What are the protective components of dietary patterns and foods associated with lower risk of cerebrovascular disease, or stroke?
Best Foods to Reduce Stroke Risk
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
“Stroke remains one of the most devastating of all neurological diseases, killing about five million people a year worldwide, and is “the leading cause of permanent disability” in the United States. But, the good news is that about 80% of stroke risk may be due to basic lifestyle factors: primarily, improving your diet, stopping smoking, and getting regular exercise.
The best way to stop smoking, evidently, is to have a heart attack. If you die, you automatically stop smoking—unless you’re incinerated, I guess. And, if you live, repeated “strong advice” from your doctor may persuade up to two-thirds to quit: “Never smoke again in any form as long as you live.” Yes, it’s very addictive. “Yes, [it’s] very difficult. It doesn’t matter; it has to be done. If you are walking along the lakeshore and one of your grandchildren is drowning, [it’s not a matter of] will power; it just has to be done.” It’s like a healthy diet. Some things just have to be done—”getting up at night to feed a baby” can be difficult, too. But, it’s not a matter of willpower; some things in life just have to be done.
For stroke prevention, that means a more plant-based diet, like a traditional Mediterranean diet centered around “whole grains, fruits, vegetables, lentils, beans, and nuts.” A vegetarian or vegan diet may also work, but must be accompanied by a regular, reliable source of vitamin B12—meaning B12-fortified foods or supplements. “Unfortunately, recommending taking B12 supplements may meet opposition among vegetarians, because misconceptions regarding this nutrient are prevalent. Many individuals still hold on to the old myth that deficiency of this vitamin is rare and occurs only in a small proportion of vegans. Future studies with vegetarians should focus on identifying ways of convincing vegetarians to routinely take vitamin B12 supplements in order to prevent a deficiency.” The research is clear on that. Now, we just need research on how we can convince vegetarians to actually take their B12 to prevent a deficiency.
What is it about plant-based diets? Previously, I talked about the role of fiber—potentially about a 1% drop in risk for every one gram of fiber per day. Or, maybe even a tad more: a 12% drop associated with every extra ten grams a day. In fact, fiber from, like, whole grains is associated with not only lower chance of dying from heart attack and stroke, but also cancer, diabetes, and respiratory diseases, and lower risk of dying even from infections or other causes. In other words, lower risk of dying prematurely from all causes put together.
Why? Perhaps because of “the anti-inflammatory effects of…fiber,” which could explain how it could help across the board. Or, maybe they’re eating fewer pro-inflammatory foods. Those who eat more whole plant foods, where fiber is found, may be eating less processed and animal foods. In fact, the study immediately preceding this one, this meta-analysis of fiber, was a meta-analysis on meat. They looked at red meat and processed meat, and found about a 10% increased risk of stroke associated with each three-and-a-half-ounce daily portion. So, that’s about the size of a deck of cards, or about 10% increased risk for every half-deck of processed meat.
Perhaps, it’s because of the heme iron (the blood and muscle iron in meat), perhaps because of “its pro-oxidative properties”—whereas, no association was found between nonheme iron and stroke (the type of iron that predominates in plants). Or, perhaps, because of some of the toxic pollutants, like PCBs, that can build up in animal fats. We’ve known that, like, living next to a toxic waste dump might increase stroke risk. But, only recently have we realized that dietary exposure, even at so-called safe levels, may increase stroke risk. As much as eight or nine times the odds of stroke for those with the highest levels of these pollutants in their bloodstream.
Please consider volunteering to help out on the site.
- Mukherjee D, Patil CG. Epidemiology and the global burden of stroke. World Neurosurg. 2011 Dec;76(6 Suppl):S85-90.
- Burt A, Thornley P, Illingworth D, White P, Shaw TR, Turner R. Stopping smoking after myocardial infarction. Lancet. 1974 Feb 23;1(7852):304-6.
- Chen GC, Lv DB, Pang Z, Dong JY, Liu QF. Dietary fiber intake and stroke risk: a meta-analysis of prospective cohort studies. Eur J Clin Nutr. 2013 Jan;67(1):96-100.
- Birbilis M, Moschonis G, Mougios V, Manios Y; Healthy Growth Study’ group. Obesity in adolescence is associated with perinatal risk factors, parental BMI and sociodemographic characteristics. Eur J Clin Nutr. 2013 Jan;67(1):115-21.
- Shcherbatykh I, Huang X, Lessner L, Carpenter DO. Hazardous waste sites and stroke in New York State. Environ Health. 2005 Aug 29;4:18.
- Lee DH, Lind PM, Jacobs DR Jr, Salihovic S, van Bavel B, Lind L. Background exposure to persistent organic pollutants predicts stroke in the elderly. Environ Int. 2012 Oct 15;47:115-20.
- Kaluza J, Wolk A, Larsson SC. Heme iron intake and risk of stroke: a prospective study of men. Stroke. 2013 Feb;44(2):334-9.
