Table Of ContentNutrition and Health
Series Editor: Adrianne Bendich
Mandy L. Corrigan
Arlene A. Escuro
Donald F. Kirby Editors
Handbook
of Clinical
Nutrition and
Stroke
N H
UTRITION AND EALTH
Adrianne Bendich, PhD, FASN, FACN, Series Editor
For further volumes:
http://www.springer.com/series/7659
Mandy L. Corrigan Arlene A. Escuro
●
Donald F. Kirby
Editors
Handbook of Clinical
Nutrition and Stroke
Editors
Mandy L. Corrigan, MPH, RD, LD, CNSC Arlene A. Escuro, MS, RD, LD, CNSC
Nutrition Support Team Nutrition Therapy
Cleveland Clinic Cleveland Clinic
Cleveland , OH , USA Cleveland , OH , USA
Donald F. Kirby, MD, FACP, FACN, FACG,
AGAF, CNSC, CPNS
Center for Human Nutrition
Department of Gastroenterology
Cleveland Clinic
Cleveland , OH , USA
ISBN 978-1-62703-379-4 ISBN 978-1-62703-380-0 (eBook)
DOI 10.1007/978-1-62703-380-0
Springer New York Heidelberg Dordrecht London
Library of Congress Control Number: 2013932865
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To my husband, Adam, thank you for all your
support and unconditional love.
To my son Max with all my love.
–Mandy L. Corrigan
To my husband, Ed, thank you for your
patience, support, and love.
–Arlene A. Escuro
Dedicated to my wonderful family,
Debra, Ran, and Sydney.
–Donald F. Kirby
Foreword
Stroke is the fourth leading cause of death in America and the second-leading cause
of death worldwide. It occurs more often in women than men, with African
Americans having almost twice the risk of fi rst-ever stroke compared with
Caucasians. Stroke is a leading cause of adult disability. Aside from the short-term
and long-term disability to the individual, the estimated direct and indirect fi nancial
costs of stroke to society are staggering. Unless there are changes in diet and life-
style, it is likely that there will be increases in the occurrence of stroke due to the
prevalence of nutritional and lifestyle risk factors associated with urbanization and
the Western-style diet.
Despite the prevalence and seriousness of the disease, little attention has been
given to the nutritional aspects of stroke, until now. The Handbook of Clinical
Nutrition and Stoke is edited by Mandy L. Corrigan, M.P.H., R.D., L.D., C.N.S.C.,
Arlene A. Escuro, M.S., R.D., L.D., C.N.S.C. and Donald F. Kirby, M.D., F.A.C.P.,
F.A.C.N., F.A.C.G., A.G.A.F., C.N.S.C., C.P.N.S. from Cleveland Clinic. They are
well known for their work in nutrition. This book is a comprehensive reference on
nutrition for the multidisciplinary team caring for stroke patients. It includes a total
of 19 chapters covering a range of topics relevant to stroke and nutrition. The fi rst
section of the book provides an overview of stroke including epidemiology, types of
stroke, risk factors, and global trends. A review of malnutrition in stroke is also
included in this section and introduces the reader to the concept of the development
of malnutrition following stroke.
There are certain risk factors such as age, family history, gender, and race which
are beyond our control. Yet, up to 80 % of strokes are preventable. With appropriate
lifestyle and medical changes, the risk for stroke can be reduced. Part 2 of the book
covers prevention and includes recommendations for lifestyle changes in the face of
diabetes, hypertension, dyslipidemia, and obesity, all of which are amenable to diet,
exercise, and medical interventions.
Although stroke occurs most often in adults, it can occur any time throughout the
lifespan. Part 2 addresses the specifi c nutrition issues of stroke in pediatrics and
vii
a d o lescence up through adulthood. This is an important section as nutritional manage-
ment of the pediatric stroke patient requires knowledge of age-specifi c nutritional
requirements, as well as normal and disease-specifi c growth and development
considerations. For the adult population, the etiology of stroke is diversifi ed and
correctly identifying underlying causes for stroke is essential for determination of
effective treatment.
Part 3 expands on the treatment and management of these patients from the acute
care setting though rehabilitation. The authors address the entire scope of nutrition
interventions from the use of parenteral nutrition, enteral tube feeding placement,
enteral formulas, unique nutrient requirements, oral dysphagia diets, and transi-
tional feedings toward a goal of achievement of nutritional autonomy.
Complex issues surrounding rehabilitation, ethics, and community resources are
addressed in the fi nal chapters of this book. The text will be a valuable practical refer-
ence for all practitioners caring for patients with stroke. It fi lls a void in books that
provide practical, comprehensive information on this complex patient population.
Greenville, NC, USA Laura E. Matarese, PhD, RD, LDN,
FADA, FASPEN, CNSC
Associate Professor
Department of Internal Medicine
Division of Gastroenterology
Hepatology and Nutrition
Brody School of Medicine and
Department of Nutrition Science
East Carolina University
Greenville, NC, USA
Preface
This Handbook of Clinical Nutrition and Stroke is intended to serve as a compre-
hensive reference on nutrition for the multidisciplinary team caring for stroke
patients. Our aim is for this handbook to provide practical information to clinicians
working with the stroke population as well as the most up to date, evidence-based
information currently available. Until this book was published, there was a gap in
publications that provide comprehensive information on this population and specifi -
cally the area of nutrition support.
The book provides an introduction on the different types of stroke, associated
risk factors, and uniquely feature global perspectives on stroke. In addition to dis-
cussing stroke risk factors, the treatment and management from the acute care set-
ting though rehabilitation is outlined. We further capture the lifespan of patients
affected by stroke (pediatric, younger adults, and older adults), and address preven-
tion (from both nutritional and medical factors). Progression of the nutrition care
plan is fully discussed from enteral tube feeding placement, enteral tube feedings,
parenteral nutrition, unique nutrient requirements, oral dysphagia diets, and transi-
tional feedings as patients regain their nutritional autonomy.
The authors were selected based on their areas of expertise with stroke patients.
The dedication and expertise of the many contributing authors made this publication
possible.
I would like to extend my sincere gratitude to Adrianne Bendich, Ph.D. and
Humana Press for making the vision for this publication a reality.
Cleveland , OH , USA Mandy L. Corrigan
ix
