Investigate the impact of a culturally-adapted Mediterranean Diet (The MediSoul Diet) on post-stroke cognitive impairment (PSCI) and post-stroke depression (PSD).

Stroke is a leading cause of long-term disability with ~10% recovering fully and 40-70% of patients developing PSCI and PSD. The Southeastern US is disproportionately affected with mortality rates 30-40% higher than the rest of the US, Black Americans being the most affected. Poor diet quality is an independent risk factor for stroke mortality and is associated with stroke disparities. 

Eligible participants were inpatients with (1) acute ischemic stroke 18-80 years old; (2) ≥1 risk factors (DM, HTN, hyperlipidemia, obesity); and (3) discharged home on an oral diet. Baseline dietary questionnaire (MEDAS), cognitive testing (MoCA), mood assessment (PHQ8), lipid profile, Hemoglobin A1C, and weight were measured. Dietary education (the MediSoul diet) was provided in the hospital, and a Community Supported Agriculture (CSA) delivered fresh produce every 2 weeks for 3 months. Follow-up at 3 months included repeat MEDAS, MoCA, PHQ8, lipid profile, HbA1C, and weight.

25 participants were enrolled August 2023-March 2024 [Mean age 59 (46-80), 62% Female, 83% African American]. Enrollment is ongoing. 2 patients were readmitted with a recurrent stroke (8%). Average weight decreased from 215.43 lbs to 200.73 lbs (0.0001). Average MEDAS increased from 4.18 (Range 2-6) to 8.94 (Range 4-13, p <0.0057). Average baseline MoCA was 23 (Range 14-27) and 22 (Range 14-28) at follow-up (p 0.09). Average PHQ8 was 9.18 at baseline, 3.125 at follow-up (p 0.034). Vascular risk factors improved (LDL 107 to 83, Triglycerides 142 to 111, HbA1C 7.28 to 6.81).

This study showcases that the introduction of a culturally-adapted Mediterranean diet at the point-of-care can significantly influence dietary adherence and affect PSCI, PSD, and stroke risk factors.