Gut microbes alter link between protein and stroke recovery
In 152 older stroke rehabilitation patients, motor recovery was linked to the interaction of protein density and butyrate-producing bacteria (β=0.046, p=0.006).
Clinical Nutrition ESPEN
The observational study evaluated 156 older patients (mean age 78.4 years; 55.8% men) admitted to a convalescent rehabilitation hospital after a stroke. Researchers measured dietary protein density, defined as protein intake per 1,000 kcal, during the first week after admission. They also profiled gut microbiota using 16S ribosomal RNA gene sequencing from stool samples collected within 14 days. Functional Independence Measure motor effectiveness served as the primary outcome.
In 152 patients analyzed in the primary model, the interaction between dietary protein density and the proportion of putative butyrate-producing bacteria was significantly associated with motor recovery in activities of daily living (β=0.046, 95% CI 0.013–0.079; p=0.006). Similar signals emerged for other Functional Independence Measure outcomes, but not for handgrip strength or skeletal muscle mass index.
Why it matters
Dietary protein is commonly used to support recovery in older adults, but individual functional outcomes vary widely. These findings suggest that variations in the gut microbiome may help explain why older individuals respond differently to post-stroke nutritional support.
Caveats
Because this was an observational registry study of 156 individuals, it cannot establish a causal relationship. The authors note that the study did not directly measure microbial metabolites or dietary fiber intake.
The paper
Kumamoto Rehabilitation Hospital · Aichi Medical University Hospital
Clinical Nutrition ESPEN · 28 Sep 2026