Dietary Intervention With the Modified Atkins Diet in Stroke Rehabilitation

Inclusion Criteria: * Age 18-99 * First time unilateral hemispheric ischemic stroke. Not more than 12 weeks after acute stroke. * Burke Stroke Rehabilitation Unit Inpatient. * Preserved cognitive ability to understand commands and participate in outcome measures and to give informed consent. In patients with aphasia, cognitive ability to give consent will be determined by a physician. * Upper extremity motor impairment with an UE Fugl Meyer score ≤ 56/66 * Independence in ADLS/ absence of major impairment prior to stroke Exclusion Criteria: * Hemorrhagic stroke * Uncontrolled hyperlipidemia with LDL \> 250 on admission * Uncontrolled Diabetes mellitus with BS \> 300 averaged over the first day of admission * Nutritional risk as defined by BMI \< 18.5 or by a score of 2 or higher on the Malnutrition Universal Screening Tool (scores BMI, % of unplanned weight loss in last 3-6 months and question whether patient is acutely ill) * Decreased renal function with eGFR \<30% * Stage III and IV pressure ulcers * Osteoporosis not sufficiently treated with oral Calcium and Vitamin D supplements * CHF as defined by class III or worse * Hypersensitivity/allergy to cholesterol lowering medications * H/o kidney stones within last 1 year prior to stroke or medications predisposing to kidney stones such as Topamax, carboanhydrase inhibitors * Inability to tolerate an oral diet and need for tube feeds * Active enrollment in any other interventional studies at Burke; enrollment in observational studies or studies using TMS as a measurement may not pose exclusion criteria * Cognitively unable to follow instructions.