The American stroke association identifies healthy diets as critical for stroke prevention, and recommends physicians provide dietary guidance for secondary stroke prevention. We surveyed neurology residents to assess their knowledge of nutrition and practice relevant to stroke patients.

An online survey was administered to neurology residents at national academic centers. Self-reported  practices regarding stroke prevention were queried. Nutritional knowledge was assessed as self-reported perception, as well as through evaluation of practice in nutritional counseling of stroke patient in the 6 months prior to taking the survey.

A total of 162 responses were collected. More than half of the residents (51.2%) considered that it was not the neurologist’s role to provide nutritional counseling to stroke patients. A total of 86% of residents felt it was the responsibility of the dietician to provide nutritional counseling, yet 45.7% never referred stroke patients to a dietician. The majority of respondents felt there are adequate data to support nutritional counseling in stroke patients (78.4%). The majority of residents (69.2%) felt they were not adequately trained to provide nutritional counseling, and only a minority (12.9%) consistently offered nutritional counseling. Barriers that residents identified were; not being well trained, lack of time in clinic visits, lack of engagement of patients, perception of patients that a healthy diet is unpalatable or too costly. Lack of educational patient resources  was not felt to be a barrier.

Neurologists in training believe diet to be an important part of stroke prevention, but practical knowledge and training in nutrition are suboptimal. This study suggests that there should be an effort towards ensuring neurologists feel responsible for providing nutritional counseling to stroke patients. Specific knowledge gaps should be the target of training of neurology residents in nutritional counseling.