The main risk factor for stroke is high blood pressure (BP) and, when properly controlled, significantly reduces the incidence rates of this disease. Despite all advances achieved in recent years, its prevention is a priority, and in this respect, blood pressure control has a prominent role.

Experts believe that accurately assessing and understanding the role of nutrition in the causes and consequences of stroke will be crucial in developing and implementing strategies to minimize the global burden of the ailment with increasing number of strokes in developing countries said to match with food and lifestyle changes arising from industrialisation and urbanisation.

Diet and nutrition have been extensively investigated as risk factors for major cardiovascular diseases like coronary heart disease (CHD) and stroke are also linked to other cardiovascular risk factors like diabetes, high blood pressure and obesity. Adequate evidence is available, from studies conducted within and across populations, to link several nutrients, minerals, food groups and dietary patterns with an increased or decreased risk of stroke.

What food items protect or reduce the incidence of stroke? Ironically, they are within the reach of many individuals. While the consumption of some food items must be increased, a reduction in the intake of other food items can keep stroke at bay.

Many dietary interventions can be applied in the prevention and treatment of risk factors for stroke, which include increased blood pressure levels, obesity, diabetes, and high cholesterol. Researchers in the 2012 issue of International Journal of Hypertension assessed six dietary interventions that protect from sudden death from stroke. These include the following:

Salt
Most adult populations around the world have average daily salt intake higher than six grammes per day although the average population salt intake should be less than six grammes per day. A series of population-based intervention studies and randomised controlled clinical trials have shown that it is possible to achieve significant reductions in blood pressure with reduced salt intake in people with and without hypertension.

Randomised trials showed that a reduction in dietary salt intake by half a teaspoon per day was associated with a reduction in cardiovascular events by 20 per cent. This is particularly important because higher salt intake is associated with a greater incidence of stroke and cardiovascular events.

Coffee
Coffee is one of the most frequently consumed beverages worldwide. Although, studies on the stroke protective benefits of stroke are controversial, researchers suggested that coffee consumption may modestly reduce risk of stroke.
For instance, a meta-analysis of 11 prospective studies of 479,689 participants, in which relative risk of stroke for three or more categories of coffee consumption was reported concluded that moderate coffee consumption may be weakly inversely associated with risk of stroke.
By contrast, in a multicentre case-crossover study with 390 subjects, the subject’s acute coffee consumption in the hour before stroke symptoms was compared with his or her usual frequency of consumption in the prior year. The authors have found that coffee consumption transiently increases the risk of ischemic stroke onset, particularly among infrequent drinkers.

Flavonoids
Flavonoids (flavonols, flavones, and isoflavones) are other dietary antioxidant compounds commonly found in concentrated amounts in multiple fruits, vegetables, and beverages, including apples, berries, grapes, onions, red wine, tea, cocoa and dark chocolate.

A high intake of flavonols when compared with a low intake was inversely associated with nonfatal and fatal stroke, suggesting that flavonols may reduce stroke risk. During seven years of follow-up, a cohort study which examined the association between flavonoid intake and cardiovascular disease linked flavonoid consumption with lower risk of death from CVD. In fact, the total flavonoid intake was more strongly associated with stroke mortality in men.

Besides flavonoids, researchers who investigated the relationship between foods and beverages that contain polyphenolic compounds, like dark chocolate and tea, said that the highest levels of chocolate consumption were associated with a reduction in cardiovascular disease and stroke. The same results can be observed when the studies assess the relationship between tea consumption and risk of stroke.

Carotenoids
Carotenoids, the pigments responsible for the yellow to red colour of some fruits and vegetables, have been implicated as beneficial substances; they are found in the human diet and primarily derived from plants and found in roots, leaves, shoots, seeds, fruit and flowers Lycopene, one of the most powerful antioxidant among plasma carotenoids, have been found to decrease risk of cardiovascular disease, including atherosclerosis and myocardial infarction. These nutrients can affect the risk of stroke.

In the Kuopio Ischaemic Heart Disease Risk Factor Study, for instance, researchers linking serum lycopene levels with the risk of coronary heart disease and stroke found that men in the lowest quarter of serum lycopene levels had a 3.3-fold risk of acute coronary heart events and stroke.

Fats
Many studies suggest that the disproportion in the consumption of omega-6 and omega-3 fatty acids in the diet can lead to the development of chronic diseases like stroke. A population-based prospective study in the Swedish Mammography Cohort, women who eat plenty of oily fish compared to those who never consumed lean fish had a 33 per cent lower risk of total stroke.

In addition, scientific evidence suggests that replacing saturated fat by polyunsaturated or monounsaturated fat such as olive oil is able to reduce both blood cholesterol.

Carbohydrates
Carbohydrates are the main source of energy for the body and daily nutrient recommendations are based on the Dietary Reference Intakes (DRIs) by age and gender. However, estimates indicate that the total caloric intake exceeds DRIs regardless of energy needs, and the evidence for the risks imposed on human health by excess carbohydrates consumption might be an increase in the development of insulin resistance, diabetes, stroke, and cardiovascular disease.

Recent study suggested that the risk of stroke is decreased with increased whole grain intake and was associated with micronutrients that accompany fibre in whole-grain cereal, contributing to lower risk of stroke.

In conclusion, the researchers wrote: “A diet rich in whole grains, fruits, and vegetables may help reduce body weight and provide adequate amounts of flavonoids, carotenoids, minerals, and trace elements, which can help to reduce chronic disease risk and stroke.”

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