Objective: To identify and summarize studies that have implemented dietary behavior interventions and reported dietary outcomes in community-dwelling adult stroke survivors. Design: Scoping Review; Setting: Not applicable. Participants: Studies eligible for review included peer-reviewed studies describing both a dietary intervention and a dietary outcome among community-dwelling stroke survivors published between January 2000 and June 2022. Results: We identified 14 articles that included both a dietary behavior intervention and a dietary outcome. All studies (5 pilot randomized controlled trials (RCTs), 6 non-pilot RCTs, 3 cohort studies) delivered multimodal health behavior interventions that included a dietary component. Interventions were delivered weekly to every other month and lasted for 1–24 months. Most studies did not use standardized assessments to assess dietary outcomes; however, 8 studies reported improvement in dietary outcomes. Conclusions: This review provides support for the efficacy of dietary behavior interventions in stroke survivors. Variability in intervention format and assessment measures across studies impedes the ability to conduct meta-analyses of outcomes to inform research knowledge and clinical practice. Additional research is needed to determine mechanisms-of-action for dietary behavior change in stroke survivors.

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Purpose: Secondary stroke prevention is an essential but unmet need for stroke survivors. Current secondary stroke prevention guidelines from the American Heart Association recommend following a Mediterranean-type diet to reduce recurrent stroke risk. However, there is a lack of published data on dietary behavior interventions and outcomes among stroke survivors. Therefore, we conducted a scoping review to characterize published dietary behavior interventions and outcomes among community-dwelling stroke survivors to identify gaps in scientific knowledge. Methods: PubMed was used to find research articles published between January 2000 and April 2021. To be included, articles must have undergone peer-review and described both a dietary intervention and dietary outcome among community-dwelling stroke survivors. Study characteristics and dietary outcomes were extracted by 3 team members for studies that met inclusion criteria. Results: 649 articles were initially identified but 637 were excluded based on eligibility criteria. Study characteristics and outcomes of the 12 included studies are described in the table. All studies (9 randomized controlled trials, 3 cohort studies) delivered multimodal health behavior interventions that included a dietary component. Interventions were delivered weekly to every other month, lasted 1-24 months, and provided 1-132 contact hours. Dietary outcomes included food frequency questionnaires and self-reported fruit, vegetable, salt, or fat consumption. Eight studies reported improvement in dietary outcomes; 6 of which reported ≥16 contact hours. Conclusions: This review provides support for the efficacy of dietary behavior interventions in stroke survivors. Intervention format and outcomes varied greatly, which impedes the ability to determine efficacy of dietary interventions in this population and represents a gap in scientific knowledge. Comparative effectiveness studies that compare outcomes across existing interventions may narrow this knowledge gap.