Background/Aims: While the first few months after a stroke are crucial for the recovery1, the role of diet in the cognitive rehabilitation for stroke survivors during the sub-acute phase is underexplored. We aimed to evaluate the association between energy and macronutrient intake and post-stroke cognition.
Methods: Baseline data were drawn from the PISCES-ZODIAC trial, which enrolled ischemic stroke survivors with no cognitive disability two months after stroke onset. Energy and macronutrient intakes (carbohydrate, protein, fat, saturated fat, fibre, and added sugar) were assessed using three 24-hour food diaries. Macronutrient intake adequacy was defined according to the Australian Dietary Guidelines2. Global cognition was measured using the Alzheimer’s Disease Assessment Scale–Cognition subscale (ADAS-Cog), with lower scores indicating better cognition. Associations were examined using age‑adjusted linear regression.
Results: Fifty‑two participants (61% male, mean age: 63±15 years) were included. Overall, higher energy intake was associated with better cognition (β: -0.163 per kcal/kg body weight; 95%CI: -0.317, -0.009), while protein intake was not associated with cognition (β: -3.233 per g/kg body weight; 95%CI: -6.563, 0.096). Stratified analyses indicated that both energy and protein intakes were positively associated with cognition only among non‑obese participants. Additionally, participants who met the recommended fibre intake (Females: ≥25 g/day; Males: ≥30 g/day) had better cognitive scores (β: -5.585; 95%CI: -9.206, -1.965). The other macronutrients were not associated with cognition.
Conclusion: These exploratory findings suggest that the positive association between energy and protein consumption and post-stroke cognition depends on obesity status, whereas adequate fibre intake may benefit all stroke survivors.