Dietary patterns in stroke patients in Northwest India Arshi Mangat 1 , Dilpreet Grewal 1 , Paramdeep Kaur 2 , Rashmi Jyotsna 2 , Ruma Singh 1 , Jeyaraj Durai Pandian 2 1 Department of Dietetics, Christian Medical College, Ludhiana, Punjab, India, 2 Stroke Unit, Department of Neurology, Christian Medical College, Ludhiana, Punjab, India Objectives: Little is known about the dietary patterns among stroke patients in India. We explored the dietary patterns in stroke patients and attempted to correlate the dietary patterns with stroke characteristics. Methods: This hospital-based study was carried out in a tertiary referral centre in Northwest India from March 2008 to September 2009. All first ever stroke (ischaemic and hemorrhagic) patients were interviewed by the dietician using an oral diet questionnaire. The demographic information and risk factors were noted and outcome was assessed after 30 days using modified Rankin scale (≤2 = good outcome). Results: A total of 210 stroke patients were enrolled. The mean age was 60 ± 14 years and 126 (60%) patients were men. Hypertension (167 (79.5%)) was the major risk factor. All patients consumed cereals and beverages. Consumption of other food items in the diet were as follows: milk and milk products (203 (96.7%)), saturated fats (butter, butter oil, cream) (133 (63.3%)), bakery items (139 (66.2%)), fried snacks (116 (55.2%)), fruits (96 (45.7%)), and juices (20 (9.5%)). Large proportion of the patients (112 (53.6%)) consumed more food calories than recommended. Use of fried snacks was significant in patients who consumed alcohol (P = 0.03) and patients who had diabetes mellitus were more likely to use saturated fats (P = 0.01). Discussion: Majority of the patients consumed milk and milk products. Fruits and juices were consumed by a small proportion of patients. Our results provide opportunities for stroke prevention by diet modification. Keywords: Developing countries, Dietary patterns, India, Stroke Introduction Stroke is the second leading cause of death and a major cause of disability worldwide. Two-thirds of stroke deaths worldwide occur in the developing countries. 1,2 According to recent reports from India, the incidence and 30-day case fatality rates are higher as compared to developed countries. 3,4 Over the past four decades, there has been a 42% decrease in stroke incidence in high-income countries and a greater than 100% increase in stroke incidence in low to middle income countries. 5 Diet plays an important role in the prevention of stroke. Salt restriction and diet low in saturated and high in polyunsaturated fats are essential in the primary and secondary prevention of stroke. 6 Apart from primary prevention, diet also plays a significant role in maintaining the nutritional status of the patients suffering from stroke. Protein energy malnu- trition and premorbid undernutrition predicts poor outcome, including death. 7–9 Recent literature states that many dietary risk factors interplay in the disease evolution very early in life and prevention measures must be started at a younger age. 10 Little is known about the dietary patterns among stroke patients in India. In Punjab state, dairy farming is a common household practice; as a result, there is an easy flow of saturated fats like butter, milk, ghee (clarified butter), cream etc. The cultural diversity in India is also reflected in traditional food habits. Hence, we carried out this study to map out the various dietary patterns in stroke patients and its relationship to stroke characteristics. Materials and methods This was a hospital-based study conducted in a tertiary referral centre in Northwest India from March 2008 to 30 September 2009. Stroke patients (ischaemic and hemorrhagic) who were admitted during the study period were approached and those who gave written informed consent were included in the study. When the patients were unable to communicate due to altered sensorium or language impairment, the next Correspondence to: Dr Jeyaraj D Pandian MD DM FRACP, Professorand Head of Neurology, Head of Research, Betty Cowan Research and Innovation Centre, Christian Medical College, Ludhiana, Punjab, 141008, India. Email: jeyarajpandian@hotmail.com © W. S. Maney & Son Ltd 2013 DOI 10.1179/1476830513Y.0000000058 Nutritional Neuroscience 2013 VOL. 16 NO. 6 288