Poor nutritional status on admission predicts poor outcomes after stroke: observational data from the FOOD trial

FOOD Trial Collaboration, Stephanie Lewis (Member of Consortium)

Research output: Contribution to journalArticlepeer-review


BACKGROUND AND PURPOSE: Previous studies suggest that undernourished patients with acute stroke do badly. The data, however, are not robust. We aimed to reliably assess the importance of baseline nutritional status as an independent predictor of long-term outcome after stroke in a large prospective cohort enrolled in the Feed Or Ordinary Diet (FOOD) trial, a multicenter randomized trial evaluating various feeding policies.

METHODS: Patients admitted to hospital with a recent stroke were enrolled in the FOOD trial. Data on nutritional status and other clinical predictors of outcome were collected at trial entry. At 6 months, the coordinating center collected data on survival and functional status (modified Rankin Scale). Outcome assessment was done by researchers blinded to baseline assessments and treatment allocation.

RESULTS: Between November 1996 and November 2001, 3012 patients were enrolled, and 2955 (98%) were followed up. Of the 275 undernourished patients, 102 (37%) were dead by final follow-up compared with only 445 (20%) of 2194 patients of normal nutritional status (odds ratio [OR], 2.32; 95% CI, 1.78 to 3.02). After adjustment for age, prestroke functional state, and stroke severity, this relationship, although weakened, still held (OR, 1.82; 95% CI, 1.34 to 2.47). Undernourished patients were more likely to develop pneumonia, other infections, and gastrointestinal bleeding during their hospital admission than other patients.

CONCLUSIONS: These data provide reliable evidence that nutritional status early after stroke is independently associated with long-term outcome. It supports the rationale for the FOOD trial, which continues to recruit and aims to estimate the effect of different feeding regimes on outcome after stroke and thus determine whether the association observed in this study is likely to be causal.
Original languageEnglish
Pages (from-to)1450-6
Number of pages7
JournalStroke; a journal of cerebral circulation
Issue number6
Early online date15 May 2003
Publication statusPublished - 2003


  • Aged
  • Body Weight
  • Cohort Studies
  • Cross Infection
  • Female
  • Follow-Up Studies
  • Gastrointestinal Hemorrhage
  • Humans
  • Inpatients
  • Logistic Models
  • Male
  • Nutrition Disorders
  • Nutritional Status
  • Odds Ratio
  • Prospective Studies
  • Randomized Controlled Trials as Topic
  • Severity of Illness Index
  • Stroke
  • Survival Rate
  • Treatment Outcome


Dive into the research topics of 'Poor nutritional status on admission predicts poor outcomes after stroke: observational data from the FOOD trial'. Together they form a unique fingerprint.

Cite this