Eating Well After a Stroke

How does eating well after a stroke help recovery?

Eating well after a stroke is key to recovery. Choosing healthy foods can help control blood pressure, body weight, reduce a person's risk of having another stroke, and may help with the demands of stroke therapy and other daily activities.

Preventing another stroke and staying healthy can be achieved when you take appropriate steps to control your weight and blood pressure. Making healthy food choices is a major step in the right direction, and a registered dietitian can help you choose the right foods. A dietitian can teach you how to prepare and plan meals and snacks to enhance your health.

This educational tool is provided to get you started on the road to recovery. No two people have the same results; therefore, incorporate these healthy eating strategies with frequent check-ups with your physician and taking your medications as prescribed.

Food groups within MyPlate

  • Grains: Make sure at least half of your choices from this group come from whole grains.
  • Vegetables: Choose often nutrient-rich dark green and orange vegetables and remember to regularly eat dried beans and peas.
  • Fruits: Eat a variety of fresh, frozen or dried fruits each day.
  • Dairy: Choose low-fat or fat-free dairy foods, or a variety of non-dairy calcium-rich foods each day.
  • Protein: Choose low-fat or lean meats, poultry; and remember to vary your choices with more beans, peas, nuts, seeds and fish sources. In terms of fats, make most of your fat sources from fish, nuts and vegetable oils. Limit fat sources from butter, stick margarine, shortening or lard.

For more information on MyPlate, visit the USDA's interactive website at www.myplate.gov.

Ten strategies to reduce your risk of a stroke

(1) Eat a variety of foods each day

Because no single food can provide our bodies with all of the nutrients we need for good health, choose a variety of foods each day. Incorporating a variety of foods as suggested by the MyPlate Food Guide is a great way to get started.

(2) Eat a rainbow of colorful foods at each meal

In order to reap the health-protective nutrients found in fruits and vegetables, its important to choose a variety of colorful foods at each meal. Go for a rainbow approach by choosing an array of fruits, vegetables and legumes – dark reds, oranges, vibrant yellows, deep greens, blues and purples. By choosing a rainbow of color you'll be sure to take in a wide range of nutrients.

(3) Choose 5 or more cups of fruits and vegetables each day

Research shows that the best way to reap the benefits of a healthy diet is to increase your intake of fruits and vegetables. So, in addition to steps 1 and 2, make sure you eat a minimum of 5 servings each day.

One serving of vegetable is equal to:

  • 1 cup raw or leafy vegetable
  • ½ cup cooked vegetables
  • 6 ounces vegetable juice

One serving of fruit is equal to:

  • 1 medium sized (tennis ball size) piece of fruit
  • 1 four-inch banana
  • ½ cup fruit cocktail, in own juice
  • ½ grapefruit
  • 1 cup diced melon or berries
  • 2 Tbsp dried fruit
  • 4 ounces 100% fruit juice

(4) Read food labels

Reading food labels is a great way to learn more about the foods you are eating. By law, most foods must have nutritional information listed in a standard way. When selecting foods for reducing your risk of stroke, focus on the following information on the food label for each serving:

Once you get used to reading food labels, you'll become a healthier shopper.

(5) Limit your intake of saturated and trans fat and cholesterol

Cholesterol is a fatty, waxy substance made by your body and found in foods of animal origin. Your body needs cholesterol to maintain the health of your body's cells.

However, too much cholesterol in your blood can increase your risk of stroke and heart disease. High levels of blood cholesterol are the result of two factors: how much cholesterol your body makes, how much fat and cholesterol is in the food you eat, and the kind of fat you eat.

Diets high in saturated fats are linked to high cholesterol and an increased risk of cardiovascular disease. Saturated fats tend to be solid at room temperature and are found in animal products like meat, cheese, egg yolks, butter, and ice cream, and some vegetable oils (palm, palm kernel and coconut). Limiting the amount of saturated fat you eat from these foods is key to stroke prevention.

