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Everyday alternatives: what really works

MagazineOctober 1996 (Vol. 7 Issue 7)Everyday alternatives: what really works

Stroke prevention, like heart disease prevention, is largely a matter of common sense

Stroke prevention, like heart disease prevention, is largely a matter of common sense. Lifestyle changes may be unlikely to produce immediate benefits; one study, for instance, concluded that dietary changes take about four years to significantly reduce blood pressure (JAMA, May 22, 1996). However, they are also unlikely to produce harmful or fatal side effects and may provide those with low to moderate risk of stroke with a better quality of life for longer.

Change your diet:

A diet rich in fruit and vegetables can help protect against stroke. For every extra three servings (a serving is defined as half a cup) per day of fruit and vegetables you could reduce the risk of stroke by 22 per cent (JAMA, 1995; 273:1113-7). Vegetables provide the greatest protection, perhaps because of their high fibre content (known to lower blood pressure). Fruit and vegetables contain a number of beneficial elements including carotenoids and vitamin C as well as antinutrients such as tannins, phytic acid, flavonoids, phyto estrogens, all which have a cholesterol lowering effect (BMJ, 1996; 312:1479; BMJ, 1996; 312:478-81; JAMA, 1995; 274:1197).

The same substances can be found in things like red wine and tea, and moderate amounts of these may offer a protective effect. One Danish study of 6051 men and 7234 women aged 30-70 showed that those who have a moderate intake of red wine (three to five glasses a day) cut their risk of heart disease and stroke by half (BMJ, May 6, 1995). The flavonoids found in fruit, vegetables, wine and tea are potent antioxidants and have an anti platelet effect (Biochem Pharmacol, 1987; 36:317-22). Although platelet inhibiting factors in flavonoids have a more direct effect on ischaemic stroke it has also been shown to reduce the risk of hemorragic stroke (JAMA, 1995; 273:317-22). The Danish study showed that abstainers had the highest risk, but the use of alcohol as a preventative needs to be weighed carefully against other debilitating side effects such as depletion of minerals such as magnesium, liver damage and, in some cases, cancer (NE J Med, May 11, 1995).

Eating walnuts has also been shown to help reduce the risk of stroke (JAMA, 1995, 273:1563). Walnuts, along with soya bean or canola oil, provide a source of the essential fatty acid alpha lineolic acid. Research shows that for every 0.13 per cent increase in alpha lineolic acid in the blood, the risk of stroke dropped 37 per cent. The reasons why are not fully understood, but it is thought that it may reduce the formation of blood clots that contribute to stroke.

Exercise:

Researchers at Birmingham Univers-ity's department of geriatric medicine looked at 125 men and women aged between 35-74 who had suffered their first stroke, together with a comparable of healthy controls. They found that vigorous exercise between the ages of 15-25 gave the most protection and that this was irrespective of other "risk" factors such as social class, smoking and alcohol consumption, family history of stroke, hypertension or diet. Continued vigorous exercise later in life also helped reduce the risk (BMJ, July 24, 1993). American research agrees: analysis of data from the 11 year national health and nutrition examination study showed clear evidence of benefit. In men and women with a sedentary lifestyle the relative risk of stoke was almost double that of their active counterparts (Am J Epidemiology, 1996; 143:860-9.)

Increase antioxidants:

Stroke victims with a high level of vitamin A in the blood recover more quickly and are less likely to die than patients with lower levels (Lancet, 1992; 339:1562-5). In fact antioxidant vitamins such as A, C and E may help reduce the level of free radicals the toxic by products of metabolism. In elderly people in particular higher levels of vitamin C can act as a protective agent against stroke (BMJ, 1995; 310:1563-4).

Lose weight:

Obesity can lead to hypertension. Analysis of one 36 year follow up study suggests that one in four adults in the United States has hypertension and that 78 per cent of the hypertension in men and 65 per cent in women is directly related to obesity (NE J Med, 1996; 334:1571-6).

Eat garlic:

Garlic taken over a few months can reduce levels of cholesterol in the blood by 15 per cent and heart attack risk by 30 per cent. It also thins the blood, reducing the risk of thrombosis. Just half a clove of garlic will reduce the stickiness in the blood (Int J Clin Pharm Ther Tox, 1991; 29:151-5).


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