Medical Speech Pathology

Curiosity, Dialogue, and Knowledge

An Ounce of Prevention

by Eve Pearce (Guest Contributor)

An old cigarette ad with the title "An Ounce of Prevention"

***Many thanks to Eve for sharing her time and expertise with this information!

Dietary Changes to Prevent a Recurrent Stroke

Just short of 800,000 Americans suffer a stroke each year and for more than a fifth of these people, it won’t be their first stroke; it is estimated if you experience one, there is around a one in four chance that you will have another during your lifetime. As recurrent strokes are more likely to be severely disabling or result in death, secondary prevention of stroke is vital. While your doctor will closely monitor and medically treat risk factors such as high blood pressure, raised cholesterol and abnormal heart rhythms, it is essential that stroke survivors and their families are provided with advice in relation to lifestyle measures that can also help. Besides keeping active, drinking alcohol in moderation and stopping smoking, making dietary changes that promote a healthy circulation, is one of the most important steps that can be taken; indeed this is supported by scientific evidence. The topic is widely covered online, with many valuable information sources, but here we consider the key dietary changes that can be taken to reduce the risk of a further blood clot within the brain. However, do discuss any changes that you intend to make with your Primary Care Physician to ensure that they are appropriate for your personal circumstances.

Modify fat intake

The main dietary influence on blood cholesterol levels is the proportion of the different types of fats we consume. Saturated fats, which largely come from foods of animal origin such as the fat on meat, butter, full fat dairy produce and any items made from these, raise levels of LDL cholesterol, the form responsible for fatty deposits in the walls of arteries, causing narrowing and reduced blood flow. Ideally we should aim to reduce our intake of sources of these, whilst increasing intake of monounsaturated fats, which are provided predominantly by olive and canola oil, as these lower LDL cholesterol without adversely affecting levels of HDL. While polyunsaturated fats – usually sourced from sunflower, corn and soya oil – were previously recommended as an alternative to saturated fat, these are now known to lower HDL cholesterol and to induce inflammation, which is another risk factor for stroke; we should therefore maintain or reduce levels of these. If you are overweight, reducing the overall amount of fat in your diet will aid weight loss, but this is inadvisable if you have a low body weight, where the key focus should be to merely switch one type of fat for another.

The following practical steps can help to achieve a favorable cholesterol profile:

  • Switch butter for a spread based on olive or canola oil and use these oils if you intend to fry anything, though use alternative cooking methods where possible.
  • Choose lean red meat and remove the fat from poultry; aim to include more white meat and fish in your diet.
  • Opt for skimmed or low fat milk, no fat or low fat yogurts and limit hard cheeses; cottage cheese or reduced fat cream cheese are better options.
  • Limit chocolate, cookies and cakes; fruit, yogurt, jello or sorbet are lower in fat for a snack or dessert, but if you want to do your own baking, use appropriate cooking margarines instead of butter.
  • Avoid take-out and microwave meals; if you need to use the latter, check the label for the fat content.

Eat more fish

Most people do not meet the recommendations for fish intake of eight ounces weekly, but if you have had a stroke it is especially important you try to reach this target. In short, white fish such as bass and catfish are low in fat, while oily fish such as salmon and trout are rich in omega-3 fatty acids. These essential fatty acids have been linked to reduced stroke risk, as they are known to lower blood pressure, reduce the stickiness of the blood and help to normalize heart rhythm.

Increase fruit and vegetables

If you have not previously managed five helpings of a combination of fruit and vegetables daily, now is the time to do so. Their nutrients are helpful on a number of fronts. Antioxidant vitamins help to maintain the health of the blood vessels and are abundant in brightly colored fruit and vegetables. The likes of pulses (peas, beans and lentils), berries and citrus fruits are rich in folate, which can lower levels of homocysteine, raised levels of which are linked to an increased risk of stroke. Green leafy vegetables are also packed withfolate, but if you take Warfarin to thin your blood they can interfere with your treatment, so it is best to discuss whether you are safe to have these with your doctor. Many fruits and vegetables are high in soluble fiber, which can further help to bring down total and LDL cholesterol. Finally, if weight loss is an aim, serving larger helpings of these lower calorie foods at meals can help to control portions of protein and carbohydrate.

Aim for more wholegrains

Wholegrains are cereals that contain all three parts of the grain. Not only are they higher in fiber than refined versions, but they are richer in vitamins and minerals, some of which are implicated in maintaining the health of the blood vessels. For example, wholegrains have a higher content of vitamin E and selenium, which are antioxidants, and certain B vitamins, which can lower homocysteine. Wholegrains include oats, barley, rye, brown rice and wholewheat and anything made from these such as porridge, rye bread or branflakes; we should aim for three servings of these foods daily.

Reduce salt

It is a well known fact that salt can raise blood pressure in susceptible individuals. Besides limiting use at the table, look to use alternative seasonings such as herbs and spices in cooking. Processed foods account for around 75% of the salt in the diet, so avoid use of the likes of readymade meals, canned soups, meats and sauces, as well as savory snacks; if you wish to buy these, check labels to find those lowest in salt.

While these are the five main changes that someone who has had a stroke can make to their diet to reduce recurrence, these may not be appropriate for everyone, owing to a consequence of their stroke such as swallowing difficulties, another medical condition or treatment with certain medications. Therefore it is always best to seek medical guidance before you embark on a new diet.


One comment on “An Ounce of Prevention

  1. Admin
    June 7, 2013

    Great Information here Eve. A great article: concise and approachable.

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