Stroke is a major cause of death and disability in the United States and around the world. Data shows that only 25% of patients arrive at the hospital within three hours after symptom onset, and as a result, the delay in getting patients treated for stroke is a major driver of poor outcomes.
Although interventions, such as thrombolytics and mechanical thrombectomy, have improved some outcomes, cognitive challenges after a stroke, such as memory changes and dementia, are prevalent following a stroke and can be extremely disabling for patients. Over 70% of stroke survivors complain of memory changes, and these changes can lead to difficulty in doing basic activities of daily living and maintaining independence.
Additionally, disparities exist in stroke awareness, recognition, appropriate action and acute treatment along racial and ethnic lines, thus the burden of stroke and its related symptoms disproportionately affects minorities.
The role of a patient’s diet on brain health
Once a person has a stroke, their risk of developing dementia doubles. Unfortunately, there is little that medication management can do to improve the cognitive side effects for stroke patients. However, there is good reason to consider the concept of food as medicine to protect against these debilitating side effects from stroke.
The large observational, epidemiological Northern Manhattan Study (NOMAS) and REGARDS study show a link between diet and stroke risk. Several clinical trials, such as the PREDIMED and Lyon Heart studies, show this correlation as well.
The late Martha Clare-Morris, ScD, a nutritional epidemiologist at Rush, invented the MIND diet, in which she combined parts of the Mediterranean and DASH diets to maximize the impact superfoods, such as dark leafy green vegetables, berries and fish, had on brain health in older individuals. Those studies followed older adults who were initially free of dementia and then tracked them over time to see who would develop cognitive impairment and dementia. Her research showed that patients who consumed foods consistent with the MIND diet were seven years younger cognitively than patients who ate a typical Western diet.
A subset of her patients also had experienced strokes and, while that number was small, these individuals appeared to benefit even more from the MIND diet compared with other patients. This study operates on the food-as-medicine paradigm, providing food and nutrition education to individuals as they integrate back into their communities after a stroke.
The NOURISH study
The Nutrition Effects on Brain Outcomes and Recovery in Stroke After Hospitalization (NOURISH) study is a 24- to 36-month-long clinical trial to test the intervention of the MIND diet versus usual post-stroke care on cognitive decline, dementia and vascular disease in patients hospitalized for an acute ischemic stroke who are subsequently discharged home. Specifically, the NOURISH study will evaluate whether this healthy diet can 1) slow the progression of memory loss and thinking abilities that can occur in persons who had a recent stroke; and 2) improve mental health, vascular biomarkers and functional outcomes in post-stroke patients.
How is the study conducted?
The NOURISH study involves older adults ages 55 years and older who 1) have recently been hospitalized for a stroke; 2) reside in the greater Chicago area; and 3) will be or are discharged back to their homes.
Patients will be divided into two groups. The experimental group will get one MIND-diet meal for 90 days, plus specific one-on-one coaching on how to cook and eat a MIND diet. The control group will get a gift card to buy groceries and will receive health education on more general stroke wellness tips.
To enroll your patient, please call (708) 660-6463 or email NOURISH@rush.edu. More information can also be found at rushu.rush.edu/nourish-study.
