Nutritional management of stroke patients

Stroke has a significant impact on public health in Italy as well as in most industrialized countries due to its high incidence, prevalence and subsequent disability rate. While appropriate diagnostic tools and pharmacological agents have proven effective in the management of this disease, the unequivocal demonstration of the usefulness of nutrition therapy in stroke patients is lacking. Since stroke patients are nutritionally vulnerable, nutrition management is expected to play a major role in the therapy of hospitalized and home care stroke patients. In both cases, stroke patients can experience one or more disabilities, which influence eating habits and dietary intake; in addition, more than half the stroke patients need feeding support when discharged from hospital to home or to other long-term care settings. We review the techniques for assessing the nutritional status of stroke patients and the strategies for managing dysphagia and feeding patients, as well as the different types of feasible nutrition therapy. In addition, clinical and radiological options for the diagnosis of dysphagia are examined. Studies concerning the nutrition treatment of stroke patients demonstrate several methodological problems including no generally accepted malnutrition definition, stroke patient heterogeneity and the availability of a wide range of outcome variables. The data regarding nutritional treatment in stroke patients remains inconclusive; therefore, long-term randomized controlled studies are needed to evaluate better the effects of defined nutritional intervention programs on determining clinically relevant outcomes. © SINPE-GASAPE.