May is National Stroke Awareness Month: Learn about the dangers of strokes, risk factors and stroke prevention with the power of nutrition.
Written by Hannah Clayton MPH, RD, LDN
What is Stroke?
A cerebrovascular accident (CVA) also known as stroke occurs when blood flow is blocked to the brain, or there is sudden bleeding in the brain. A stroke due to blocked blood flow is called an ischemic stroke, this is the most common type of stroke. The blockage is usually caused by a piece of plaque or a blood clot. A stroke that occurs due to bleeding in the brain is called a hemorrhagic stroke. During a stroke blood flow to the brain is disrupted which prevents brain tissues from getting oxygen, this causes rapid brain cell death and neuron damage. Strokes happen quickly and can result in permanent brain damage, long-term disability, and sometimes death.
Image credit: Center for Disease Control and Prevention (CDC), https://www.cdc.gov/stroke/about/index.html
Risk Factors for Stroke
There are many risk factors for stroke. Risk factors are divided into two main categories. Modifiable risk factors and non-modifiable risk factors. Modifiable risk factors are things we can influence and change like diet, lifestyle behaviors, and management of health conditions. Non-modifiable risk factors are things we cannot change like our age, sex, race, and genetics. Although some conditions like diabetes and heart disease cannot be cured, they are considered modifiable because they can be managed through diet, lifestyle, medication, and other therapies. When a health condition is well-managed, it can significantly decrease the risk of stroke and other health complications and improve quality of life.
Modifiable risk factors for stroke:
Effects of Stroke
The effects of a stroke vary from person to person and all strokes are different. Strokes can cause physical, emotional, and cognitive impairments that disrupt a person’s quality of life and ability to live independently. Rehabilitation is often needed to help regain functional abilities. The length and outcomes of rehabilitation depend on where the stroke occurred in the brain, the severity of the stroke and the individual. According to the American Stroke Association (ASA), about 40% of stroke survivors experience moderate to severe impairments. Impairments like dysphagia (swallowing dysfunction), loss of fine motor skills, paralysis, chronic pain, and cognitive issues can have a significant impact on nutrition status and overall health.
Dietary Changes for Stroke Prevention
Following a healthy diet is one of the most important lifestyles changes you can make to prevent stroke. There is no one-size fits all stroke prevention diet, but an overall heart-healthy and anti-inflammatory dietary pattern is recommended. This means consuming plenty of fruits, vegetables, whole grains, beans, nuts, seeds, lean meats, and healthy fats. Let’s break down some of the main components of a heart-healthy anti-inflammatory eating pattern.
Cutting Down on Sodium
Why should we limit our sodium intake? Sodium, which is naturally present in foods and added to foods via salt (sodium-chloride), is a mineral that is essential for fluid balance and muscle contractions. However, consuming too much sodium can become dangerous. High sodium diets are linked to chronic inflammation, high blood pressure, stomach cancer, kidney disease, osteoporosis, and heart failure. Consuming too much sodium on a regular basis raises our blood pressure which puts excessive strain on the heart, increasing our risk of having a stroke.
Sodium Recommendations: The American Heart Association recommends no more than 2,300mg of sodium per day, with an optimal goal of no more than 1,500mg per day for most adults. Most of our daily sodium intake comes from pre-made, packaged foods – not from homecooked meals.
According to the Centers for Disease Control and Prevention (CDC), about 40% of the sodium consumed by Americans comes from the following foods:
Tips for reducing sodium intake:
Focus on Fiber
Why should we consume more fiber? Fiber is a type of carbohydrate that does not get broken down into glucose. Fiber instead helps slow digestion, remove excess cholesterol from the body, regulate blood sugar levels, and improve gut-health. Most adults in the U.S. do not eat enough fiber. Consuming fiber from a variety of foods such as beans, whole grains, fruits, and vegetables is an important part of a heart-healthy diet. Foods like oats, apples, flaxseeds, lentils, beans, chia seeds, and blueberries are high in soluble fiber which can help lower blood cholesterol levels by helping remove excess cholesterol from our body. A high fiber diet has also been linked to a lower risk of heart disease, metabolic syndrome, type 2 diabetes, and some cancers.
Fiber Recommendations: It is recommended that adults should aim for around 27-38 grams of fiber per day. If you are not used to eating a lot of fiber, switching to a high fiber diet too quickly can overwhelm your digestive system. Add fiber gradually, and drink plenty of fluids to keep things moving along in your system.
Tips on how to increase fiber intake:
Reduce Saturated Fat
Why should we reduce saturated fat intake? Eating excessive saturated fat can impair the liver’s ability to remove cholesterol from our bloodstream. When cholesterol accumulates to high levels in the blood it penetrates artery walls, which triggers inflammation and plaque formations that contribute to heart disease and stroke. We cannot entirely avoid saturated fats, eating a small amount is fine, but it’s important to focus on replacing saturated fats in the diet with heart-healthy foods, and omega-3, 6, and 9 fatty acids which are shown to improve cardiovascular health.
Fat Recommendations: It is recommended to limit saturated fat intake to less than 6% of total calories. For example, if you are consuming a 2,000-calorie diet it is recommended to limit saturated fat intake to 13 grams daily. Did you know? Dietary fats are composed of a mixture of fatty acids. Look at the chart below to see some comparisons.
Saturated fat can add up very quickly & is found in many foods. The following is a list of estimated saturated fat contents of various food items:
Tips on how to switch to Heart-Healthy Fats:
Anti-Inflammatory Foods to Combat Oxidative Stress
What is inflammation? Inflammation is part of our body’s natural immune response that helps keep our body healthy when we are injured or sick. In a healthy body, it removes damaged tissue and starts the healing process. However, if inflammation becomes chronic (prolonged) then it can cause ongoing tissue damage, even to healthy tissue. Chronic inflammation can increase risk of stroke, heart attack, type 2 diabetes, autoimmune disorders, dementia, and cancer.
What foods are anti-inflammatory? A tool called the Dietary Inflammatory Index (DII) is used to evaluate the inflammatory potential of nutrients, foods, and other compounds on inflammatory biomarkers. Inflammatory biomarkers are indicators that detect inflammation in the body. Research shows that consuming a diet high in anti-inflammatory foods is beneficial for overall health and lowering our risk of chronic disease.
Foods that are anti-inflammatory (decrease inflammation) based on the DII include:
Foods that are pro-inflammatory (increase inflammation) based on the DII:
Summary
The research shows that nutrition and lifestyle choices play an integral role in stroke prevention. Eating a healthy and nutritious diet is one of the most effective ways to reduce your risk of stroke. Additionally, if you have already suffered a stroke, you can greatly reduce your risk of a second stroke by following a healthy diet.
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