Out of the 293 stroke patients, 150 patients with a diagnosis of acute stroke (ischemic and hemorrhage) were included in the study. Patients with prior history of stroke were excluded from the study. Those patients/relatives who were not willing to respond to the dietary questionnaire and those patients diagnosed with subarachnoid hemorrhage, venous infarct, and nonatherosclerotic vasculopathy were excluded from the study. Stroke patients were matched with 150 healthy controls [Figure 1]. Healthy individuals were those who visited the hospital for a routine health checkup and attendees of outpatient department and patients suffering from headache, musculoskeletal pain, and backache. Further, healthy individuals who were not on any dietary modifications were included in the study group as controls.
Information regarding reliable variables in the study, comprising demographic details, vascular risk factors and comorbid illnesses, type of stroke, questionnaire for selected dietary components, and water intake were collected using a structured pro forma. General information included the respondent’s age, sex, weight, height, occupation, and type of stroke. Information regarding medical history of diabetes mellitus, hypertension, heart disease, prior stroke, migraine, hormonal therapy, and any other medical illness was collected. Habitual history, if any, of smoking, alcohol use, or tobacco chewing was also included. It was a 1-month recall of diet consumed and also its quantity. Depending on the type of food consumed, the quantity was measured as handful of rice, number of chapatti, liter of water, and teaspoon (tsp) of salt, sugar, oil, and pickles.
Participants were inquired about the frequency of consumption (daily, weekly, monthly, or rarely) of each food item and its quantity. Food categories included cereals, pulses, dairy products, vegetables, fruits, meat and meat products, fish, egg, fats and oils, sugars and jaggery, sweet items, fried snacks, junk foods and bakery items, salt and pickles, and carbonated beverages. The dietary questionnaire sought details on the frequency of intake of water and the consumption (daily, weekly, twice or thrice in a week, and monthly) of major food items such as cereals (rice, wheat, and jowar), whole grain, milk and milk products (tea, coffee, milk, curd, and buttermilk), and saturated fats (ghee, butter, dalda/vanaspati); type of oil (sunflower, groundnut, coconut, palm, mustard, olive, rice brain, cotton, and vegetable oil) consumed per day, per week, per month; daily, weekly, and monthly intake of fruits, fruit juices, snacks, biscuits, vada/puree, Chinese foods, junk foods such as noodles and fried rice; consumption of poultry products (egg, chicken), meat and meat products (mutton, pork, beef, and organ meat), seafoods (fish, prawn, crab) daily, per week, twice or thrice monthly. Organ meat included intake of liver, brain, spleen, and heart of chicken, mutton, beef, and pork; intake of sweets (sweet dishes, sugars, and jaggery), salts (1/2 tsp), pickles (1/2 tsp), papads, and groundnut and coconut chutney; information was gathered on the frequency of use of beverages (beer, whiskey, gin, rum, arrack) and cool drinks [Questionnaire 9.1]. Dietary data for stroke patients and healthy controls were entered simultaneously. Dietary questionnaire was answered by the patient himself/herself. However, in cases where the patient’s response was inhibited due to the impact of stroke, a close relative was assigned to do it. The consent of the patient/relative was taken initially, and on completion, the respondent was required to sign at the end of the pro forma.
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