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Depending on what you normally eat (your dietary pattern), you can either increase your risk for strokes or can decrease your risk. It's up to you.

A large European study involving 9 countries and 418,329 persons found that regularly eating greater amounts of fruits, vegetables, fiber (from foods), milk, cheese, and yogurt were each linked to a lower risk of ischemic stroke. But not hemorrhagic stroke. However, hemorrhagic stroke was associated with a greater consumption of eggs.

The great majority of strokes are ischemic strokes, which occur when an artery in the brain becomes blocked. [Fatty deposits lining the vessel walls, called atherosclerosis, are the main cause.] Hemorrhagic strokes are due to leaking or bursting of a blood vessel in the brain.

On average, participants who developed an ischemic stroke reported lower intakes of cheese, cereals and cereal products, fruit and vegetables, legumes, nuts and seeds, but higher intakes of red and processed meat. [NOTE: Once again a diet rich in fruits, vegetables, whole grains, seeds, nuts is best. Think Mediterranean style dietary pattern.]

Unfortunately, the participants in the study only answered one lifestyle and food questionnaire (asking about their usual diet) at the start of the study, after which they were followed for 12.7 years. The thinking is that people tend not to change how they eat over time. (But is that true for everyone?)

Looking at the study details, I unfortunately did not see any mention of highly processed foods, or oils (vegetable, canola, corn, palm, olive, etc). There is a lot of excitement right now about extra virgin olive oil being healthy, anti-inflammatory, and "protective" for a number of diseases.

From Medical Xpress: Study of 418,000 Europeans finds different foods linked to different types of stroke  ...continue reading "The Foods You Eat And Stroke Risk"

Moderation seems best for so many things in life. And apparently this may also be true for a person's cholesterol levels. In a large study researchers found that having low levels of LDL cholesterol (below 70 mg/dL) significantly increased the risk of hemorrhagic stroke (intracerebral hemorrhage).Typically, lowering LDL (low-density lipoprotein) cholesterol is recommended as a way to reduce the risk of a heart attack or ischemic stroke, but several studies now confirm this very low LDL cholesterol - hemorrhagic stroke association.

The study was led by Pennsylvania State University researcher Xiang Gao, but conducted over a 9 year period in an industrial area in northern China. The 96,043 participants had their LDL cholesterol levels measured 4 times over that period. The researchers didn't find any increased risk of hemorrhagic stroke when LDL levels were above 70 mg/dL.

From Medical Xpress: Cholesterol that is too low may boost risk for hemorrhagic stroke

Current guidelines recommend lowering cholesterol for heart disease risk reduction. New findings indicate that if cholesterol dips too low, it may boost the risk of hemorrhagic stroke, according to researchers.  ...continue reading "Can Cholesterol Levels Go Too Low?"

Another study that found benefits to dog ownership. The study authors concluded that: "Our study provides evidence that dog owners are at a lower risk for ischemic stroke, hemorrhagic stroke and heart failure." This could be to daily exercise, or that dog ownership results in less stress or better psychosocial health, or even some other reason (perhaps dog owners are healthier to start with).   Note: myocardial infarction (MI) is commonly known as a heart attack. From Medscape:

Canine Companions Appear to Help Heart Health: Swedish Study

Middle-aged and older dog owners were less likely to die from cardiovascular heart disease (CVD) or all causes, and those who lived alone were less likely to have an MI (myocardial infarction) or stroke, during a decade of follow-up in a large study based on Swedish national registry data[1]. The findings suggest that "especially for those who live alone, dog ownership makes a significant difference . . . in health status," Dr Mwenya Mubanga (Uppsala University, Sweden) told Heartwire from Medscape.....

Dog owners get daily exercise from walking their dogs, and canine companions can reduce stress, which might explain these findings, the researchers speculate....Similarly, Dr Gang Hu (Pennington Biomedical Research, Baton Rouge, LA).....pointed out that the dog owners do more exercise (by walking their dogs), which may contribute to having a lower body weight, lower blood pressure, and possibly good lipid levels and a lower risk of diabetes—which may all act to lower mortality. Having a dog may also reduce the chances of having depression, which might partly explain the more striking findings in the people who lived alone, he added.

Since 2001, dog owners in Sweden have been required by law to register their dogs, and an estimated 83% of dogs were registered that year with the Swedish Board of Agriculture and/or the Swedish Kennel Club dog registries, Mubanga and colleagues explain. They examined the Swedish national registry data to see how dog ownership was related to new CVD events or mortality.....This included 162,091 dog owners (4.8% of the population) and 3,195,153 people who were not dog owners.

Dog owners who lived alone or with at least one child or adult were less likely to die of CVD or all causes during follow-up compared with those who did not own a dog, but the relationships were stronger for solitary dwellers. Among dog owners, solitary dwellers (but not others) were also significantly less likely to have an MI or stroke than people who did not have a dog.

