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Reduce Your Risk for Stroke

Cardiovascular disease can affect not only the heart but also the brain.

A stroke occurs when a blood clot blocks one of the vessels that transports oxygen and nutrients to the brain or the vessel itself bursts. The affected part of the brain cannot get the fuel it needs and begins to die. Stroke is the third leading cause of death in the United States, striking about 700,000 people each year. And stroke-related injuries impact quality of life in innumerable ways.
Are You at Risk?
The risk factors for stroke are many, and some are beyond our control: increasing age, gender (stroke is more common in men than women), family history, race (African Americans are at much higher risk of death from a stroke than Caucasians), and a previous stroke or heart attack. The good news is that most of the risk factors for stroke can be treated or controlled.

High blood pressure. Elevated blood pressure (140/90 or higher) is a major risk factor for stroke, but a plant-based diet can help lessen or prevent hypertension.
High cholesterol. High total cholesterol (240 or higher) is a very serious risk factor for heart disease, which raises the risk of stroke. High levels of LDL, or "bad," cholesterol (greater than 100) and triglycerides (150 or higher) have been shown to increase the risk of stroke in people who have heart disease or who have had a transient ischemic attack (TIA, or "ministroke"). Low levels (less than 40) of "good" HDL cholesterol also may raise stroke risk.
Obesity and lack of activity. Your risk of developing high blood pressure and heart disease is greater when you are obese or inactive. If you can't get in 30 minutes of daily activity, rearrange your schedule so that you can exercise nearly every day.
Alcohol consumption. If you are a woman who drinks more than an average of one alcoholic beverage per day (two if you're a man), be aware that it can raise your blood pressure and increase your stroke risk.
Tobacco use. The toxins in tobacco smoke reduce the amount of oxygen in the blood and also damage blood vessel walls, making clots more likely. Lifestyle changes can prevent your suffering a stroke. Jonathan Sackner Bernstein, MD, who directs the Heart Failure Prevention Program at North Shore University Hospital in New York, recommends lowering blood pressure to below 115/75 and LDL below 100, while raising HDL above 40 for men and above 50 for women. Losing weight with the right diet and regular exercise is critical.


Choose a Plant-Based Diet
You know that fruits and vegetables can slash your risk of a variety of cancers. But did you know that they also reduce your risk for stroke? The Dietary Approaches to Stop Hypertension (DASH) trial was a landmark multicenter study demonstrating that a diet rich in fruits, vegetables, and low-fat dairy foods can substantially lower blood pressure.
Subjects were randomly assigned to three diet groups: the control diet (a continuation of the typical American diet); a similar diet but rich in fruits and vegetables (8 to 10 servings per day); and the "combination" diet rich in fruits, vegetables, and low-fat dairy products (up to three servings a day) with reduced saturated and total fat. Sodium intake and body weight were maintained at constant levels in all groups.

In only eight weeks, the combination diet significantly reduced systolic and diastolic blood pressure by 5.5 and 3.0, respectively. The high-fruits-and-vegetables (without dairy) diet reduced systolic blood pressure by 2.8 and diastolic blood pressure by 1.1, while the participants who followed the typical American diet experienced little or no change in blood pressure.

Another major difference between the control and combination diet in the DASH study was the amount of calcium consumed, 443 mg and 1,265 mg, respectively. Calcium supplementation, typically 800 to 1,300 mg per day, has also been shown to have a blood-pressure lowering effect.

- CLARE M. HASLER, PHD, MBA


SELECTED SOURCES
American Stroke Association, www.strokeassociation.org
Before It Happens to You by Jonathan Sackner Bernstein, MD ($26, Da Capo, 2004)
"Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease" by P. M. Kris-Etherton, PhD, RD, et al., Circulation, 2002