(Part 2 of 2 Articles) Medical statistics about strokes and their cause has been gathered from around the globe. These stats tell us that heart disease and stroke are the two leading causes of death worldwide. The National Stroke Association estimates that up to 80% of strokes can be prevented. A shocking statistic! So what is the key? Does daily nutrition play a role in stroke prevention? To determine whether or not there is a connection between nutrition and having a stroke – it is necessary to look at the risk factors for stroke and specifically, how nutrition impacts those risk factors.
As stated by the latest nutritional research and information from the American Heart Association there are three major risk factors for stroke. And according to a Review of Studies in The International Journal of Preventative Medicine, there seems to be a definite connection between those three risk factors and daily food consumption or nutrition.
The 3 risk factors for stroke are:
1. Unhealthy / poor cholesterol levels defined as:
• total cholesterol level of 200 mg/dL (milligrams per deciliter) or higher,
• high levels of LDL (bad) cholesterol – from 160 to 190 mg/dL
• low levels of HDL (good) cholesterol – less than 40 mg/dL.
2. High blood pressure
3. Excess weight / obesity
Here is a closer look at each risk factor, including the effects of nutrition
1. Unhealthy / poor cholesterol levels
Cholesterol is a necessary type of fat that is found in the bloodstream and all your cells. The body naturally produces the cholesterol it needs and an increase in cholesterol levels is not healthy.
LDL (low density lipoprotein) takes cholesterol to your tissues for storage via the bloodstream. Studies have indicated that LDL (bad) cholesterol becomes oxidized, causing it to accumulate on artery walls. This leads to narrowing of the arteries, which contributes to atherosclerosis.
HDL (good) cholesterol is deemed to be a protection against stroke. It takes cholesterol away from your tissues to the liver. The liver then processes the cholesterol through its filtering system and it is eliminated from your body. An HDL cholesterol level of 40 mg/dL is considered low, and a level of 60 mg/dL is considered healthy.
Unhealthy cholesterol levels can be caused by
• consuming unhealthy fats and oils in your diet – such as a high level of saturated fats (long chain fatty acids mostly from animal fat).
• unhealthy trans fats in your diet. Our North American culture is obsessed with consuming convenient, highly refined foods. And so many refined foods contain unhealthy fats, partially hydrogenated oils and trans fats, even though the food labels may not indicate the type of fat in that product.
Current research is indicating that:
• Choosing to consume lean meats, chicken and fish is helpful in reducing saturated fat intake.
• A Mediterranean type diet or the DASH diet (dietary approach to stop hypertension diet) that is high in beneficial oils, whole grains, fruits, vegetables and low in cholesterol and animal fat is beneficial in lowering overall cholesterol levels.
• The type of fat (healthy fat) and the high nutrient and antioxidant content of the fruit and vegetables consumed in the Mediterranean or DASH diet might protect the endothelial lining of the arteries, keeping them healthy.
• Adding fiber to your diet can help to reduce the cholesterol level anywhere from 6% to 19%.
• The best cooking methods to replace frying are steaming, baking, broiling, and grilling.
• People who are physically active generally tend to have lower cholesterol levels. Getting exercise for 30 minutes per day X 5 days per week is very helpful, especially when it includes aerobic activity on most of those days.
2. High blood pressure – how it is affected by certain nutrients and foods:
• Thirteen published studies involving 170,000 people between 1996 and 2008 show that a higher salt intake is related to a greater incidence of stroke and cardiovascular events.
• Studies have indicated that reducing salt intake by 6 grams per day lowers blood pressure as follows:
o in people with healthy blood pressure (who do not have hypertension), systolic and diastolic blood pressure are lowered by 4 mmHg and 2 mmHg respectively.
o in people with hypertension (people that have high blood pressure) systolic and diastolic blood pressure are lowered by 7 mmHg and 4 mmHg respectively.
• Excess consumption of salt could increase blood pressure as well as cause fibrosis (thickening and scarring of tissue) in the heart, the arteries and the kidneys.
• Eleven observational studies of 247,510 adults were done, with 5 to 19 years of follow-up. The results showed that a higher daily potassium intake (1.64 g per day) was associated with a 21% lower risk of stroke, and conversely, a lower daily intake of potassium was linked to a higher stroke risk.
• The effects of calcium on the body seem to be unclear. There is a great deal of conflicting information about how calcium affects the cardiovascular system and risk of stroke.
• Some studies indicate that a higher intake of calcium may be beneficial for lowering risk of cardiovascular and stroke events. Other studies indicate exactly the opposite. Research is ongoing, and the controversy continues.
Refined carbohydrates – highly refined foods and junk food:
• This includes white flour, sugar, candy, baked goods, refined packaged foods, french fries, burgers, hot dogs, pizza, pretzels, potato chips and refined snack foods, fast foods of all descriptions, sweetened beverages and most gluten free processed foods.
• Highly refined foods are carbohydrates that typically have ZERO nutrition, which means they do not give your body nutrients and they are not a healthy source of energy to sustain the body.