The finding that the oral bacteria Streptococcus mutans, which is found in 10% of the population, is linked with hemorrhagic strokes is big. S. mutans is found in tooth decay or cavities (dental caries). The researchers found a link with cnm-positive S. mutans with both intracerebral hemorrhage (ICH) and also with cerebral microbleeds.

Some risk factors for strokes have long since been known, such as high blood pressure and advanced age, but then there are those hemorrhagic strikes that don't seem to fit the norm, with no apparent risk factors. Well, apparently the presence of cnm-positive S. mutans is one. My understanding of what cnm-positive S. mutans means is S. mutans bacteria that carries the collagen-binding Cnm gene. This bacteria can be found in a person's saliva and in dental plaque, and swabs of both were taken for this study.

This study builds on other studies that find a link between the bacteria Streptococcus mutans and a number of systemic diseases, including bacteremia, infective endocarditis and hemorrhagic stroke. The researchers of this latest study suggest that infection with cnm-positive S. mutans causes constant inflammation (as shown by 2 inflammatory markers: CRP and fibrinogen), which then causes damage to blood vessels (endothelial damage) in the brain. Bottom line: take care of your teeth and gums.

From Science Daily: Oral bacteria linked to risk of stroke

In a study of patients entering the hospital for acute stroke, researchers have increased their understanding of an association between certain types of stroke and the presence of the oral bacteria (cnm-positive Streptococcus mutans).

In the single hospital study, researchers at the National Cerebral and Cardiovascular Center in Osaka, Japan, observed stroke patients to gain a better understanding of the relationship between hemorrhagic stroke and oral bacteria. Among the patients who experienced intracerebral hemorrhage (ICH), 26 percent were found to have a specific bacterium in their saliva, cnm-positive S. mutans. Among patients with other types of stroke, only 6 percent tested positive for the bacterium.

Strokes are characterized as either ischemic strokes, which involve a blockage of one or more blood vessels supplying the brain, or hemorrhagic strokes, in which blood vessels in the brain rupture, causing bleeding.

The researchers also evaluated MRIs of study subjects for the presence of cerebral microbleeds (CMB), small brain hemorrhages which may cause dementia and also often underlie ICH. They found that the number of CMBs was significantly higher in subjects with cnm-positive S. mutans than in those without. The authors hypothesize that the S. mutans bacteria may bind to blood vessels weakened by age and high blood pressure, causing arterial ruptures in the brain, leading to small or large hemorrhages.

"This study shows that oral health is important for brain health. People need to take care of their teeth because it is good for their brain and their heart as well as their teeth," Friedland said. "The study and related work in our labs have shown that oral bacteria are involved in several kinds of stroke, including brain hemorrhages and strokes that lead to dementia."

Multiple research studies have shown a close association between the presence of gum disease and heart disease, and a 2013 publication by Jan Potempa, Ph.D., D.Sc., of the UofL School of Dentistry, revealed how the bacterium responsible for gum disease worsens rheumatoid arthritisThe cnm-negative S. mutans bacteria is found in approximately 10 percent of the general population, Friedland says, and is known to cause dental cavities (tooth decay). Friedland also is researching the role of oral bacteria in other diseases affecting the brain.  http://www.nature.com/articles/srep20074

Another study that links following the Mediterranean diet with a beneficial health effect - this time a lower risk of ischemic stroke. Unfortunately, it did not seem to lower the risk of hemorrhagic stroke.

The findings were presented at the American Stroke Association's annual meeting. From Medical Xpress:

Mediterranean diet may lower stroke risk, study finds

A Mediterranean diet may reduce your risk of one type of stroke, new research suggests. People who most closely followed the Mediterranean diet were less likely to suffer an ischemic stroke—caused by a blood clot—compared to people with the lowest adherence to the diet, the study found.

A Mediterranean diet includes plenty of fruits and vegetables, whole grains, legumes, nuts, fish, poultry and olive oil. There is limited consumption of red meat, sweets and saturated fats such as those in meat, butter and full-fat dairy products, according to the researchers.

Sherzai's team analyzed data from more than 104,000 teachers in California, averaging 52 years of age, who are taking part in a long-term study. The participants, 90 percent of who were white, were divided into five groups based on how well they followed a Mediterranean diet.

While closely following a Mediterranean diet was associated with a reduced risk of a stroke caused by a blood clot, the healthy eating plan had no effect on a person's odds for a bleeding (hemorrhagic) stroke, according to the study.

According to the researchers, prior research has shown that people who follow a Mediterranean diet have a lower risk of heart disease, mental decline and death, but there is little information about how the diet affects stroke risk.Wright noted that the study was especially rigorous, since the authors accounted for "other factors that would reduce stroke risks, such as exercise, total caloric intake,body mass index, smoking and menopausal/hormonal status."

