Premorbid dietary intake of protein is associated with early outcomes but not with severity of ischemic stroke

Background and Objectives: Dietary protein intake has been associated with reduced risk of stroke. This study aimed to examine the relationship between premorbid dietary intake of protein and both stroke severity and neurological outcomes in patients with acute ischemic stroke. Methods and Study Design: Consecutive patients with first-ever ischemic stroke in Jinling Hospital were screened for eligibility of participation. A validated food-frequency questionnaire (FFQ) was performed to collect necessary data for calculating pre-stroke dietary intakes. Stroke severity was assessed by the National Institutes of Health Stroke Scale (NIHSS) at baseline. Neurological outcomes were assessed by the modified Rankin scale (mRS) 90 days after stroke onset. Multivariable logistical regression was applied to analyze the impacts of dietary protein intake on stroke severity or neurological outcomes. Results: Of the 201 enrolled patients, 110 (54.7%) were classified as minor (NIHSS <= 5) and 91 (45.3%) as major stroke (NIHSS >= 6). After adjusting for potential confounders, multivariable logistic regression did not detect significant association between total (odds ratio (OR)=0.98, p=0.15), animal (OR=1.01, p=0.87) or plant protein intake (OR=0.96, p=0.07) and stroke severity. According to the 90-day mRS, 127 patients (63.2%) were determined with good (mRS <= 2), and 74 (36.8%) with poor outcomes (mR 3-6). Multivariable logistic regression detected that premorbid dietary intake of total protein was positively associated with good neurological outcomes (OR=1.05, p=0.04). Conclusions: Higher level of premorbid protein intake may be associated with favorable neurological outcomes independent of stroke severity.