Protein supplementation may enhance the spontaneous recovery of neurological alterations in patients with ischaemic stroke

Objective: To determine whether protein supplementation could enhance neurological recovery in subacute patients with ischaemic stroke. Design: Alimentation-independent patients with ischaemic stroke were randomly allocated to either 21 days of protein supplementation (protein-supplemented group; n=20) or to a spontaneous diet only (control group; n=21) in order to investigate the recovery of neurological changes (measured using the National Institute of Health (NIH) Stroke Scale). Setting: Tertiary care rehabilitation in Italy. Participants: Forty-two patients (27 male and 15 female; 66.4 +/- 11 years) 16 +/- 2 days after the acute event. Intervention: Supplementation with a hyperproteic nutritional formula (10% protein). Main outcome measures: NIH Stroke Scale and protein intake. Results: At admission to rehabilitation, both groups of patients were homogeneous for demographic, clinical and functional characteristics. After 21 days from the start of the protocol, the NIH Stroke Scale was found to be enhanced in the group with supplemental proteins (-4.4 +/- 1.5 score versus -3 +/- 1.4 of control group; P<0.01). When expressed as difference (Delta) between baseline and 21 days, the NIH Stroke Scale correlated negatively with change in protein intake (g/day) (r=-0.50, P=0.001) and positively with change in carbohydrate/protein ratio (r=+0.40, P=0.01) Conclusions: Protein supplementation may enhance neurological recovery in subacute patients with ischaemic stroke.