Response to 'Intermittent Fasting and Brain Protection After Stroke'

Intermittent fasting may have neuroprotective potential post-stroke but faces significant clinical challenges.

• Clinical application of intermittent fasting is complicated by post-stroke catabolic stress and dysphagia, which affects about 50% of patients.
• There is a potential risk of sarcopenia associated with intermittent fasting in metabolically vulnerable patients.
• Recent findings suggest that shorter eating windows may be linked to increased mortality, raising questions about the benefits of intermittent fasting.
• The 'obesity paradox' indicates that having nutritional reserves could aid survival in stroke patients.
• Recommendations include focusing on protein-rich diets, screening for dysphagia, involving dietitians in monitoring, and considering supplements.
• Further randomized controlled trials are necessary to confirm the safety and efficacy of intermittent fasting in this population.

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