To cut the saturated fat in your diet, make the following substitutions:

Saturated Fat Substitutions

  • Instead of Butter
    • Choose Light or diet margarine
  • Instead of Regular cheese
    • Choose Low-fat or nonfat cheese
  • Instead of Creamer or half & half
    • Choose Nonfat creamer or nonfat half & half
  • Instead of Whole or 2% milk
    • Choose 1% or nonfat (skim) milk
  • Instead of Cream cheese
    • Choose Reduced fat or nonfat cream cheese
  • Instead of Regular ice cream
    • Choose Nonfat or low-fat frozen yogurt or sorbet
  • Instead of 2-4% milk fat cottage cheese
    • Choose 1% or nonfat cottage cheese
  • Instead of Alfredo or other cream sauces
    • Choose Marinara, primavera or olive-oil based sauce
  • Instead of Mayonnaise
    • Choose Light or nonfat mayonnaise
  • Instead of Prime grades of beef
    • Choose Choice or Select grades of beef
  • Instead of Spareribs
    • Choose Tenderloin
  • Instead of Chicken with skin on
    • Choose Chicken without skin
  • Instead of Whole egg
    • Choose Egg whites or egg substitutes

Diets high in trans fats are also associated with high cholesterol and increased risk of cardiovascular disease. Trans fats are formed when an unsaturated vegetable oil is turned into a more saturated one through a process called hydrogenation. Food products that contain partially hydrogenated vegetable oils should be avoided.

Trans fats are found in:

  • Anything made with partially hydrogenated fats (e.g., many processed foods including cookies, crackers, fried snacks and baked goods, and canned frostings)
  • Stick margarine
  • Vegetable shortening
  • Most fried foods

Choose the following substitutions to limit the trans fat in your diet. Look for foods that are labeled trans fat free or those that use liquid vegetable oils instead of hydrogenated ones in their ingredients.

Trans-fat Substitutions

  • Instead of Stick margarine, Choose Trans-free margarine or liquid margarine
  • Instead of Deep fried foods, Choose Baked, grilled or broiled foods
  • Instead of Crackers made with hydrogenated oil, Choose Baked crackers or crackers made with vegetable oil
  • Instead of Granola bars made with partially hydrogenated oil, Choose Granola bars containing canola or other liquid oil
  • Instead of Energy bars dipped in frosting or chocolate, Choose Plain, non-coated energy bars
  • Instead of Powdered creamers containing hydrogenated oils, Choose Nonfat half & half, skim milk

Limiting cholesterol in foods is another important step to cholesterol control and stroke management, and can be achieved by:

  • Trimming visible fat from meats and the skin of poultry
  • Cutting back on how frequently you eat meats, poultry and other animal-derived foods
  • Limiting your portion size of meat to no more than 3 ounces at a sitting (size of a deck of cards)
  • Limiting butter
  • Eliminating lard
  • Choosing nonfat or low-fat dairy foods

(6) Trim the sodium in your diet

Most Americans eat much more sodium than they need. Eating too much sodium may cause you to retain fluids and increase your blood pressure. Not adding salt to foods at the table is one way to cut down on your sodium, but it isn't enough.

Cut down on sodium by following these tips:

  • Substitute herbs and spices for table salt. Table salt is one of the largest sources of sodium in our diet. Instead of using salt, try using herbs and spices. Avoid mixed seasonings and spice blends that include salt or garlic salt.
  • Use fewer processed and canned foods. In addition to adding flavor, sodium is also used to preserve foods. In fact, the more the food is processed, the higher its sodium content. To cut your sodium intake, limit convenience foods such as canned and instant soups or vegetables, canned meats, frozen entrees, frozen side dishes with sauce packets, instant cereal and puddings, gravy and sauce mixes, and quick cooking boxed mixes for rice, pasta and potatoes. Low-sodium canned soups may be used.
  • Think fresh. Use fresh ingredients when possible and foods with no salt added.
  • Select frozen entrees that contain 600 milligrams or less of sodium. Limit to one of these per day. Check the package label for sodium content.
  • Choose snack foods wisely. Most snack foods like potato chips, peanuts, pretzels and crackers are high in sodium. Choose low or reduced sodium versions of snack foods or eat more natural snacks like plain popcorn, vegetables or fruit.
  • Read medication labels. Although not a significant source of sodium in your diet, read cold, headache, and stomach medication labels. Many contain sodium in the ingredients.

