Preventing Strokes with Diet

Preventing Strokes with Diet
4.38 (87.5%) 56 votes

Increasing the intake of potassium-rich foods is associated with a significantly lower stroke risk.

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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.

A review of all the best studies ever done on potassium intake, and its relationship to two of our top killers—stroke and heart disease—was recently published in the Journal of the American College of Cardiology. A 1,600 milligram per day higher potassium intake was associated with a 21% lower risk of stroke.

That still wouldn’t get the average American up even to the minimum adequate intake, but may still might be able to wipe out a fifth of their stroke risk. “These results support recommendations for higher consumption of potassium-rich foods to prevent vascular diseases.”

What does that mean, potassium-rich foods? “Potassium is particularly abundant in fruits and vegetables. A greater fruit and vegetable consumption has already been shown to protect against the occurrence of stroke.” According to another meta-analysis, “5 or more servings of fruit and vegetables per day are associated with [a quarter] lower rate of stroke compared with 3 or fewer servings.”

And, it’s not just bananas. Chiquita must have had some great PR firm or something. I don’t know why that’s like one of the only things people know about nutrition. In reality, bananas don’t even make the top 50 sources, coming in at #86—right behind fast-food vanilla milk shakes. And, only then, bananas. 

In reality, the top five sources are tomato and orange concentrates, and then, in terms of the best whole foods—greens, beans, and dates.

Please consider volunteering to help out on the site.

Image thanks to Bobjgalindo via Wikimedia

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.

A review of all the best studies ever done on potassium intake, and its relationship to two of our top killers—stroke and heart disease—was recently published in the Journal of the American College of Cardiology. A 1,600 milligram per day higher potassium intake was associated with a 21% lower risk of stroke.

That still wouldn’t get the average American up even to the minimum adequate intake, but may still might be able to wipe out a fifth of their stroke risk. “These results support recommendations for higher consumption of potassium-rich foods to prevent vascular diseases.”

What does that mean, potassium-rich foods? “Potassium is particularly abundant in fruits and vegetables. A greater fruit and vegetable consumption has already been shown to protect against the occurrence of stroke.” According to another meta-analysis, “5 or more servings of fruit and vegetables per day are associated with [a quarter] lower rate of stroke compared with 3 or fewer servings.”

And, it’s not just bananas. Chiquita must have had some great PR firm or something. I don’t know why that’s like one of the only things people know about nutrition. In reality, bananas don’t even make the top 50 sources, coming in at #86—right behind fast-food vanilla milk shakes. And, only then, bananas. 

In reality, the top five sources are tomato and orange concentrates, and then, in terms of the best whole foods—greens, beans, and dates.

Please consider volunteering to help out on the site.

Image thanks to Bobjgalindo via Wikimedia

Doctor's Note

Very few people are eating enough plants—see 98% of American Diets Potassium-Deficient. The banana listing reminds me of a similarly humorous finding about the levels of eyesight-saving nutrients; see Egg Industry Blind Spot. Bananas are also kind of pitiful antioxidant-wise (see Best Berries). Is a fruit a fruit, or should we really go out of our way to eat plants with the most antioxidants? See Anti-Inflammatory Antioxidants. This three-part video series ends with a surprising twist—the anti-inflammatory effects of potassium! Check out Potassium and Autoimmune Disease.

Also, be sure to check out my associated blog post for additional context: Do Vegans Get More Cavities?

If you haven’t yet, you can subscribe to my videos for free by clicking here.

37 responses to “Preventing Strokes with Diet

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  1. Like your videos. But, what is with the 5 yellow star rating if there is no way to rate the video? If it’s a fake star rating I would recommend removing as it questions credibility.

    1. sheof: Regarding your question about the ratings: I believe that you have to be logged into this site to rate a video. Anyone can watch a video and comment on it. But some features on the site are only for those people who (freely) register and log in. That’s my understanding anyway.

    2. OK, I just gave it a try. I don’t normally bother logging in, but when I do, I *can* rate the videos. Hope that helps to put your mind at ease.

  2. To make the potassium content easier to relate to other foods, I would suggest using the calorie content of the food, not the weight. When you do that I get 1,145 grams of potassium for banana, which is double the potassium of the date on an equal calorie basis. And molasses gets 1,464 grams of potassium. And Wholesome organic molasses blows regular molasses out of the water, too. For a tablespoon of Grandma’s molasses the label says 110 grams of potassium. Wholesome says 720 grams of potassium. I’m using either product labels or CronOMeter for my data.

    1. Potassium was specifically linked to reduced risk of ischemic strokes, those caused by a blockage in an artery feeding the brain. They account for about 80 percent of strokes.The mineral was not, however, linked to a lower risk of hemorrhagic stroke, which occurs when there is bleeding in the brain. Larsson, et. al., Dietary Potassium Intake and RIsk of Stroke. Stroke. 2011;42:2746-2750.

  3. I’ve found that you have no video on psoriasis yet. Is there anything out there on the nutritional treatment of scalp psoriasis? I have found a coal tar shampoo to be at least mildly effective. But I am concerned about its carcinogenic properties!?

