Nutrition and Physical Activity in Patients With Cerebrovascular Disease
Nutrition and Physical Activity in Patients With Cerebrovascular Disease
The study will provide evidence of eating habits and physical activity in cerebrovascular
 patients in Luxembourg and of the degree to which these habits may be changed acutely (after
 one month) and in the long run (after 4 months) by intensive counselling. Furthermore the
 influence of intensive counselling and of the consumption of red wine on cerebrovascular risk
 factors, cognition, and on surrogate parameters for stroke will be assessed.
Quality of life in the elderly and their families is severely affected by stroke and
 cognitive dysfunction caused by atherosclerosis of the brain supplying arteries. Nutrition,
 namely a Mediterranean-style diet, nuts, soybean products, whole grain products, dark
 chocolate, fish oil and avoidance of salt, and regular physical activity play a major role in
 the prevention of these diseases. Data are available on cardiac patients, however little is
 known on cerebrovascular patients. The role of red wine in the protection of cerebrovascular
 disease is discussed; it may be simply an epiphenomenon of otherwise healthy lifestyle in the
 population with a regularly low alcohol consumption not properly corrected for in
 epidemiological studies. No prospective randomised data is available.

 We intend to perform a prospective randomised study on nutrition and physical activity in 100
 patients with chronic cerebrovascular disease (i.e. patients with atherosclerotic stenosis,
 at least 20% of a brain supplying artery as demonstrated by carotid ultrasound and without an
 acute stroke/TIA). The study consists of three parts:

 (1) Assessment of eating and physical activity habits in these patients and correlation with
 indicators of cerebrocardiovascular disease (cerebral perfusion as measured by transcranial
 Doppler sonography, pulsatility of the transcranial and extracranial Doppler signal,
 elasticity of the carotid artery, ankle-brachial index, cognitive functioning) and risk
 factors of cerebrovascular disease (blood pressure and blood pressure amplitude assessed by
 24 h ambulatory blood pressure measurement; HDL, LDL, triglycerides, Lp(a), glucose, HbA1c,
 homocysteine, and fibrinogen; waist-hip ratio and BMI).

 2) Half of these patients will be randomised to intensive counselling concerning healthy
 eating and physical activity habits during the first month once a week. All the 100 patients
 will be reassessed after one month and after 4 months with the above mentioned parameters.

 3) In a double cross-over design half of the patients allocated to intensive counselling
 (i.e. n=25) and half of the patients without intensive counselling (n=25) will be allocated
 to 0,2 l of red wine daily (men) or 0,1l of red wine daily (women), respectively. The
 remaining 50 patients will be advised to avoid red wine for the time of the study.
Inclusion Criteria:

 -  In- and outpatients of the Neurology Department of the CHL and their family members

 -  Carotid atherosclerosis assessed by B-mode ultrasound of at least 20% lumen reduction

 -  No acute stroke/TIA/amaurosis fugax (at least 3 months ago)

 -  Temporal ultrasound window suitable for recording of the middle cerebral artery

 -  Ability to give informed consent

 Exclusion Criteria:

 -  No signed informed consent

 -  patient not able to give informed consent