- Pawlak R. Is vitamin B12 deficiency a risk factor for cardiovascular disease in vegetarians? Am J Prev Med. 2015 Jun;48(6):e11-26.
- Boden-Albala B, Southwick L, Carman H. Dietary interventions to lower the risk of stroke. Curr Neurol Neurosci Rep. 2015 Apr;15(4):15.
- Bergkvist C, Kippler M, Larsson SC, Berglund M, Glynn A, Wolk A, Åkesson A. Dietary exposure to polychlorinated biphenyls is associated with increased risk of stroke in women. J Intern Med. 2014 Sep;276(3):248-59.
- Jacobs DR Jr, Ruzzin J, Lee DH. Environmental pollutants: downgrading the fish food stock affects chronic disease risk. J Intern Med. 2014 Sep;276(3):240-2.
- Huang T, Xu M, Lee A, Cho S, Qi L. Consumption of whole grains and cereal fiber and total and cause-specific mortality: prospective analysis of 367,442 individuals. BMC Med. 2015 Mar 24;13:59.
- Chiuve SE, Rexrode KM, Spiegelman D, Logroscino G, Manson JE, Rimm EB. Primary prevention of stroke by healthy lifestyle. irculation. 2008 Aug 26;118(9):947-54.
- Garrow J. Treatment for obesity. Lancet. 1998 May 23;351(9115):1590.
- Spence JD. Intensive risk factor control in stroke prevention. F1000Prime Rep. 2013;5:42.
- Threapleton DE, Greenwood DC, Evans CE, et al. Dietary fiber intake and risk of first stroke: a systematic review and meta-analysis. Stroke. 2013;44(5):1360-8.
Image credit: Neil Conway via flickr. Image has been modified.
- animal fat
- beans
- cancer
- diabetes
- exercise
- fiber
- fruit
- grains
- heme iron
- iron
- lentils
- lifestyle medicine
- meat
- Mediterranean diet
- mortality
- nutrition myths
- nuts
- PCBs
- persistent organic pollutants
- Plant-Based Diets
- prediabetes
- processed foods
- safety limits
- smoking
- stroke
- supplements
- vegans
- vegetables
- vegetarians
- vitamin B12
- vitamins
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
“Stroke remains one of the most devastating of all neurological diseases, killing about five million people a year worldwide, and is “the leading cause of permanent disability” in the United States. But, the good news is that about 80% of stroke risk may be due to basic lifestyle factors: primarily, improving your diet, stopping smoking, and getting regular exercise.
The best way to stop smoking, evidently, is to have a heart attack. If you die, you automatically stop smoking—unless you’re incinerated, I guess. And, if you live, repeated “strong advice” from your doctor may persuade up to two-thirds to quit: “Never smoke again in any form as long as you live.” Yes, it’s very addictive. “Yes, [it’s] very difficult. It doesn’t matter; it has to be done. If you are walking along the lakeshore and one of your grandchildren is drowning, [it’s not a matter of] will power; it just has to be done.” It’s like a healthy diet. Some things just have to be done—”getting up at night to feed a baby” can be difficult, too. But, it’s not a matter of willpower; some things in life just have to be done.
For stroke prevention, that means a more plant-based diet, like a traditional Mediterranean diet centered around “whole grains, fruits, vegetables, lentils, beans, and nuts.” A vegetarian or vegan diet may also work, but must be accompanied by a regular, reliable source of vitamin B12—meaning B12-fortified foods or supplements. “Unfortunately, recommending taking B12 supplements may meet opposition among vegetarians, because misconceptions regarding this nutrient are prevalent. Many individuals still hold on to the old myth that deficiency of this vitamin is rare and occurs only in a small proportion of vegans. Future studies with vegetarians should focus on identifying ways of convincing vegetarians to routinely take vitamin B12 supplements in order to prevent a deficiency.” The research is clear on that. Now, we just need research on how we can convince vegetarians to actually take their B12 to prevent a deficiency.
What is it about plant-based diets? Previously, I talked about the role of fiber—potentially about a 1% drop in risk for every one gram of fiber per day. Or, maybe even a tad more: a 12% drop associated with every extra ten grams a day. In fact, fiber from, like, whole grains is associated with not only lower chance of dying from heart attack and stroke, but also cancer, diabetes, and respiratory diseases, and lower risk of dying even from infections or other causes. In other words, lower risk of dying prematurely from all causes put together.
Why? Perhaps because of “the anti-inflammatory effects of…fiber,” which could explain how it could help across the board. Or, maybe they’re eating fewer pro-inflammatory foods. Those who eat more whole plant foods, where fiber is found, may be eating less processed and animal foods. In fact, the study immediately preceding this one, this meta-analysis of fiber, was a meta-analysis on meat. They looked at red meat and processed meat, and found about a 10% increased risk of stroke associated with each three-and-a-half-ounce daily portion. So, that’s about the size of a deck of cards, or about 10% increased risk for every half-deck of processed meat.