Understanding the sodium content in foods

  • Low-sodium: the food contains 140 mg or less sodium per serving.
  • Very low sodium: The food contains 35 mg or less of sodium per serving.
  • Reduced sodium: The food has 25% less sodium than the comparable food product.
  • Light or Lite in sodium: The food has at least 50% less sodium than the comparable food product.
  • No salt added: No salt was added in the processing of the food product. However, naturally-occurring sodium may be present in the ingredients.

How much sodium should you consume each day?

Most health professionals limit persons with high blood pressure or a history of heart disease or stroke to 1,500 milligrams each day. Talk with your doctor to determine what your sodium level should be.

(7) Choose foods high in fiber

As part of a heart-healthy diet, fiber can reduce cholesterol and your overall risk for cardiovascular disease. Dietary fiber is the part of plants the body cannot digest. As it passes through your body it affects the way your body digests foods and absorbs nutrients. How much fiber you eat affects not only your cholesterol level and risk for stroke, but may have other health benefits: helps control blood sugar, promotes regularity, prevents gastrointestinal disease and helps in weight management.

Most of us fall short of the recommended daily fiber guidelines

  • 38 grams for men 50 and under
  • 25 grams for women 50 and under
  • 30 grams for men over 50
  • 21 grams for women over 50

How to get more fiber in your diet

  • Start the day off right with whole grain cereal or whole grain toast (if your cholesterol is high, choose oatmeal or oat bran cereal or toast).
  • Instead of fruit juice, have a whole piece of fruit.
  • For a fiber-packed lunch toss ½ cup garbanzo beans into a dark leafy green salad.
  • Choose whole grain buns, bagels, English muffins, crackers and bread instead of enriched or white varieties.
  • Purchase whole-wheat pasta and brown rice instead of enriched or white varieties.
  • Top yogurt or cottage cheese with fresh fruit or nuts.
  • Give zest to broth soup by adding veggies, dried beans or barley.
  • Substitute brown rice for white.
  • Grab fruit, veggies, a granola bar or trail mix for a change-of-pace healthy snack.

The best sources of dietary fiber are raw or cooked fruits and vegetables, whole-grain products, and legumes (e.g., dried beans, lentils, split peas). Refined foods like soda, fruit juice, white bread and pasta and enriched cereals are low in dietary fiber. The refining process strips the outer coat (called the bran) from the grain, lowering the fiber content.

Substituting enriched, white pasta and rice and other refined foods with whole-grain varieties is a great way to boost dietary fiber intake and help to prevent blood sugar fluctuations throughout the day. This, in turn, helps keep you feeling satisfied and can help prevent sudden cravings for sweets or other quick-sugar foods later in the day. The end result: weight control.

(8) Maintain or achieve a healthy body weight

Another important strategy to reducing your risk of a stroke is to achieve a healthy body weight. Watching your portion sizes, eating foods high in fiber and low in fat, avoiding fad diets, increasing your activity, and keeping track of your eating habits are all ways to achieve a healthy body weight. Keep in mind that weight loss does not happen overnight, so establish realistic short and long-term goals from the start.

(9) Reduce intake of added sugar

Excess intake of added sugar is associated with hypertension, obesity, type 2 diabetes, and dyslipidemia, which are all risk factors for stroke. Examples of added sugar are white sugar, brown sugar, honey, molasses, jelly, jam, and sweetened drinks. MyPlate suggests lowering your intake of added sugar by using products less often or by decreasing the amount you use.

(10) Get enough potassium

Adequate dietary potassium intake is necessary in order to maintain proper heart function. However, most adults do not consume enough potassium. Potassium is abundant in fruit, vegetables, and milk products. Therefore, if you consume recommended amounts of these food groups, you should achieve an adequate intake of potassium. Good fruit choices include bananas, apricots, oranges, cantaloupe, and apples. High-potassium vegetables include potatoes, sweet potatoes, spinach, zucchini, and tomatoes.

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