Abstract P239: Dietary Behavior Interventions And Outcomes In Stroke Survivors: A Scoping Review

Abstract

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.

Stroke Survivor Adherence to the Mediterranean Diet

“…1 Despite recommendations to follow a healthy dietary pattern, only 22% of stroke survivors report consuming an “ideal” diet with respect to fruits and vegetables, whole grains, and sodium, 5 and mixed results have been reported for interventions seeking to improving dietary intake in community-dwelling stroke survivors. 8 Thus, effective dietary interventions for stroke survivors need to be developed and tested. 9…”