Nutrition management across the stroke continuum of care to optimize outcome and recovery

Stroke and the resulting long-term disability impose a substantial socio-economic burden. Stroke survivors have nutritional challenges at many stages along their care pathway, and the role of nutritional therapy and medical nutrition in stroke recovery is often overlooked. Appropriate nutrition is a prerequisite for optimizing short-term outcome and recovery from stroke and should be integral across the continuum of care, with management intervention if needed. Nutrition should be reviewed as part of the care for all people post-stroke. If nutrition support is required, it should be initiated at the acute phase and adjusted according to the ability to eat and drink throughout the care pathway. A range of complications arising post-stroke including malnutrition, dysphagia, sarcopenia, and pressure injuries can be prevented or improved by timely appropriate nutritional therapy. This also improves physical and mental function, increases strength and mobility which facilitates effective neurorehabilitation, reduces the risk of infection and pressure injuries, promotes wound healing, and improves the quality of life. An appropriately trained nutrition specialist or dietitian should assess and monitor the individual, but all members of the multidisciplinary team have a role in delivering, monitoring, and supporting the nutritional status and changing needs of the stroke survivor. This review by authors from multidisciplinary fields in stroke care is a consensus based on serial, open discussion meetings. The review explores the interrelationship between malnutrition, sarcopenia, nutrition, and pressure injuries, and seeks to raise awareness among all health professionals who manage the stroke survivor, of the supportive role of nutritional therapy.