According to a recent large Swedish study, a healthy lifestyle lowers the risk of ischemic stroke (caused by a blood clot) - up to 54% lower risk. But unfortunately it does not lower the risk for a hemorrhagic stroke.

A healthy lifestyle was considered to be: healthy diet, moderate alcohol consumption, not smoking, being physically active, and being a normal weight (not overweight or obese). The more healthy life-style factors, the lower the risk for an ischemic stroke. In this study, healthy foods were considered to be: fruits, vegetables, legumes (beans), nuts, low-fat dairy foods, whole grain foods, and fish. 

From Science Daily: Healthy lifestyle may cut stroke risk in half for women

Women with a healthy diet and lifestyle may be less likely to have a stroke by more than half, according to a study. The study looked at five factors that make up a healthy lifestyle: healthy diet; moderate alcohol consumption; never smoking; physically active; and healthy body mass index (BMI). Compared with women with none of the five healthy factors, women with all five factors had a 54-percent lower risk of stroke.

For the study, 31,696 Swedish women with an average age of about 60 completed a 350-item questionnaire about their diet and lifestyle. They were then followed for an average of 10 years. A healthy diet was defined as within the top 50 percent of a recommended food score measuring how often the participants ate healthy foods such as fruits, vegetables and low-fat dairy products. Moderate alcohol consumption was defined as three to nine drinks per week. Physically active was defined as walking or biking at least 40 minutes a day along with more vigorous exercise at least one hour per week. Healthy BMI was considered below 25.

Most of the women had two or three of the healthy factors. Only 589 women had all five healthy factors, and 1,535 had none. There were 1,554 strokes among study participants. The risk of stroke steadily decreased with each additional healthy lifestyle factor.

Women who had a healthier diet were 13 percent less likely to have a type of stroke called a cerebral infarction than those whose diet was not as healthy. Women with healthier diets had a rate of 28 strokes per 10,000 women per year compared to 43 strokes per 10,000 women per year among those with a less healthy diet.

Cerebral infarction is the most common cause of stroke, accounting for up to 80 to 85 percent of all strokes. Cerebral infarction is caused by a blockage in a blood vessel preventing blood and oxygen from getting to an area of the brain.

There was no relationship between the healthy factors and the risk of hemorrhagic stroke. Hemorrhagic stroke, which is caused by bleeding in and around the brain, accounts for about 15 to 20 percent of all strokes.

A banana a day keeps the doctor away? A recent large study found that older women who eat foods with higher amounts of potassium may be at lower risk of stroke and death, when compared to women who eat fewer potassium rich foods. The association was with ischemic stroke (caused by clot) and not hemorrhagic stroke.

Some good food sources of potassium are: bananas, cantaloupe, grapefruit, oranges, white and sweet potatoes, and white beans. The U.S. Department of Agriculture recommends that women eat at least 4700 mg of potassium daily, but in this study the average intake of the postmenopausal women was 2611 mg per day.

This study followed  90,137 postmenopausal women (aged 50 to 79 years at baseline), and followed them an average of 11 years. Now this same study needs to be done with men and women of all ages. From Science Daily:

Potassium-rich foods cut stroke, death risks among older women

Older women who eat foods with higher amounts of potassium may be at lower risk of stroke and death than women who consume less potassium-rich foods. The health benefits from potassium-rich foods are greater among older women who do not have high blood pressure. Most older American women do not eat the recommended amounts of potassium from foods.

"Our findings give women another reason to eat their fruits and vegetables. Fruits and vegetables are good sources of potassium, and potassium not only lowers postmenopausal women's risk of stroke, but also death."

Researchers studied 90,137 postmenopausal women, ages 50 to 79, for an average 11 years. They looked at how much potassium the women consumed, as well as if they had strokes, including ischemic and hemorrhagic strokes, or died during the study period. Women in the study were stroke-free at the start and their average dietary potassium intake was 2,611 mg/day. Results of this study are based on potassium from food, not supplements.

The researchers found: -Women who ate the most potassium were 12 percent less likely to suffer stroke in general and 16 percent less likely to suffer an ischemic stroke than women who ate the least. -Women who ate the most potassium were 10 percent less likely to die than those who ate the least. They also said there was no evidence of any association between potassium intake and hemorrhagic stroke, which could be related to the low number of hemorrhagic strokes in the study.

The U.S. Department of Agriculture recommends that women eat at least 4,700 mg of potassium daily. "Only 2.8 percent of women in our study met or exceeded this level. "Our findings suggest that women need to eat more potassium-rich foods. You won't find high potassium in junk food. Some foods high in potassium include white and sweet potatoes, bananas and white beans."

