Considerations of dietary bioactive compounds/postbiotics, foods, and cooking methods in stroke

Objectives: This review addresses dietary intervention for secondary stroke prevention. The review focuses on gut dysbiosis, innate and adaptive immune system, ischemic brain injury, proinflammatory cytokines, chemokines, mast cell degranulation, and blood brain barrier disruption.Methods: We investigated mitochondrial dysfunction, mast cells degranulation in conjunction with poststroke and alterations in gut microbiota. We discussed gut dysbiosis in conjunction with poststroke and the two-way gut-brain interactions. We evaluated the mechanisms underlying the involvement of dysbiosis in stroke and poststroke development including immune-mediated inflammatory responses, variation in blood-brain-barrier and intestinal barrier function, and reciprocal effects of microbial metabolites. We analyzed the nutrigenomic effects of the main cooking methods proposed for poststroke individuals and performed a comparative analysis of the nutrigenomic properties of the Mediterranean Diet and other Blue Zones healthy diets such as the Okinawa and Nordic diets.Results: Evidence in animals and humans is emerging about the interplay of gut microbiota before stroke including dysbiosis before stroke and stroke-induced dysbiosis. We proposed poststroke diet with dietary bioactive compounds from healthy plant-based foods, supplements, and appropriate cooking methods that will reestablish eubiosis and ameliorate the neurological and neuropsychiatric deficits in poststroke patients. Interventions to address the intersectionality of diet, gut microbiota and stroke and recommendations for food texture modifications in post-stroke dysphagia may help mitigate the downstream effects of acute and chronic inflammatory and immune damage.Discussion: The inclusion of dietary research intervention trials not limited to DASH, MIND, and the ongoing NOURISH trial may help further progress in the clinical treatment of stroke.