  4. That’s funny, because I was doing the Eat to Live diet, avoiding salt altogether, and eating all fruits and veggies and ended up being hospitalizes for low sodium and high potassium, taking 3 bas of saline solution to cure.
    Now I eat some salt and follow your diet and I had the best fasting labs ever!
    Love your incites. Judith McConnell

    1. Indeed, a failed attempt at mythbusting I’d say. The table says 150g banana (I guess one big banana) have about half the potassium of one cup of beans, beet greens or 178g dates. Which is a lot. I don’t know about everyone else, but I’d eat 2 bananas over the other stuff any time of the day. It only takes a few minutes and is a great snack, too…

    2. The hands down potassium boost is sun dried tomatoes. I do eat these as a sort of vegan jerky when hiking. 3427mg per 100gm. And they don’t get smooshed and black in my backpack. :)

  5. Parsley is another green vegetable that is absolutely loaded with potassium. Parsley has 1080 mg in just two little sprigs. I put way more than two little sprigs of parsley in spaghetti sauce, which I use in a tortilla lasagne, or tomato based, Spanish Gazpacho soup, Vegetables are generally lower in fructose than bananas, although, I also love bananas, just have to restrain myself.

    All plants have potassium.especially wasabi root and amaranth leaves. Unfortunately, these are more difficult to find.

    1. Where are you getting this information about parsley? The USDA nutrient database lists fresh parsely as 55mg for 10 sprigs – leaving just 11mg for 2. Well below bananas.

  6. Chiquita, which use to be known as the United Fruit Company, did in fact have a PR company. They hired Edward Bernays, the founder of modern public relations. United Fruit Company did a lot a reprehensible things in its glory days of the 50s and 60s. Although this isn’t the site to get into all that…

    On another note, most likely they did in fact try to sell more bananas by convincing the general public they were high in potassium. I would imagine that all kinds of misinformation about nutrition actually started in the minds of PR guys.

    1. But on potassium it is not MISinformation. Bananas ARE a good sources of potassium – more realistic than tomato sauce for example. Why this negativity to this staple fruit? I can eat 10 bananas easier than I eat 2-3 cups of tomato sauce! Diversity of sources should be stressed not optimal single doses…. otherwise we risk getting reductionist.

  7. On Facebook you linked this study: http://1.usa.gov/U6G5eP
    And there is a line that says “Low-fat diet was not found to have a protective effect.”

    I am a huge fan of yours, been following you for a while, and respect you and your work more than anyone else out there. I consider you a type of Bodhisattva of nutrition :) Would you please tell me your stance when it comes to consuming oils?

    I know Dr. Esselstyn and Dr. McDougall are almost ideologically against oil and their reasoning makes a lot of sense “oils are extremely low in terms of nutritive value. They contain no fiber, no minerals and are 100% fat calories”. But I question it in my specific circumstance. In the case of people accustomed to consuming the average American diet and living the average American lifestyle, the practical wisdom of “NO OIL!” is very valuable. But I am 32 years old, I have virtually no body fat (I’m 5’10” weighing 128 pounds) I am VERY physically active in sport competition martial arts, with the exception of occasional oil consumption, I eat almost entirely whole foods and am entirely a plant based vegan (wide variety of vegetables, whole grains, legumes, mushrooms and so forth). I personally feel I need more calorie dense foods for my body type and lifestyle and using first cold pressed, unfiltered olive oil seems to help. What is your opinion?

    1. Dr. McDougall gives example of two athletes who lived on potatoes for six months and due to needing more calories, oil was added to their diet. It was considered of no nutrient value except to add calories and thus didn’t mess up the experiment. Sounds like you’re another who can add oil!

  8. My potassium is 5.8, my Dr. says this is high and to cut down to 1 banana instead of 5/day. I am vegan & eat a lot of fruit & veg. Do you consider 5.8 high?

    1. It depends on the laboratory normals where the tests are run. Remember that some folks run a bit high or a bit low normally… about 1 in 20 are outside “normal values” even though it is normal for them. The interpretation needs to be viewed in conjunction with other values. It is possible that this in a normal value for you or the lab might have made an error. When blood is drawn into the syringe the red blood cells are sometimes broken up liberating potassium which causes a “false” positive. Previous values help sort this our but if you do cut to one banana and the value goes down you might increase to 3 and repeat the test. The number of banana’s may not be a critical issue. Good luck.

  9. You write often about strokes and stroke prevention. But while most strokes are ischemic (blood clots), a significant percentage are hemorrhagic (bleeding). Since the two kind of strokes work in opposite ways (blood too thick v. blood too thin), don’t different nutritional safeguards apply?

  10. In a properly managed vegan diet, is potassium chloride (salt substitute) used as seasoning a useful way to increase potassium intake?

  11. Yeah when I look at the USDA list that Dr. G is using, I’m not seeing anything that says bananas are low in potassium. The problem is that when you search the USDA database by nutrient, it sorts everything by the cup, or something similar. So like a comment has already observed, who’s going to eat a whole cup of tomato paste every day? Who’s going to eat an entire cup of spirulina? No, according to the database, a medium-sized banana (118g) has more potassium than a cup of cooked quinoa.