The great effects (especially for hemorrhagic stroke) were found in people eating just 1 1/2 portions of fresh fruit daily. The amazing part is that 6.3% admitted to never consuming fruit. From Science Daily:

Fruit consumption cuts cardiovascular disease risk by up to 40 percent

Daily fruit consumption cuts the risk of cardiovascular disease (CVD) by up to 40 percent, according to research. The findings from the seven-year follow-up study of nearly a half million people in the China Kadoorie Biobank found that the more fruit people ate, the more their risk of CVD declined.

Dr Du said: "CVD, including ischaemic heart disease (IHD) and stroke, is the leading cause of death worldwide. Improving diet and lifestyle is critical for CVD risk reduction in the general population but the large majority of this evidence has come from western countries and hardly any from China."

The current study included 451 681 participants with no history of CVD and not on anti-hypertensive treatment at baseline from the China Kadoorie Biobank(1) conducted in 10 different areas of China, 5 rural and 5 urban. Habitual consumption of fruit was recorded at baseline according to five categories: never, monthly, 1-3 days per week, 4-6 days per week, daily.

Over the seven year follow up period there were 19 300 cases of IHD and 19 689 strokes (14 688 ischaemic and 3562 haemorrhagic). Some 18% of participants consumed fruit daily and 6.3% never consumed fruit. The average amount of fruit eaten by the daily consumers was 1.5 portions (~150g).

The researchers found that compared to people who never ate fruit, those who ate fruit daily cut their CVD risks by 25-40% (around 15% for IHD, around 25% for ischaemic stroke and 40% for haemorrhagic stroke). There was a dose response relationship between the frequency of fruit consumption and the risk of CVD.

Dr Du said: "Our data clearly shows that eating fresh fruit can reduce the risk of cardiovascular disease, including ischaemic heart disease and stroke (particularly haemorrhagic stroke). And not only that, the more fruit you eat the more your CVD risk goes down. It does suggest that eating more fruit is beneficial compared to less or no fruit."

The researchers also found that people who consumed fruit more often had significantly lower blood pressure (BP). Eating fruit daily was associated with 3.4/4.1 mmHg lower systolic/diastolic BP compared to those who never ate fruit. 

In a separate analysis, the researchers examined the association of fruit consumption with total mortality and CV mortality in more than 61,000 patients from the China Kadoorie Biobank who had CVD or hypertension at baseline. They found that compared to those who never ate fruit, daily consumers of fruit cut their overall risk of death by 32%. They also reduced their risks of dying from IHD by 27% and from stroke by around 40%.

Two studies about food and health benefits.  From Science Daily:

Can citrus ward off your risk of stroke?

Eating foods that contain vitamin C may reduce your risk of the most common type of hemorrhagic stroke, according to a study released today that will be presented at the American Academy of Neurology's 66th Annual Meeting in Philadelphia, April 26 to May 3, 2014.

Vitamin C is found in fruits and vegetables such as oranges, papaya, peppers, broccoli and strawberries. Hemorrhagic stroke is less common than ischemic stroke, but is more often deadly.

The study involved 65 people who had experienced an intracerebral hemorrhagic stroke, or a blood vessel rupture inside the brain. They were compared to 65 healthy people. Participants were tested for the levels of vitamin C in their blood. Forty-one percent of cases had normal levels of vitamin C, 45 percent showed depleted levels of vitamin C and 14 percent were considered deficient of the vitamin.

On average, the people who had a stroke had depleted levels of vitamin C, while those who had not had a stroke had normal levels of the vitamin.

"Our results show that vitamin C deficiency should be considered a risk factor for this severe type of stroke, as were high blood pressure, drinking alcohol and being overweight in our study," said study author Stéphane Vannier, MD, with Pontchaillou University Hospital in Rennes, France. "More research is needed to explore specifically how vitamin C may help to reduce stroke risk. For example, the vitamin may regulate blood pressure."

From Science Daily:

Eat spinach or eggs for faster reflexes: Tyrosine helps you stop faster

A child suddenly runs out into the road. Brake!! A driver who has recently eaten spinach or eggs will stop faster, thanks to the amino acid tyrosine found in these and other food products. Leiden cognitive psychologist Lorenza Colzato publishes her findings in the journal Neuropsychologia.

Colzato and her colleagues created a situation in which test candidates had to interrupt a repetitive activity at a given instant. The participants had two sessions in the test lab. On one occasion they were given orange to drink that contained tyrosine, and on the other occasion the orange juice contained a placebo. The tests showed that the candidates performed better on the stopping task if they had drunk the juice with tyrosine.

The positive effect of tyrosine on our reaction speed can have benefits for road safety. But there are many more examples. Colzato: 'Tyrosine food supplements and tyrosine-rich food are a healthy and inexpensive way of improving our intellectual capabilities.

Tyrosine is found in such foods as spinach, eggs, cottage cheese and soya.