Dietary Intervention With the Modified Atkins Diet in Stroke Rehabilitation
| Status: | Completed |
|---|---|
| Conditions: | Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 18 - 99 |
| Updated: | 4/21/2016 |
| Start Date: | March 2012 |
| End Date: | May 2014 |
Dietary Intervention in Stroke Recovery in the Acute Rehabilitation Setting With the Modified Atkins Diet.
This phase 1 study tests whether use of the Modified Atkins Diet (MAD) can improve motor
impairment after stroke. It is based on the hypothesis that after stroke, the brain's
utilization of glucose, it's primary source of energy, is disrupted. The MAD is a
low-carbohydrate diet that has can switch the body's metabolism from using glucose to using
products of fat metabolism, so-called ketones. Ketones may act as an alternative energy
substrate for the brain. Ketones also have several neuroprotective effects after stroke.
impairment after stroke. It is based on the hypothesis that after stroke, the brain's
utilization of glucose, it's primary source of energy, is disrupted. The MAD is a
low-carbohydrate diet that has can switch the body's metabolism from using glucose to using
products of fat metabolism, so-called ketones. Ketones may act as an alternative energy
substrate for the brain. Ketones also have several neuroprotective effects after stroke.
Inclusion Criteria:
- Age 18-99
- First time unilateral hemispheric ischemic stroke. Not more than 12 weeks after acute
stroke.
- Burke Stroke Rehabilitation Unit Inpatient.
- Preserved cognitive ability to understand commands and participate in outcome
measures and to give informed consent. In patients with aphasia, cognitive ability to
give consent will be determined by a physician.
- Upper extremity motor impairment with an UE Fugl Meyer score ≤ 56/66
- Independence in ADLS/ absence of major impairment prior to stroke
Exclusion Criteria:
- Hemorrhagic stroke
- Uncontrolled hyperlipidemia with LDL > 250 on admission
- Uncontrolled Diabetes mellitus with BS > 300 averaged over the first day of admission
- Nutritional risk as defined by BMI < 18.5 or by a score of 2 or higher on the
Malnutrition Universal Screening Tool (scores BMI, % of unplanned weight loss in last
3-6 months and question whether patient is acutely ill)
- Decreased renal function with eGFR <30%
- Stage III and IV pressure ulcers
- Osteoporosis not sufficiently treated with oral Calcium and Vitamin D supplements
- CHF as defined by class III or worse
- Hypersensitivity/allergy to cholesterol lowering medications
- H/o kidney stones within last 1 year prior to stroke or medications predisposing to
kidney stones such as Topamax, carboanhydrase inhibitors
- Inability to tolerate an oral diet and need for tube feeds
- Active enrollment in any other interventional studies at Burke; enrollment in
observational studies or studies using TMS as a measurement may not pose exclusion
criteria
- Cognitively unable to follow instructions.
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