Diet taboos for patients with cerebral infarction

High-salt foods with excessive daily sodium intake, high-fat foods containing a large amount of saturated fat/trans fat, and high-glycemic foods with a glycemic load exceeding 20. Other statements such as "you cannot eat fat" and "absolutely not touch meat" have no clear evidence-based medical basis. Specific taboos need to be adjusted flexibly based on individual underlying diseases and recovery stages.

Last week, I went to the outpatient clinic with Senior Sister Wang from the Department of Neurology. I met 62-year-old Uncle Zhang, who had just been discharged from the hospital for cerebral infarction three months ago. He heard from fellow patients in the community that "if you have cerebral infarction, you can only eat vegetarian food." He even picked out the yolks of boiled eggs and threw them away. He lost almost 10 pounds in three months. During the follow-up examination, his albumin was much lower. His limb recovery was much slower than that of patients at the same stage. We couldn't laugh or cry.

Let’s talk about the most familiar high-salt problem first. In fact, many people’s understanding of “salt restriction” is still based on adding less salt in cooking. There used to be a 70-year-old aunt who drank clear porridge with two pieces of soybean curd every day. She felt that she had not eaten salt at all. When she checked, her blood pressure soared to 170. After a calculation, she found out that a piece of red soybean was enough. The sodium content of tofu accounts for almost 40% of the recommended daily intake of ordinary people, not to mention the invisible sodium hidden in noodles, quick-frozen dumplings, salad dressings, and even preserved plums. Statistics from the nutrition field have shown that 70% of our daily sodium intake comes from processed foods, not the spoonful of salt used in cooking. There is actually quite a bit of controversy here: Public nutrition schools generally recommend that patients with cerebral infarction should limit their daily sodium intake to less than 3g, which is about the amount of a beer bottle cap. However, many clinical doctors will mention that patients who sweat a lot in summer or are taking natriuretic diuretics should not be so stuck, otherwise it will easily lead to hyponatremia, dizziness and fatigue, or even worsen the condition. It really cannot be generalized.

Speaking of fat, which everyone is so afraid of. After a cerebral infarction, many people want to completely insulate themselves from meat. Even egg yolks are regarded as a scourge. In fact, it is really unnecessary. What should be clearly avoided is pork fat, animal fat, butter cakes made of margarine, and shortening bread. The saturated fat and trans fat in them will aggravate the formation of atherosclerotic plaques. This is the consensus of the entire academic community. But Omega 3 in deep-sea fish and monounsaturated fat in olive oil are good for blood vessel repair. Last week, an old patient ate steamed seabass three times a week, and his blood lipids were more stable than when he was a vegetarian. Different guidelines have also changed quite a bit on this point: earlier guidelines required patients with cerebral infarction to have a daily cholesterol intake of no more than 300 mg. The latest "China Stroke Prevention and Treatment Guidelines" has relaxed the restrictions. As long as you don't eat super high-cholesterol foods such as fatty sausages and brains, one egg a day and one or two lean pork is perfectly fine. Excessive dietary restrictions can lead to malnutrition.

Another point that many people overlook is the issue of high-glycemic foods. Many people think that as long as they eat less salt and oil, everything will be fine. They eat white rice and steamed buns for a meal, and then eat two pieces of Shaqima as a snack. As a result, blood sugar goes up and down, and the damage to the vascular endothelium is actually no less than high oil and high salt. Especially for cerebral infarction patients with diabetes, it is best to replace half of the polished rice and white flour with low-glycemic staple foods such as brown rice, oats, and mixed beans. Of course, there is no need to go to the extreme of giving up carbohydrates completely. I just admitted a patient last month who went on a vegetarian diet without eating staple foods in order to control sugar. As a result, he fainted on the road due to hypoglycemia, which almost caused a second cerebral infarction. It was really not worth the loss.

As for the mythical claims on the Internet that "you cannot eat mutton or seafood due to cerebral infarction", to be honest, there is really no scientific basis. I have seen many patients from Inner Mongolia who have eaten beef and mutton all their lives. After getting sick, they only need to add less salt and sauce when cooking, and choose leaner parts to eat. Their blood pressure and blood lipids are very stable, but they feel uncomfortable after they forcefully switch to a vegetarian diet. Of course, if you are a cerebral infarction patient with high uric acid, you should avoid touching seafood and animal offal. This must be combined with your basic disease. There is no unified standard answer.

In fact, after staying in Shen Nei for so long, I have seen too many patients who regard dietary taboos as a scourge. They dare not touch this or eat that, which in turn destroys their bodies. Sister Wang often tells patients that there is really no need to stick to those rules and regulations. If you measure your blood pressure and blood sugar after eating something, if the indicators jump up particularly high after eating, then this thing is something you should avoid. Other people's experiences may not be suitable for you. After all, diet is only an auxiliary part of the rehabilitation of cerebral infarction. Taking medicine regularly, reviewing regularly, and following the doctor's instructions for rehabilitation training are much more important than worrying about whether you can take a bite of cake. Just don't put the cart before the horse.