Impact of Early High-protein Diet on Neurofunctional Recovery in Rats with Ischemic Stroke

Abstract

BackgroundIschemic stroke, featuring high incidence, morbidity, and mortality, is one of the three major diseases troubling human beings. The purpose of the study was to examine the impact of early high-protein diet on neurofunctional recovery in rats with ischemic stroke as well as their cerebral infarct areas and molecular expressions of oxidative stress.Material/MethodsThe middle cerebral artery occlusion model (MCAO) was established, and 48 adult, male Sprague Dawley (SD) rats of clean grade aged seven to eight months (250–280 g body weight) were randomized into four groups: the MCAO group with high-protein diet (MH), the MCAO group with standard-protein diet (MS), the sham group with high-protein diet (SH), and the sham group with standard-protein diet (SS). High-protein diet intervention started on the first day of the surgery, and the rats’ body weights and their neurological deficit scores were measured on each postoperative day while the scores of motors coordination and balance ability were recorded every other day. In addition, their cerebral infant areas and the molecular expressions of oxidative stress injuries were detected as well.ResultsCompared to the MS group, the rats in the MH group gained faster weight growth (p<0.05), presented significantly lower neurological impairment scores (p<0.05), remarkably improved motor coordination and balance ability (p<0.05) as well as showed smaller cerebral infarct areas (p<0.05), increased expression of SOD (superoxide dismutase), and reduced expressions of MDA (malondialdehyde) and iNOS (inducible nitric oxide synthase). However, there was no significant difference between the SS group and the SH group (p>0.05).ConclusionsEarly high-protein diet facilitates the recovery of body weights and neurological functions as well the reduction of the cerebral infarct areas of rats, thus alleviating ischemic stroke-caused oxidative stress injuries.

The effect of addition protein, phosphatidylcholine, phosphatidylserine, and inulin on GFAP levels of acute ischemic stroke patients at Dr. Kariadi Hospital, Semarang

“…Probiotic bacteria will ferment inulin in the intestines and become short-chain fatty acids called SCFA. 10, 23,27 In this study, the intervention gave still affected even though it was not statistically significant (p> 0.05), according to research from Ji et al (2018), a high protein diet given earlier can improve motor coordination. Currently, most of the hospitals have implemented facilities such as flexor and elbow extensor training, physiotherapy, for example, teaching good movement patterns and posture.…”

“…In some studies, the minimum duration of intervention given was 14 days and obtained significant results. 26,[32][33][34][35] The results obtained by the DM sub-group analysis of GFAP levels in the intervention group showed an increasing trend of 0.4 (-0.3 -1.3) compared to the control group of 1 (-0.5 -7.9) and statistically not significantly different (p>0.05). Unlike the case with the non-DM subgroup in the intervention group which showed a decreasing trend of -0.2(-3.5 -3.4) compared to the control group where there was an increasing trend of 0.8 (-0.5 -4.9) and not statistically significant (p> 0.05).…”

“…This suggests that oxidative stress can be inhibited if a high-protein diet is given early on so that free radicals and inflammation in the body can be reduced and can improve post-stroke clinical outcomes. 32 Supported by research by Aquilani et al (2008) which provided supplementation with hyperproteic nutritional formulas (10% protein = 40 grams of protein) in 20 patients for 21 days, it showed that the National Institutes Stroke Scale (NIHSS) scores of patients with protein administration increased on average 4.4 compared to a control group average of 3.0. However, there was an increase in motor recovery of the paretic arms and legs which were found to be better able to withstand gravity for 10 seconds (with legs outstretched) in the intervention group.…”

The effect of additional protein, phosphatidylcholine, phosphatidylserine, and inulin on S100β levels of acute ischemic stroke patients at Dr. Kariadi Central Hospital, Semarang

“…According to research, a high-protein diet given from the beginning provides regulation at the molecular level, which helps to increase SOD expression, suppresses MDA expression, and restores iNOS expression. 41 This suggests that a high-protein diet given from the beginning can inhibit oxidative stress, thereby helping the body to eliminate free radicals that play a role in the pathophysiological process of stroke. 41 Vitamin B supplementation (folic acid, riboflavin, vitamin B12) and choline are effective in improving stroke recovery by suppressing the transcription factor p53 mechanism which causes apoptosis (death of nerve cells) where p53 activation is triggered by an increase in homocysteine.…”

“…41 This suggests that a high-protein diet given from the beginning can inhibit oxidative stress, thereby helping the body to eliminate free radicals that play a role in the pathophysiological process of stroke. 41 Vitamin B supplementation (folic acid, riboflavin, vitamin B12) and choline are effective in improving stroke recovery by suppressing the transcription factor p53 mechanism which causes apoptosis (death of nerve cells) where p53 activation is triggered by an increase in homocysteine. Also, there is an increase in neuroplasticity through increased BDNF (Brain-derived neurotrophic factor) expression and activation of anti-oxidative mechanisms characterized by increased levels of the transcription factor Nrf2 (nuclear factor erythroid 2related factor 2) and SOD2 (Superoxide dismutase 2) enzyme.…”