Perhaps, it’s because of the heme iron (the blood and muscle iron in meat), perhaps because of “its pro-oxidative properties”—whereas, no association was found between nonheme iron and stroke (the type of iron that predominates in plants). Or, perhaps, because of some of the toxic pollutants, like PCBs, that can build up in animal fats. We’ve known that, like, living next to a toxic waste dump might increase stroke risk. But, only recently have we realized that dietary exposure, even at so-called safe levels, may increase stroke risk. As much as eight or nine times the odds of stroke for those with the highest levels of these pollutants in their bloodstream.
Please consider volunteering to help out on the site.
- Mukherjee D, Patil CG. Epidemiology and the global burden of stroke. World Neurosurg. 2011 Dec;76(6 Suppl):S85-90.
- Burt A, Thornley P, Illingworth D, White P, Shaw TR, Turner R. Stopping smoking after myocardial infarction. Lancet. 1974 Feb 23;1(7852):304-6.
- Chen GC, Lv DB, Pang Z, Dong JY, Liu QF. Dietary fiber intake and stroke risk: a meta-analysis of prospective cohort studies. Eur J Clin Nutr. 2013 Jan;67(1):96-100.
- Birbilis M, Moschonis G, Mougios V, Manios Y; Healthy Growth Study’ group. Obesity in adolescence is associated with perinatal risk factors, parental BMI and sociodemographic characteristics. Eur J Clin Nutr. 2013 Jan;67(1):115-21.
- Shcherbatykh I, Huang X, Lessner L, Carpenter DO. Hazardous waste sites and stroke in New York State. Environ Health. 2005 Aug 29;4:18.
- Lee DH, Lind PM, Jacobs DR Jr, Salihovic S, van Bavel B, Lind L. Background exposure to persistent organic pollutants predicts stroke in the elderly. Environ Int. 2012 Oct 15;47:115-20.
- Kaluza J, Wolk A, Larsson SC. Heme iron intake and risk of stroke: a prospective study of men. Stroke. 2013 Feb;44(2):334-9.
- Pawlak R. Is vitamin B12 deficiency a risk factor for cardiovascular disease in vegetarians? Am J Prev Med. 2015 Jun;48(6):e11-26.
- Boden-Albala B, Southwick L, Carman H. Dietary interventions to lower the risk of stroke. Curr Neurol Neurosci Rep. 2015 Apr;15(4):15.
- Bergkvist C, Kippler M, Larsson SC, Berglund M, Glynn A, Wolk A, Åkesson A. Dietary exposure to polychlorinated biphenyls is associated with increased risk of stroke in women. J Intern Med. 2014 Sep;276(3):248-59.
- Jacobs DR Jr, Ruzzin J, Lee DH. Environmental pollutants: downgrading the fish food stock affects chronic disease risk. J Intern Med. 2014 Sep;276(3):240-2.
- Huang T, Xu M, Lee A, Cho S, Qi L. Consumption of whole grains and cereal fiber and total and cause-specific mortality: prospective analysis of 367,442 individuals. BMC Med. 2015 Mar 24;13:59.
- Chiuve SE, Rexrode KM, Spiegelman D, Logroscino G, Manson JE, Rimm EB. Primary prevention of stroke by healthy lifestyle. irculation. 2008 Aug 26;118(9):947-54.
- Garrow J. Treatment for obesity. Lancet. 1998 May 23;351(9115):1590.
- Spence JD. Intensive risk factor control in stroke prevention. F1000Prime Rep. 2013;5:42.
- Threapleton DE, Greenwood DC, Evans CE, et al. Dietary fiber intake and risk of first stroke: a systematic review and meta-analysis. Stroke. 2013;44(5):1360-8.
Image credit: Neil Conway via flickr. Image has been modified.
- animal fat
- beans
- cancer
- diabetes
- exercise
- fiber
- fruit
- grains
- heme iron
- iron
- lentils
- lifestyle medicine
- meat
- Mediterranean diet
- mortality
- nutrition myths
- nuts
- PCBs
- persistent organic pollutants
- Plant-Based Diets
- prediabetes
- processed foods
- safety limits
- smoking
- stroke
- supplements
- vegans
- vegetables
- vegetarians
- vitamin B12
- vitamins
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Best Foods to Reduce Stroke Risk
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Content URLDoctor's Note
I love the sentiment that some things just have to be done. After all, what we regularly eat every day is, indeed, a matter of life and death.
For more on how to reduce stroke risk with diet, see:
- How to Prevent a Stroke
- Preventing Strokes with Diet
- PREDIMED: Does Eating Nuts Prevent Strokes?
- Food Antioxidants, Stroke, and Heart Disease
- Chocolate and Stroke Risk
- Does Diet Soda Increase Stroke Risk as Much as Regular Soda?
- Lowering Our Sodium-to-Potassium Ratio to Reduce Stroke Risk
What does vitamin B12 have to do with stroke? Watch my video Vitamin B12 Necessary for Arterial Health to find out.
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