Impact of Mediterranean Diet prior to Stroke on the Prognosis of Patients Undergoing Endovascular Treatment

Abstract

Introduction: Mediterranean diet (MeDiet) has been associated with lower risk of stroke. Additionally, animal models suggested that some components of MeDiet are associated with better outcomes after ischemic stroke (IS). We aimed to evaluate the association between global adherence to the MeDiet and the consumption of particular components of the MeDiet with stroke outcomes. Material and Methods: Multicenter observational study of consecutive IS patients treated with endovascular therapy. Inclusion criteria were large anterior circulation vessel occlusion and pre-stroke modified Rankin scale (mRS) <2. Adherence to MeDiet prior to stroke was evaluated using MEDAS 14-item scale. We evaluated the total score and also individual components of the scale. Clinical, radiological, and prognostic variables were collected. Good functional prognosis was considered as mRS ≤2 and complete recanalization as thrombolysis in cerebral infarction 3. Results: From January 1 to October 30, 2018, 239 patients were included (mean age 71 years, 48% women, median baseline NIHSS 16). Median MEDAS scale was 8 points (7–10). Patients with a higher adherence to MeDiet had significantly lower total and LDL-cholesterol levels. Total adherence score was not associated with stroke outcomes. In multivariate analyses, consumption of olive oil as the principal source of fat was independently associated with good functional outcome at 3 months, OR 3.2 (1.1–10.1) and daily consumption of wine was independently associated with complete recanalization, OR 2.0 (1.1–3.8). Conclusions: Our study suggests that some components of MeDiet, such as olive oil and wine consumption, are related to better prognosis after stroke. More studies are needed to confirm these findings.

Gastrointestinal Dysfunction in Stroke

“…200 Patients adhering to a Mediterranean diet, with olive oil as the principal fat source, had better 3-month functional outcomes post-stroke. 201 Further, a high-fiber diet may increase protective gut metabolites, such as SCFAs. 130 Standardization of the post-stroke diet and large-scale validation in multicenter RCTs should be considered before applying specific diets in stroke patients.…”

Ischemic stroke and concomitant gastrointestinal complications- a fatal combination for patient recovery

“…These variable results might be due to the differences in used animal models or the composition of protein diets. Furthermore, a Mediterranean diet with a higher percentage of plant-based foods and olive oil was shown to have short and long-term protective effects on stroke outcomes ( 69 ). Another study demonstrate that feeding stroked mice with a high-fat diet increased infarct volumes and more hemorrhagic complications via the mechanisms involving altered lipid profiles and high blood sugar levels ( 70 ).…”

Neuroprotection Afforded by an Enriched Mediterranean-like Diet Is Modified by Exercise in a Rat Male Model of Cerebral Ischemia

“…Similarly, post-stroke administration of HT also revealed beneficial effects in the recovery of animals undergoing a stroke [30,31]. Results from clinical studies assessing the relationship between a Mediterranean diet and stroke have observed associations with less atherosclerotic etiology and better outcomes, specifically with the consumption of olive oil [32][33][34][35][36].…”