  12. “Postmenopausal women should eat more potassium-rich foods, such as fruits, vegetables, beans, milk and unprocessed meats in order to lower their risk of stroke and death,” said Sylvia Wassertheil-Smoller, professor emerita with the department of epidemiology & population health at Albert Einstein College of Medicine in New York City.

    I get that the dairy and meat special-interest groups spend millions to manipulate humans into devouring such Russian Roulette foods to ensure the longevity of their multibillion dollar industry while shortening all lifespans. But I’m more shocked and angry that most supposedly life-saving doctors also commit this same murderous practice of promoting known killers such as meat and dairy for the same psychopathic reasons of profit without the slightest hint of remorse for encouraging millions to die every year. It should be a crime for doctors to recommend meat and dairy.

  13. Editorial
    Endarterectomy, Stenting, or Neither for Asymptomatic Carotid-Artery Stenosis
    J. David Spence, M.D., and A. Ross Naylor, M.D.
    February 18, 2016DOI: 10.1056/NEJMe1600123
    http://www.nejm.org/doi/full/10.1056/NEJMe1600123

    …Outside clinical
    trials, endarterectomy and stenting should be reserved for patients
    with symptomatic severe stenosis or for asymptomatic patients who are
    shown to be at higher risk for stroke with medical therapy than with
    intervention. Such patients (approximately 10 to 15% of patients with
    asymptomatic stenosis of 70 to 99%)…

    …Carotid Revascularization and Medical Management for
    Asymptomatic Carotid Stenosis Trial (CREST-2; ClinicalTrials.gov number,
    NCT02089217)…Pending the completion of
    CREST-2, we think that it would be desirable for interventionists and
    surgeons to forgo stenting and endarterectomy in low-risk asymptomatic
    patients outside that trial. This restraint would not only spare
    patients from procedures that may be unnecessary, but it should also
    facilitate early completion of the trial (and so avoid the fate of
    SPACE-2), so that it may be possible to identify which patients will
    benefit from an intervention rather than medical therapy alone in an
    evidence-based rather than an eminence-based manner.

    ***********************************************************************
    In a related article, medical management was described as systolic blood pressure targets of less than 140 mmHg, LDL less than 70
    mg/dL, A1C targets are lower, aggressive use of statins, and lifestyle interventions — smoking cessation, diet, and
    exercise programs.

  14. I wonder if the rule for protein could be the same for potassium, as plant based diets are easiest for the body? I have been put on a 2,000mg.potassium intake because of my stage iv ckd, I want to go full veg. but I’m apprehensive!?

  15. My post is an elevated serum potassium one. I have only discovered Dr. Greger’s videos that address typical potassium deficiency as related to the SAD. So, if my questions are addressed in videos I have yet to discover, please direct me to them.

    I’ve been eating whole food, plant-based, very little oil (but striving for no oil) for over 3 years. In October I had blood work done. There were several results that were abnormal. Very concerning to my doctor was my potassium level. Lab norm is 3.5 – 5.1. Mine was 5.4. Three weeks later the potassium was repeated. It was 5.1. Last week I had blood work repeated and, again, my potassium was elevated at 5.6. By phone, my doctor is recommending that I reduce my intake of foods high in potassium. She is assuming I am eating many bananas a day as well as drinking orange juice and that I need to reduce or eliminate these foods. In the course of a week, I may eat 2 or 3 bananas and never drink orange juice. I do eat the little clementines nearly daily. But I also eat canned low sodium or salt-free beans, home-cooked lentils, fresh tomatoes and their canned counterparts, dried halawi dates and gooseberries and apple rings, pressure-cooked sweet potatoes and all other varieties of potatoes and lots of fresh or frozen greens amongst other things; all things high in potassium.

    So, am I to dramatically reduce my consumption of these foods in order to lower my serum potassium or am I possibly one of those individuals who has a high normal?

    The other abnormal labs were triglycerides at 246 (lab norm is 39).

    In the last 3 years I have lost 41 lbs and have another 33 lbs to lose to reach a goal weight of 134. I am 5′ 6.5″. I take no prescription drugs and occasionally, maybe once a week, use a vegan B-12 spray.

    If I am one of those with a high normal for serum potassium, how does one get that established so that my doctor’s concerns can be alleviated? Is it possible (something I should explore further) for the products I use topically, which have some form of potassium as an ingredient, to be absorbed through the skin to a degree which would elevate my serum potassium just beyond the lab’s high normal?

    Your input will be most appreciated.

    1. HI Carmela- do you know how high your potassium was and if your health care providers knows why it is high? This would help to give a more precise answer to your question. Until knowing more, however, it may be wise to limit your intake of high potassium foods.

  16. LindaT: I had “abnormal” bloodwork also. My physician was all concerned. I showed the results to Dr. Esselstyn and he said “you are on the most healthy diet in the world. You bloodwork with NOT be normal. You are chasing your tail.”

    I suspect your physician, like most, is just ignorant. Find a physician who works with those on our healthy diet. A difficult, but worthwhile search…

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