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Impact of Serum Nutritional Status on Physical Function in African American and Caucasian Stroke Survivors

DOI: 10.1155/2014/174308

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Background. The purpose of this study is to compare serum nutritional profiles in chronic stroke survivors to a representative sample of US Adults (NHANESIII) and determine whether these serum markers differed by race and impact physical function in stroke. Methods. Fasting serum samples were collected for analysis of lipids, uric acid, and albumin in 145 African American (AA) and 111 Caucasian (C) stroke survivors (age: 60 ± 1 years [mean ± SEM]). A six-minute walk was performed in a subset of stroke survivors (N = 134). Results. Triglycerides were higher and HDL-cholesterol and albumin lower in C than AA women stroke survivors (Ps < 0.05). Uric acid was lower in C than AA stroke survivors (P < 0.05). Compared to NHANESIII, HDL-cholesterol, albumin, and hemoglobin generally were lower (Ps < 0.05) and lipids were more favorable in stroke (Ps < 0.01). Uric acid was related to six-minute walk performance among a subset of stroke survivors (P < 0.05). Conclusion. In stroke, racial differences exist with regard to serum nutritional risk, but these differences are similar to that observed in the general population. Regardless of race, nutritional risk appears elevated above that of the general population with regard to many of the serum markers. As a modifiable biomarker, uric acid should be monitored closely as it may provide insight into the functional risk of stroke survivors. 1. Introduction Both suboptimal or excessive caloric intake and poor dietary quality affect nutritional risk and may hinder recovery from stroke. In as little as six months following discharge from an initial stroke incident, ~41% of survivors are at nutritional risk, based upon patient interviews regarding appetite, digestion, mobility, and swallowing difficulties [1]. Another study shows that 11% of stroke survivors with initial motor deficits and communication impairment still require feeding assistance six months after stroke [2]. Further, we have previously shown that well into the chronic phase of stroke recovery (>6 months), survivors are obese and have greater intramuscular fat relative to muscle area in their affected limb [3], indicating imbalanced dietary intake relative to energy expenditure. While these data suggest that poor caloric intake exists in chronic stroke, little data are currently available regarding diet quality in stroke. Difficulties with speech and cognition may interfere with obtaining accurate dietary records to assess dietary quality in those chronically disabled by stroke. However, several serum biomarkers commonly found on general comprehensive

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