Introduction: Level of alertness in acute stroke patients is often deteriorated during hospitalization, even though they can orally eat food on admission and their stroke is not severe. Then, it is difficult to improve their level of alertness. If their level of alertness is not improved, their nutritional status is probably deteriorated. Hypothesis: Dark chocolate 5g tablet containing 86% cacao and 147mg polyphenol can improve level of alertness and prevent deterioration of nutritional status. Methods: We included acute stroke patients for retrospective analysis who 1) were admitted between August 2017 and July 2018, 2) presented alert consciousness on admission and orally eat food then, 3) underwent blood examination on admission, the 3rd day and 7th day, 4) presented mild deterioration of level of alertness during hospitalization and 5) took dark chocolate 5g containing 86% cacao and 147mg polyphenol twice a day. We evaluated patients’ features, Glasgow Coma Scale (GCS) as level of consciousness, albumin (Alb), prealbumin (PreAlb), high-sensitivity C-reactive protein (hs-CRP) on admission, on the initial chocolate day and on the 7th day. Results: Eighteen patients met our inclusive criteria and were analyzed. The median age, GCS score, body mass index, blood glucose (BG), hs-CRP, Alb and PreAlb were 85 years, 14, 21.8 kg/m2, 119 mg/dl, 0.1165 mg/dl, 3.9 g/dl and 20.4 mg/dl, respectively. They started to eat 86% cacao chocolate 5g supplementation twice a day median on the 3rd day. On the 3rd day when chocolate was started, their median GCS score, Alb and PreAlb decreased to13 (p<0.0001), 3.45 mg/dl (p<0.0001) and 19.1 mg/dl (p<0.001), respectively, and their median hs-CRP increased to 0.4325 mg/dl (p<0.05). On the 7th day, their median GCS increased to 14 (0.0001), median Alb, PreAlb and hs-CRP levels were 3.45 mg/dl (ns), 16.5 g/dl (ns) and 0.506 mg/dl (ns). Conclusion: Dark chocolate containing 86% cacao and 147mg polyphenol probably improved level of alertness and prevented further deterioration of nutritional status in patients who could orally eat food.
Read full abstract