5 Ways to Reduce Stroke Risk

Strokes account for 6% of deaths in Canada each year(1).  Since June is stroke awareness month, I want to focus on a ways we can reduce our risk of having a stroke.

1. The old adage— Eat more fruits and vegetables— is more important than ever.

A brilliant sign I spotted in Maui, advertising the local farmer’s market.

A meta-analysis of nine studies, with a total of 257,551 participants over an average of 13 years, showed the consumption of more than five servings of fruit and vegetables per day could lead to a reduction in having a stroke(2). The original fast food turns out to be the best medicine!

All fruits and vegetables contain potassium which lowers blood pressure thus reducing risk of a stroke (2,3,4,5). All you need to do is simply increase your consumption and you will be increasing your potassium intake.

More specifically some of these fast food bandits are recommended more often. Green leafy vegetables (kale, spinach, collard greens, bok choy, arugula, watercress), broccoli, cabbage, Brussels sprouts, turnips, radishes and cauliflower are all cruciferous vegetables and have been shown to have a protective effect in preventing a stroke(3).

Super-size your intake of any these fast food items anytime you like!

2. Watch your sodium intake.

The saying what goes up must come down does not apply when we look at sodium intake and blood pressure. Most people are sensitive to sodium and as a result, the more sodium we eat the higher our blood pressure. The higher our blood pressure the higher our risk of having a stroke. This is one mineral we need to manage.

Were you just about to say well I don’t use the salt shaker? While that’s a great habit, be aware that most of the sodium Canadians consume actually comes from processed foods.

The good news is that it’s very easy to monitor our sodium intake as it is listed on the label of all processed foods. A simple way to manage your sodium intake is to add up how much sodium you eat daily and aim for 2300 mg per day (2,3,4,5).

Interesting fact: bread and bread products top the list of where we get most of our sodium.

If you eat a diet high in sodium, cutting back will be hard at first as your taste buds are used to a certain level. But the good news is we can retrain our taste buds in as little as two weeks to enjoy foods with less sodium.

3. Increase your fibre intake.

fruit - pixa

Fibre intake has been linked to a reduction in risk of having a stroke (6). Fibre is found in whole grains, brown rice, legumes, nuts, seeds, vegetables and fruit. An easy way to up your fibre is adding psyllium husk to your baking.

4. Watch what type of fats and proteins you consume.

butter-pixa

When it comes to fat we should be focusing on eating more omega 3 fats (e.g. salmon, sardines, halibut, tuna, mackerel and rainbow trout), canola and olive oil and less saturated fat from butter and red meats. Avoid trans fats completely (2,3,4,5). If you like butter, I recommend making “Better Butter”. You take 1 lb of butter and mix with 1 cup canola or olive oil. Beat till blended. This basically adds in the right amount of good fat to counteract the negative effect of the bad fat.

The goal with meat is to consume red meat less often. This is a hard selling feature to any Albertan, I know! But an analysis of a study looking at 84,010 women from the Nurses’ Health Study and from 43,150 men from the Health Professionals Follow-Up Study, a study showed that a higher intake of red meat (1 serving/day) was associated with an increased risk of stroke; whereas a higher consumption of poultry (1 serving/day) was associated with a 27% reduced risk of stroke. Proof is in the hen house!

5. Supplements are not the solution.

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It seems that many think if they don’t eat a balanced diet taking multiple vitamin and mineral supplements will help cover their bases. A meta-analysis of 68 randomised trials with a total of 232,606 participants concluded that beta carotene, vitamin A and vitamin E supplements, singly or combined cause us more harm than good (8). Vitamin C, vitamin B and folic acid supplements have not shown to have a protective effect against stroke either (9,10,11,12,13). Studies on vitamin D have also been inconclusive to date. The take home message is do not mega dose supplements.
If you want to take a supplement, stick with a general multivitamin. You can also ask your dietitian to assess your supplement at your next visit if you want to be sure your supplement is right for you.

 


References:
1. Statistics Canada, 2008
2. He FJ, Nowson CA, MacGregor GA. Fruit and vegetable consumption and stroke:meta-analysis of cohort studies. Lancet 2006;367:320–6.
3. Apostolopoulou M, Michalakis K, Miras A, Hatzitolios A, Savopoulos C. Nutrition in the primary and secondary prevention of stroke. Maturitas. 2012 May;72(1):29-34. Epub 2012 Mar 9.
4. Lawrence M, Kerr S, McVey C, Godwin J. The effectiveness of secondary prevention lifestyle interventions designed to change lifestyle behavior following stroke: summary of a systematic review. Int J Stroke. 2012 Apr;7(3):243-7. doi: 10.1111/j.1747-4949.2012.00771.x.
5. Yang Y, Chan SW, Hu M, Walden R, Tomlinson B. Effects of some common food constituents on cardiovascular disease. ISRN Cardiol. 2011;2011:397136. Epub 2011 Jun 16. Oh K, Hu FB, Cho E, et al.
6. Carbohydrate intake, glycemic index, glycemic load, and dietary fiber in relation to risk of stroke in women. Am J Epidemiol2005;161:161–9.
7. Bernstein AM, Pan A, Rexrode KM, et al. Dietary protein sources and the risk of stroke in men and women. Stroke 2011. December 29 [Epub ahead of print].
8. Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis. J Am Med Assoc 2007;297(8):842–57.
9. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of antioxidant vitamin supplementation in 20,536 high-risk individuals: a randomized placebo-controlled trial. Lancet 2002;360(9326):23–33.
10. Sesso HD, Buring JE, Christen WG, et al. Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians’ Health Study II randomized controlled trial. J Am Med Assoc 2008;300(18):2123–33.
11. Toole JF, Malinow MR, Chambless LE, et al. Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death: the Vitamin Intervention for Stroke Prevention (VISP) randomized controlled trial. J Am Med Assoc 2004;291:565–75.
12. Cook NR, Albert CM, Gaziano JM, et al. A randomized factorial trial of vitamins C and E and beta carotene in the secondary prevention of cardiovascular events in women: results from the Women’s Antioxidant Cardiovascular Study. ArchIntern Med 2007;167(15):1610–8.
13. Clarke R, Halsey J, Lewington S, et al. Effects of lowering homocysteine levels with B vitamins on cardiovascular disease, cancer, and cause-specific mortality: meta-analysis of 8 randomized trials involving 37 485 individuals. Arch Intern Med 2010;170:1622–31.