This is the first study to report data on weight loss and its
relation to predictors and indicators of weight loss over time
in a population-based group of first-ever stroke patients.
Previous studies of nutritional problems in stroke patients
were performed in selected groups of patients discharged to
rehabilitation facilities or nursing homes, who had moderate
to severe stroke, and who often had prestroke disabilities and
nutritional problems.2,3,12,27 Even though our patients were in
good physical condition before stroke onset (98% were
independent), no less than a quarter of them had a weight loss
3 kg in the short term as well as the long term. The
strongest baseline predictor of weight loss was stroke severity
(measured as NIHSS score). On the other hand, obesity,
particularly abdominal obesity, has been reported to be a risk
factor for stroke, and weight reduction has been emphasized
in stroke prevention programs.28 However, a recent Cochrane
review concluded that this hypothesis is not based on strong
scientific evidence resulting from randomized, controlled
clinical trials, at least not for primary prevention.29 Our
results indicate a need to follow up weight after stroke to
detect unintentional weight loss 3 kg related to possible
malnutrition. Otherwise, the large proportion of patients with
eating difficulties related to weight loss 3 kg and other
factors related to nutritional status might not be detected.
Table 2. BMI of 305 Stroke Patients Followed Up Twice
BMI Classification
Baseline,
n (%)
Follow-Up I,
n (%)
Follow-Up II,
n (%)
UW: BMI 18.5 kg/m2 11 (4) 13 (5) 16 (5)
NW: BMI 18.5–24.9 kg/m2 125 (41) 129 (42) 123 (41)
OW: BMI 25–29.9 kg/m2 130 (42) 126 (41) 126 (41)
Obese: BMI 30 kg/m2 39 (13) 37 (12) 40 (13)
20.5 kg/m2* 25 (8) 35 (12) 35 (12)
*20.5 was indicated as the cutoff in nutritional risk screening according to
Kondrup et al.6
920 Stroke March 2008
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