How to cope with eating difficulties after a stroke
If you've had a stroke, or are looking after someone who has, keeping nourished can be a challenge. Senior Dietitian Victoria Taylor gives her advice on eating after a stroke.
A stroke can affect the way you eat in different ways, depending on how it affects your brain.
You might have difficulties with swallowing, which can affect the amount and type of food you can eat, or you may have been affected in other ways making it difficult to go out to buy your own food, to prepare meals or to feed yourself.
For some people, stroke won’t have affected their ability to eat, in which case the focus will be on healthy eating to help prevent it happening again.
However you have been affected, there will be team of health professionals who will work together and with you to help you in your recovery.
1. If you have swallowing problems...
Any problems with your swallowing should be picked up while you were in hospital, but if you think that you might have problems that haven’t been addressed, it’s important to speak to your doctor about this.
A speech and language therapist can advise on the types of foods and textures of food that are best for you to eat. They might recommend a soft or pureed diet, which can be easier to swallow and you might need to add a special powder to drinks to thicken them, too.
Your speech therapist will also monitor your progress. The good news is that for most people swallowing problems are temporary and the issues resolve. Mostly improvements are seen in the first few weeks after a stroke, although for some people it takes a longer period of time.
Tips for eating pureed food
If you can only eat pureed food, this can affect the range and nutritional content of your diet. Usually liquid will need to be added to the food when it’s being blended to get the right consistency, which will dilute the mixture, making it lower in energy for the same weight.
You might also find that you get tired while eating, which can mean that you consume less food, so it’s important to make every mouthful count. Try adding in nutritious liquids rather than just water when you blend your food - like extra tomato sauce, milk or white sauce, depending on the dish. This will give you more nutrients.
2. If you have problems shopping, preparing or feeding yourself...
While you were in hospital, you should have been assessed by a physiotherapist as well as an occupational therapist. They work closely together to help with your movement and to see where you might have difficulties with day to day activities and suggest ways around this. For example, this could be through recommending help that you could have at home to do your weekly shop, or liaising with social services to help you access services like meals on wheels.
They can also recommend adaptations to your home to help you to be more independent, or special crockery, cutlery or mats that can make it easier for you to feed yourself.
If you’ve not been seen by an occupational therapist and think that this might be helpful, you can ask your GP or social services (contact them via your local council) to refer you to the local service for an assessment.
3. If you have lost weight after your stroke...
Some people will find it difficult to meet their nutritional requirements after a stroke for some time, and weight loss is a common problem.
If you were underweight before your stroke, this should have been picked up in hospital. It’s important to address this as being underweight or malnourished can affect how well you do after a stroke.Being underweight can affect your strength and ability to work on rehabilitation goals, as well as putting you at greater risk of infections.
If you’ve seen a dietitian you should also have been given some advice on how to make the most of your meals. If weight loss is a problem, it can be useful to add extras (depending on your texture requirements) like peanut butter, oil, cheese and full-fat dairy products. Small frequent meals are also a good idea if you struggle to eat big meals.
You might also have been prescribed milky supplement drinks or puddings. If that’s the case, then it’s important to take them as recommended.
Healthy eating to prevent future strokes
Preventing a future stroke is the focus after a stroke or a transient ischaemic attack (TIA). Keeping to a healthy weight and eating a heart-healthy diet, such as a Mediterranean-style diet, can help to reduce your risk, as will any medication you’ve been recommended to take. Eating a healthy diet can help to lower blood pressure and cholesterol levels as well as helping to achieve and maintain a healthy weight.
This means eating a diet that includes at least five portions of fruit and vegetables per day, fish (white and oily), pulses and wholegrains. You should limit sweets, cakes, biscuits and processed and fatty meats. It’s important to also switch the saturated fats in your diet for unsaturated fats and to reduce your salt intake by avoiding high-salt foods like processed meats, salty snacks and ready-made soups, as well as not adding salt to foods.
If you drink alcohol, limit your intake to no more than 14 units a week, and if you drink as much as this in a week, spread it out over several days and make sure you have some alcohol-free days in the week too.