Answer:

Your father's body mass index (BMI) is about 31.1 kg/m2. According to the World Health Organization (WHO) standards for Asians, this is class II obesity. Obesity is a leading risk factor for stroke recurrence or worsening, so your father should lose weight as soon as possible.

Stroke survivors often have more difficulty losing weight. After a stroke, many physiological and motor changes can affect weight loss effectiveness.

First, the patient's body may experience a decrease in basal metabolic rate, meaning the amount of energy expended each day decreases. This is because nerve, muscle, and internal organ activity is no longer as efficient as before.

Second, your father's ability to exercise may have changed. If he could previously walk briskly, run, or play sports, after a stroke, the intensity of exercise is often limited. This reduced daily energy expenditure makes creating a calorie deficit (consuming fewer calories than expended in a day) for weight loss more challenging.

Here are some nutritional and exercise principles for your father to consider:

Reducing sodium intake to less than 2 g per day (equivalent to less than 5 g of salt) helps control blood pressure, a leading risk factor for stroke. Reducing food intake to a reasonable level, as recommended by a nutritionist, creates a calorie deficit, thereby supporting gradual weight loss (a reduction of about 0.5-1 kg per month is reasonable and safe).

Limiting saturated fat and refined sugars such as fried foods, fast food, organ meats, sweets, and carbonated soft drinks helps reduce the risk of increased LDL cholesterol and triglycerides in the blood. These are two factors that contribute to atherosclerosis, heart attack, and stroke. A diet limiting these foods also helps prevent obesity, type 2 diabetes, and other metabolic disorders.

Doctor An advises on nutrition for patients. Photo illustration: Tam Anh General Hospital

Your father should increase his intake of green vegetables, fresh fruit, fish, whole grains, and unsaturated fats to provide fiber, vitamins, minerals, and antioxidants that are good for the heart. These foods not only help lower LDL cholesterol and increase HDL cholesterol, but also help control blood pressure and blood sugar, and maintain a healthy weight.

Stroke survivors like your father do not need high-intensity exercise. Instead, they should engage in moderate-intensity exercises such as brisk walking, cycling, or gentle swimming for 30-45 minutes daily, at least 5 days a week. The exercises should be personalized according to post-stroke motor function.

Patients should not adopt extreme diets such as fasting, prolonged detox, or complete elimination of nutrient groups such as carbohydrates or fats. These methods can cause electrolyte imbalance, micronutrient deficiencies, and weaken the cardiovascular system, making blood pressure and blood vessels more dangerous.

You should take him to a reputable medical facility's weight management and obesity treatment center for a comprehensive assessment by endocrinologists, cardiologists, nutritionists, and sports medicine specialists, who can advise on a safe treatment plan.

Doctor Tran Quyen An

Center for Weight Management and Obesity Treatment

Tam Anh General Hospital, Hanoi