• Foods with a high glycemic index and high glycemic load (such as added sugars, sweetened foods and beverages, and refined starches and carbohydrates mentioned above) increase the body’s fasting blood glucose level. This has a negative impact on blood pressure, LDL cholesterol and trigylcerides (a type of fat in the blood).
• A steady diet of refined carbohydrates has been proven to be linked to many preventable, serious health issues including: metabolic syndrome, pre-diabetes, Type 2 diabetes, high blood pressure, obesity, inflammation, fatty liver, high cholesterol, digestive issues, heart and circulatory issues and even stroke.
• Sugar sweetened beverages, including soft drinks:
o Sugar sweetened beverages have no nutritional value and are generally a great contributor to weight gain and/or obesity as well as other health issues such as inflammation, fatty liver, insulin resistance and more.
o The Nurses Health Study followed 84,085 women for 28 years (1980 to 2008), and the health professionals follow up study followed 43,371 men for 22 years (1986 to 2008). These two studies indicated that greater consumption of sugar sweetened beverages and soft drinks were associated with a considerably higher risk of stroke.
• Having more fiber in your daily diet has been shown to help reduce blood pressure, control blood glucose levels, reduce triglycerides and LDL (bad) cholesterol.
• Increasing dietary fiber slows down the body’s absorption of blood sugar, keeps blood sugar balanced, and keeps you feeling satisfied (less hungry) between meals.
• Fiber is also highly beneficial for the digestive system, particularly the elimination of the toxins and the body’s waste products.
Fruits and vegetables:
• Fruits and vegetables provide a healthy source of dietary fiber and a wide range of vitamins, minerals, phytonutrients and antioxidants that are beneficial to overall health, including the cardiovascular system and the brain.
• Vegetables and fruits contain plenty of nutritionally dense, healthy carbohydrates, which supply your body with energy. In fact, your body is designed to use these healthy, nutrient rich carbohydrates as its main energy source.
• A study of 257,551 individuals (followed for 13 years) indicated that consuming more than 5 servings of fruits and vegetables daily was associated with a lower risk of stroke than consuming less than three servings of fruits and vegetables daily.
• There are definitely varying points of view when it comes to the health effects of consuming meat, particularly red meat. Some sources suggest that consuming red meat could have an effect on blood pressure. This debate has been ongoing for many years and will likely continue for many more years. Research continues.
• Evidence is starting to suggest that highly refined meats may contribute to health issues, possibly even stroke and cardiovascular events. Reason: the process of refining meats often includes nitrates and harmful chemicals and preservatives.
3. Excess weight / obesity
Obesity is becoming a chronic health issue and has been shown to be a risk factor for many serious health issues, including:
• Pre-diabetes and full blown Type 2 diabetes
• Cardiovascular issues
• Heart disease
• High blood pressure
• Fatty liver
How is obesity determined?
• Body mass index (BMI) is used as the marker to determine obesity of an individual. It is a numeric value that indicates mass (weight) and height of a person. • BMI is expressed in units of kg/m2 indicating mass in kilograms and height in metres.
• Generally accepted BMI ranges are:
o Obesity: a BMI of greater than 30 kg/m2.
o Underweight: a BMI of less than 18 kg/m2
o Normal weight: a BMI of 18-25 kg/m2
o Overweight: a BMI of 25-30 kg/m2.
Obesity and risk of stroke:
• Walter N Kernan, MD and four other doctors wrote a report on obesity. Their report cites 40 published studies that were done between 1983 and 2011, which examine the connection between obesity and cerebrovascular disease. The studies show that for every 1 unit increase in BMI (approximately 7 pounds for an average height person) above the normal weight range – the risk of ischemic stroke increases by about 5%. Clearly obesity is a factor!
• Several of the research studies I read talk about two indicators of obesity that are associated with stroke risk: BMI, and the amount of abdominal fat independent of a BMI measurement. Many health care professionals use BMI as a measurement of obesity because it is simply easier to determine.
• The prevalence of adult obesity has been rising steadily over the last fifty years. In the USA obesity has risen from 13% to 34%. In other countries the adult obesity rates are lower, and vary greatly compared to the USA, yet some are still alarming. Canada has a 24% adult obesity rate, Germany 23% and China 4%.
To answer the question ‘Stroke and nutrition – is there a connection?’ – I would have to emphatically say YES – there definitely is a connection! I know first hand that part of the stroke recovery protocol involves choosing nutritious, healthy foods that nourish the body for both recovery and to help prevent further stroke issues. Exercising as much as possible (or perhaps physiotherapy to regain mobility) is also part of the protocol.
My own experience in life and my experience as a Health Coach has proven to me that healthy, whole foods nutrition consistently every day is the basis of our physical, mental and emotional health. Each of us has been gifted with an amazing bio-technical machine that we call our body, which has the ability to heal itself if it is given the right conditions. Nutrition is a key part of the right conditions. If you would like to increase your nutritional intake and reduce your risk for serious health issues – contact me. I can help!
Read Cathy’s Part 1 of 2 Articles titled Stroke Signs and Symptoms – FAST and 9 More!
US National Library of Medicine, National Institutes of Health Stroke and Nutrition: A Review of Studies
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