Mini Review - (2022) Volume 13, Issue 8
Stroke is the greatest cause of long-term disability and lost earnings, and it is the second leading cause of mortality worldwide, behind ischemic heart disease. In the United States (US), there are 795,000 incident strokes annually. Despite the fact that the death rate from Cardiovascular Diseases (CVD) has been declining for more than ten years, a worrying plateau in that trend and even an increase in CVD mortality have recently surfaced, partly due to the high incidence of diet-related obesity and diabetes.
Stroke; Cardiovascular Disease
Poor food quality has been demonstrated to be an independent risk factor for mortality in stroke and has been named as the primary cause of premature deaths and disability in the United States.Diet may influence stroke through various mechanisms. mechanisms such as insulin resistance and inflammation that are unrelated to their function in blood pressure and cholesterol . According to the Primary Prevention of Cardiovascular Disease with a Mediterranean Diet trial (PREDIMED), eating a Mediterranean-style diet was linked to a 30% decrease in major cardiovascular events, primarily due to fewer strokes, when compared to conventional low-fat diets in a population with mixed risk factors and treatments . By altering one's diet to follow the Mediterranean pattern, the Lyon Diet Heart research found that Myocardial Infarction (MI) and cardiac mortality were reduced by 72% in secondary prevention [1-2].
Despite being proven to be successful and well-liked by patients, strategies including doctors to minimise cardiovascular risk through diet education and assistance are still underutilised . This could be as a result of the fact that only 8% of doctors feel competent in how they offer nutritional advice, and just 10% to 30% of doctors receive proper training in this area . Primary care physicians and cardiologists have access to these data , but neurologists, who frequently deal with CVD risk factors, do not.
The financial costs of treating individuals with CVD are extremely expensive, especially for people without insurance and those receiving Medicaid . The potential for improving public health and reducing healthcare costs by putting more emphasis on nutrition education and practise is significant given the potential for CVD event reduction of 30% to 70% through dietary changes.
Healthy diets are essential for cardiovascular health, according to the American Stroke Association. It advises doctors to give dietary advice for secondary stroke prevention and recommends reducing the risk of illness (CVD) in general and stroke in particular. According to a recent study using data from the CDC's National Ambulatory Medical Care Survey (NAMCS), fewer stroke patients received food counselling from neurologists than from other medical specialties. The reasons for these low counselling rates are unknown, though . A study of neurology residents at academic centres around the nation was carried out in order to find out more about the knowledge, attitudes, and behaviours related to diet counselling in stroke among neurologists [3].
According to our knowledge, our study is the first to offer information on stroke patients' nutritional understanding and dietary counselling by neurology residents. Internal medicine residents and cardiology fellows , but never neurology residents, have previously been studied in terms of their understanding and practise of nutrition. Our research demonstrates that while neurology residents acknowledge the value of nutritional counselling in the treatment of stroke patients, they do not feel adequately prepared to do it. More concerningly, our data reveals that almost half of them believe it is the dietician's or possibly the primary care physician's obligation to provide nutritional guidance rather than their own.
The cause of neurology residents' lack of involvement and ownership lack of nutritional education during medical school and residency in neurology is undoubtedly one of the many contributing factors to the paucity of nutritional advice in stroke patients. Even though medical schools are only mandated to offer 25 hours of nutrition education over the course of four years of study, a recent analysis revealed that 71% of medical schools still fall short of this requirement . Despite a growing corpus of research revealing the connection between diet and neurological illnesses in general and stroke in particular, nutrition education is not included in the neurology curriculum after medical school. Training deficits in counselling are another factor contributing to residents' lack of confidence in their ability to influence the food habits of their patients. In fact, surveys on counselling to help people quit smoking have revealed that knowledge alone is insufficient to influence behaviour connected to counselling. In actuality, studies have not demonstrated a connection between the mere possession of knowledge of smoking cessation techniques and the performance of counselling activities, but have demonstrated a strong association between prior training in smoking cessation counselling and performance of specific counselling activities . To get the desired outcome, you essentially require instruction in smoking cessation approaches as well as understanding of relevant techniques. Residents in neurology lack the expertise and training in these methods.
To increase their chances of success, residents should receive comprehensive training on how to offer dietary guidance change. In addition to highlighting the value of nutrition and a healthy diet in preventing strokes, the 2017 American Heart Association/American Stroke Association Guidelines also stress the necessity of first evaluating patients' diets, then determining their limitations, and finally promoting behaviour change. In our study, neurology residents gave strong warnings that might cause patients to become hostile while failing to evaluate their patients' diets consumption of fruits and vegetables, fat content, or impediments to adhering to a healthy diet. Neurology programmes would fulfil their purposes at a time when stroke education is increasingly centred on an interventional approach with simulations and bootcamps of acute strokes and requests for integrating teleneurology into curricula of vascular neurology fellowships [4-5].
Although nutrition expertise and training are lacking, neurologists in training think that diet is a key factor in preventing strokes. This work is a crucial starting step towards filling in this knowledge gap. For the health of both individual patients and the general public, it may be beneficial for neurology residency programmes to incorporate counselling and nutrition practises into their curricula.
Citation: Groves C. A Call to Action: Nutritional Counseling of Stroke Patients by Neurology Residents. J Neurol Neurophysiol. 2022,13(8), 001-002
Received: 02-Aug-2022, Manuscript No. jnn-22-79664; Editor assigned: 09-Aug-2022, Pre QC No. jnn-22-79664 (PQ); Reviewed: 13-Aug-2022, QC No. jnn-22-79664 (Q); Revised: 19-Aug-2022, Manuscript No. jnn-22-79664 (R); Published: 28-Aug-2022, DOI: 10.35248/2471-268X.22.13.8 .59
Copyright: ©2022 Groves C. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
