Food intake in stroke survivors is complicated by bodily functions that are affected by paralysis due to the stroke. Loss of function of any part of the body can make eating, chewing, and swallowing of food difficult or even impossible.
If a person has lost the use of his dominant hand or arm this will prevent self-feeding until the patient has learned how to use his other hand. With physiotherapy and patience such patients can learn to use their still mobile limb to compensate for the loss of their dominant hand and/or arm.
If the stroke has affected the patient’s sight (a condition such as hemianopsia where one half of the field of vision is obliterated), then she must be taught to turn her head to compensate for this disability. For example, the patient may only eat half of the food on a plate because she is only able to recognize half of the contents of the plate as actual food.
The loss of the ability to chew and/or swallow is much more difficult to treat. Stroke survivors who are no longer able to chew food need to be given a soft or semi-liquid diet so that they do not exhaust themselves trying to chew foods such as meat, bread, tough vegetables, whole fruits, etc.
Probably the most challenging aftereffect of a stroke in relation to food intake is dysphagia. When a patient can also not swallow (dysphagia), food intake is severely impaired and use must be made of enteral feeding (via a tube) or parenteral feeding (delivery of nutrients into the bloodstream). Symptoms include:
- Drooling, choking and coughing during or after meals
- Inability to suck liquids through a straw
- A change in voice quality (the voice may become gurgly)
- Storing food in the cheeks (patients may not even be aware of this phenomenon)
- Lack of a gag reflex which can lead to choking
- Chronic upper respiratory infections
Because of all these complications, patients may develop malnutrition and anorexia which can endanger their health even further.
What you can do to help
The first and most important contribution that can be made by family members and friends of a stroke patient are to be observant of how they are coping with the eating process. Staff members in most of our hospitals are overworked to such a degree that they do not have the time to sit and observe each patient to try and determine if they are able to eat solids or semi-solids or if they require liquid diets.
So watch what is happening when your loved ones start eating again after a stroke. Make notes if necessary and arrange a meeting with the medical team which should, but may often not, include a neurologist and/or physician, nurses, a dietitian and ward assistants who usually assist with feeding impaired patients, so that you can transmit your observations to the team and ask them to arrange for an assessment of the degree of dysphagia the patient is suffering from.
Once this has been determined it is possible to select an appropriate diet for the stroke patient with dysphagia to ensure that he or she can obtain the best possible nutrition care despite problems with eating.
Next week we will consider the different types of diet and feeding methods that should be used depending on the degree of dysphagia your loved one is suffering from.
Healthy eating after stroke
Fruit and vegetables contain antioxidants, which can help reduce damage to blood vessels. They also contain potassium which can help control blood pressure.
The fiber in fruit vegetables can lower cholesterol. Folate – which is found in green leafy vegetables – may reduce the risk of stroke. Whole grains and cereals also contain fiber and folate.
Dairy foods are another source of potassium, along with calcium, which can also help control blood pressure. Alternatives to dairy include calcium-enriched soy or rice milks. Other sources of calcium include fish with bones, almonds and tofu.
Things to limit after stroke are:
Salt. Too much salt can raise your blood pressure. Read labels and choose lower salt options. Don’t add salt when cooking or at the table. Use herbs and spices to increase flavour instead. If you reduce your intake gradually, your taste buds will adjust in a few weeks.
Sugar. Too much sugar can damage blood vessels. Read labels and choose lower sugar options. Even foods you may not think of as sugary can have added sugar.
Saturated fats. These cause high cholesterol. Eat mostly polyunsaturated and monounsaturated oils and spreads. Try nut butters or avocado.
Alcohol. Drinking too much alcohol contributes to a number of stroke risk factors, including high blood pressure. Healthy men and women should have no more than two standard drinks a day. After a stroke, your doctor can advise when it is safe for you to start drinking alcohol again and how much it is safe for you to drink.
The contents of this and other individual articles are based upon the opinions of the author, unless otherwise noted. The information is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of health professionals we follow and their respective communities. We encourage you to make your own health care decisions based upon your research and in partnership with a qualified health care professional.