Baseline oxidative defense and survival after 5-7 years among elderly stroke patients at nutritional risk: Follow-up of a randomized, nutritional intervention trial

Clin Nutr. 2015 Aug;34(4):775-8. doi: 10.1016/j.clnu.2014.07.002. Epub 2014 Jul 25.

Abstract

Background & aims: Patients at nutritional risk are particularly vulnerable to adverse outcomes of acute stroke. We previously found that increased energy- and protein intervention improved short-term survival among stroke patients with the highest baseline antioxidant capacity. We now examined survival of these patients after 5-7 years.

Methods: We studied 165 patients >65 years admitted to hospital for acute stroke and enrolled in a randomized nutritional intervention study in 2005-2007. Cox regression analysis was used to estimate the associations between all-cause mortality (through 2011) and baseline plasma levels of antioxidant markers (glutathione reducing capacity, alpha-tocopherol, vitamin C and total carotenoids).

Results: We found no significant difference (P = 0.86) in survival between the intervention and control group. Among the tested antioxidant markers, plasma levels above the median for total carotenoids were associated with reduced risk of death in the intervention group (adjusted hazard ratio, 0.29; 95% confidence interval, 0.12-0.71).

Conclusions: Hospitalized patients that received enhanced dietary energy- and protein after acute stroke and with baseline plasma total carotenoids above median level, had reduced risk of death after 5-7 years. Further trials testing intervention with diets rich in antioxidants are warranted.

Keywords: Antioxidants; Elderly; Nutrition; Stroke; Survival.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antioxidants / administration & dosage
  • Ascorbic Acid / blood
  • Biomarkers / blood
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / diet therapy
  • Cardiovascular Diseases / mortality
  • Carotenoids / blood
  • Diet
  • Dietary Proteins / administration & dosage
  • Energy Intake
  • Female
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Oxidative Stress / drug effects*
  • Proportional Hazards Models
  • Stroke / diet therapy*
  • alpha-Tocopherol / blood

Substances

  • Antioxidants
  • Biomarkers
  • Dietary Proteins
  • Carotenoids
  • alpha-Tocopherol
  • Ascorbic Acid