Dietary Fiber May Predict Stroke Severity and Outcome

Caroline Cassels

February 29, 2008

February 29, 2008 (New Orleans, Louisiana) — Higher dietary-fiber intake may result in less severe stroke and improve stroke outcomes, new research suggests.

Presented here at the American Stroke Association International Stroke Conference 2008, a preliminary, observational study found total dietary-fiber and insoluble-fiber intake was inversely correlated with baseline National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) at 3 months.

"There has been a lot of research on dietary-fiber intake and stroke risk, but to our knowledge this is the first study to look at the impact of dietary fiber on stroke severity and functional outcomes," first author Angela Besanger, from Massachusetts General Hospital, in Boston, told Medscape Neurology & Neurosurgery.

According to Ms. Besanger, higher fiber intake has been previously correlated with lower levels of C-reactive protein (CRP), a marker of inflammation, in healthy populations.

"Given this information, we wanted to see if this held true in acute stroke patients, so our hypothesis was that dietary fiber might have an impact on stroke outcomes, possibly through this anti-inflammatory effect," she added.

The study included 50 incident acute stroke subjects who underwent baseline measurements of stroke severity using the NIHSS and CRP levels within 9 hours of symptom onset.

In addition, patients' dietary fiber intake was assessed using a 24-hour food recall survey and served as a general indication of patients' daily dietary fiber intake.

Patients' medical histories, medication use, and lifestyle variables were also assessed at the time of admission. At 3-month follow-up, data on patients' interim medical history, lifestyle information, and modified Rankin Scale (mRS) scores were reassessed.

Fiber Recommendations Not Met

According to Ms. Besanger, higher total-fiber and insoluble-fiber intake were correlated with less severe stroke and better 3-month functional outcomes. However, soluble fiber was not.

The investigators were surprised to find that fiber intake appeared to have no impact on CRP levels, a finding that suggests there is some other mechanism at play.

The average daily fiber intake among study subjects was approximately 10 g per day, an amount that falls well short of the recommended 20 to 35 g per day.

These results, she said, support American Heart Association guidelines for 14 grams of fiber per 1000 calories consumed (20 to 35 g of fiber per day) to maintain heart and digestive health.

The association between total- and insoluble-fiber intake and stroke severity and functional outcomes was dramatic, but Ms. Besanger pointed out that it was an observational study with a small sample size. These findings, she added, need to be replicated in a larger study.

International Stroke Conference 2008: Abstract P503. Presented February 20, 2008.

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