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Healthy Eating Habits and Stroke Each year many people are admitted to hospitals because they had a stroke, sometimes even more than once. Preventing a first stroke is referred to as “primary prevention”. “Secondary prevention” refers to treatment or lifestyle changes that can help to reduce the risk of a recurrent stroke. In secondary prevention, it is important to make healthy lifestyle changes and continue to have medical treatment. Lifestyle changes should include quitting smoking, eating a healthy balance diet, maintaining a healthy weight, exercising regularly and reducing alcohol intake.

A low salt, low fat and low cholesterol diet can help prevent a new or recurrent stroke. People with high blood pressure should limit the amount of salt. Salt is also known as sodium chloride and the daily requirement of sodium is 2000mg per day or one level teaspoon of salt per day. Those with high blood cholesterol or hardening of the arteries should limit foods containing high levels of fat especially saturated fats. Saturated fats include animal fats, coconut milk and full fat dairy products. People with diabetes need to learn how to stabilize their blood glucose levels with a regular balance diet and be physically active. These dietary changes together with the use of medications will help to improve the control of high blood pressure, high blood cholesterol and diabetes.

Weight management is also important. Inactive people can easily become overweight from overeating and having a sedentary lifestyle. Obesity can also make it difficult for someone with a stroke-related disability to move around and exercise. It is therefore important for those who are on the road to recovery or recovered from stroke to keep as active as possible.


Healthy Eating Pyramid Eat Least

Eat 2 – 3 servings per day

Eat 2 servings per day Eat 2 servings per day

Eat 5 –7 servings per day

Eat Most

You can follow a healthy diet according to the Healthy Eating Pyramid. This means enjoying a wide range of foods while practicing moderation. The following tips can help you make sensible food choices:


Enjoy a wide variety of nutritious foods from the 4 food groups.

Breads, cereals, rice,

Vegetables

Fruit

Meat & Alternatives

2 serves daily

2 serves daily

2 –3 serves daily

½ cup cooked vegetables 1 cup salad

1 small apple 1 wedge papaya 1 medium banana 10 grapes

1 palm size meat 1 cup cooked lentils 1 glass of milk

pasta and noodles 5 – 7 serves daily

1 serving = 2 slices bread 1 bowl rice 1 bowl noodles 1 bowl porridge

1 slice cheese

Eat a variety of carbohydrate foods such as whole grain breads, cereals, and grain products such as rice, and noodles.

Choose higher fibre foods such as whole grains, fruit, vegetables and legumes.

Reduce the amount of fat in diet such as choosing low fat dairy products, choosing fish, lean meat and poultry without skin, and having more steamed grilled or broiled food instead of fried or coconut milk-based food.

Tips when eating out In Singapore, many people eat out or buy food home rather than cook. It is important to realize that even when eating out, one can choose healthier choices. You can always ask for no added oil and more vegetables, choose soup-based noodles instead of fried or dried noodles, choose plain rice whenever possible, keep all gravies to a minimum, limit drinking the soup after eating the noodles, and limit adding fried onions or sauces in food.


Tips when eating at home When preparing for a meal at home, the healthier cooking methods includes steaming, grilling, baking, light pan-frying, and preparing curry without coconut milk or substituting with low fat milk. Use unsaturated oils like canola, sunflower, and corn oil when cooking. Limit the amount of oil added and avoid using recycled oil. It is not necessary to add salt or processed sauces to meals as fresh meat and vegetables contain natural sodium in them. The use of natural ingredients like garlic, ginger, lemon juice, onion, pepper, herbs and spices can spice up meals. If a stronger flavour is required, you can increase the amounts of natural ingredients.

Limit buying salted snack foods, processed meats or vegetables and highly salted processed foods. It is best to buy fresh or frozen foods and try to prepare foods "from scratch" instead of relying on packaged convenience foods, which may contain a high amount of salt. Be aware that there is hidden sodium in baking powder, sodium bicarbonate or MSG (monosodium glutamate).

It is also important to note that after a stroke, a person who has recovered or on the road to recovery may have swallowing difficulties and decreased mobility. Some people with stroke may require modified food consistencies such as blended or soft diet and thickened fluids as a result of their swallowing impairment and ill-fitting dentures. Moreover, having a reduced sense of taste or smell can make food unappealing. A person who lives alone may even skip meals because of the effort involved in buying and preparing food, or because of a lack in support. They are at risk of developing undernutrition if they are unable to obtain food and eat adequately from a balanced diet. This can influence their progress with rehabilitation. Therefore, it is important that measures are taken to ensure that adequate nutrition is met to maintain optimal nutritional status after stroke so that undernutrition does not occur. Some suggestions include providing small, frequent meals and snacks, serving food with stronger natural flavours to improve the appetite of those who are not eating enough, and including all foods from the food groups in the Healthy Eating Pyramid.


Stroke is a leading global health problem and is predicted to grow. It is the fourth leading cause of death in Singapore and is a major disability worldwide. Therefore whether it is a primary or secondary prevention, it is important to have a healthy balance lifestyle to minimize the risk of stroke occurring.

Michele Wong, Dietitian, Nutrition and Dietetics Department, Tan Tock Seng Hospital


Eating Wise and Stroke