, as these tend to contain Vitamin K which can interfere with the function of Coumadin). The consumption of cruciferous vegetables (for example: broccoli and cauliflower) seems to be of particular benefit.
  1. Choose whole foods and avoid processed foods. By preparing your own food, you can control the amount of salt and sugar added to your diet. High intake of dietary salt has been linked to significant elevated risk of heart disease and stroke, possibly through its direct effect on raising blood pressure. The DASH diet (Dietary Approaches to Stop Hypertension) consists of fruits, vegetables, and low-fat dairy products, grains, poultry, fish, and nuts and limits salt, saturated fat/red meat and sweets, as well as sugar-containing beverages. This diet been shown to significantly lower high blood pressure as well as decrease the risk of heart disease and stroke. Recipes in accordance with this diet can be found here.
  1. Limit your intake of saturated fat. Saturated fat can be found in fatty cuts of meat, high fat cheeses, butter and whole milk/cream. Not all fat, however, is bad for you. Supplementing your diet with extra virgin olive oil (EVOO) and tree nuts (walnuts, almonds, hazelnuts) can lead to a significant reduction of stroke risk. This benefit has been shown in subjects following the so-called Mediterranean diet. Both the DASH diet and the Mediterranean diet are considered to be very healthy; while the DASH diet gives strict standards as to how many servings of each component (grains, fruits, vegetables) should be included, the Mediterranean diet emphasizes the consumption of fruits, vegetables, olive oil, and other healthy foods, without giving specific recommendations. More information can be found here.
  1. Spice it up. Curcumin, a component of the spice turmeric, has been shown to have potent neuroprotective effects, and its use has been studied in a variety of conditions such as arthritis, cancer, Alzheimer’s disease and autoimmune processes. While I would not go so far as to recommend taking this spice in pill form as a supplement, adding it in liberal amounts to your diet may be a delicious way to reap its benefit.

Choosing healthier foods doesn’t mean you have to spend more at the grocery store, either. Here are a few tips for healthy eating on a budget:

  • - Consider buying frozen vegetables over fresh. Veggies you find in the freezer aisle have been flash-frozen and thus retain many of their vitamins. The amount of vitamins in produce diminishes the longer the items travel and are stored, which means that going for frozen may well give you more vitamin bang for your buck.
  • - Include beans and whole grains in your diet, which you can often buy in bulk
  • - Avoid pre-cut vegetables and fruit as they are often sold at a higher price
  • - Some planning can go a long way: plan the meals of the week ahead of time and go to the store with a list in hand—this  can help prevent spur of the moment buys
  • - Take advantage of the internet: the USDA, for example, offers a recipe library that is easily searchable and can be customized according to budget considerations. You can find it here.

Bon appétit!


Share

Stroke Recovery: What to Expect

Posted on Tuesday, October 1st, 2013

Stroke Recovery: What to Expect

With so much left unknown about how the brain repairs itself after a stroke, it is hard to predict exactly how much a patient will recover. However, with the help of medical rehabilitation, post-stroke patients can achieve the best possible long-term outcome.

More than 700,000 people in the U.S. experience a stroke each year and 10 percent of them recover almost completely, 25 percent recover with minor impairments, 40 percent experience moderate to severe impairments and 10 percent require care at a long-term care facility. For all of these survivors, rehabilitation can substantially help them relearn skills such as talking, eating, dressing and walking, that were lost due to brain damage. Though therapy cannot reverse the effects of stroke in that it cannot undo the injury to the brain, it can help patients regain as much independence as possible.

Working towards Recovery

Rehabilitation therapy can begin as early as a day or two after the stroke, once the patient’s condition has been stabilized. At an acute rehabilitation hospital like Burke, post-stroke patients will have a team of clinicians, from physicians, nurses, speech therapists, physical and occupational therapists to a variety of other rehabilitation specialists like neuropsychologists, who will design and implement the patient’s therapy plan.

Along with medical management, patients will receive at least three hours of therapy daily that comprise:

  • - Physical therapy – to help improve muscle strength and coordination, decrease muscle tension (spasticity) and regain range of motion. Physical therapy can help with paralysis, which is one of the most common disabilities resulting from stroke, and ataxia, which is when the body has trouble controlling movement. The latter can lead to problems with body posture, walking and balance.
  • - Occupational therapy – to help patients re-learn how to do familiar tasks like eating and dressing, to help them regain as much independence as possible. Occupational therapy also helps patients learn to use adaptive equipment like walking aids in daily living.
  • - Speech therapy – to help patients regain abilities like swallowing, speaking, listening, writing and comprehension. At least 25 percent of stroke survivors experience language impairments such as aphasia (inability to convey thoughts) and dysphagia (problems swallowing).

IMG_0735Stroke patients may also meet with a neuropsychologist who can help them with cognitive impairments including personality changes, depression, anosognia (inability to recognize physical impairments), neglect (inability to respond to stimuli) and apraxia (inability to carry our learner purposeful movement), brought on by stroke. Burke also offers robot-assisted therapy to assist patients perform repetitive motions with their impaired limbs, helping them rebuild strength and function.

There are many facets that come in to play during recovery and each person will have varying results. It’s hard to predict how many abilities may be recovered and how soon, but in general, success depends on the severity of the stroke, motivation, skill of the rehab team, a good support network, timing of rehabilitation (the sooner started, the better), and continuing rehab activities outside of therapy.

The recovery process can be long and at times, a frustrating experience. These difficulties are common and normal, but if patients are dedicated to working toward improvement they can increase their chances for success.

—Carolin Dohle, M.D.
Associate Director
Stroke Rehabilitation
Program

Share

Written by

Carolin Dohle, M.D.

More Articles  /  View Bio

 

Ask us a question

 

Subscribe to Burke's Newsletter

Keep up with the latest news about Burke by signing up for our newsletter. 

Latest Tweet

Donate

PLEASE NOTE: Burke's Rehab Insights blog is intended to provide general information about rehabilitation topics. It should not take the place of medical care. Burke physicians cannot answer questions about individual medical cases.