title: Baseline oxidative defense and survival after 5-7 years among elderly stroke patients at nutritional risk: Follow-up of a randomized, nutritional intervention trial.
abstract: OBJECTIVE
  Patients at nutritional risk are particularly vulnerable to adverse outcomes of acute stroke. We previously found that increased energy- and protein intervention improved short-term survival among stroke patients with the highest baseline antioxidant capacity. We now examined survival of these patients after 5-7 years.
  
  
  METHODS
  We studied 165 patients >65 years admitted to hospital for acute stroke and enrolled in a randomized nutritional intervention study in 2005-2007. Cox regression analysis was used to estimate the associations between all-cause mortality (through 2011) and baseline plasma levels of antioxidant markers (glutathione reducing capacity, alpha-tocopherol, vitamin C and total carotenoids).
  
  
  RESULTS
  We found no significant difference (P = 0.86) in survival between the intervention and control group. Among the tested antioxidant markers, plasma levels above the median for total carotenoids were associated with reduced risk of death in the intervention group (adjusted hazard ratio, 0.29; 95% confidence interval, 0.12-0.71).
  
  
  CONCLUSIONS
  Hospitalized patients that received enhanced dietary energy- and protein after acute stroke and with baseline plasma total carotenoids above median level, had reduced risk of death after 5-7 years. Further trials testing intervention with diets rich in antioxidants are warranted.
authors.affiliation: Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway. Electronic address: poiversen@hotmail.com.
authors.forename: Per O
authors.initials: PO
authors.lastname: Iversen
authors.affiliation: Atlantis Medical University College, Oslo, Norway.
authors.forename: Lisa
authors.initials: L
authors.lastname: Ha
authors.affiliation: Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway; Department of Clinical Service, Division of Cancer Medicine Surgery and Transplantation, Oslo University Hospital, Oslo, Norway.
authors.forename: Rune
authors.initials: R
authors.lastname: Blomhoff
authors.affiliation: Department of Gastroenterology, Oslo University Hospital, Ullevaal, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway.
authors.forename: Truls
authors.initials: T
authors.lastname: Hauge
authors.affiliation: Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway; Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway.
authors.forename: Marit B
authors.initials: MB
authors.lastname: Veierød
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000008:administration & dosage; D001205:Ascorbic Acid / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000178:diet therapy / Q000401:mortality; D002338:Carotenoids / Q000097:blood; D004032:Diet; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D016016:Proportional Hazards Models; D020521:Stroke / Q000178:diet therapy*; D024502:alpha-Tocopherol / Q000097:blood
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D004044:Dietary Proteins; D002338:Carotenoids; D024502:alpha-Tocopherol; D001205:Ascorbic Acid
keywords: Antioxidants; Elderly; Nutrition; Stroke; Survival