A stroke is when the blood flow to your brain is blocked, which eventually causes your brain cells to die. As you can imagine, strokes can have dangerous outcomes, and many people are living with risk factors for having one.
If you’re wondering how to avoid a stroke, or prevent another one, there are several things you can start doing today. Along with other healthy lifestyle habits, many foods can help prevent stroke.
To understand why certain foods prevent stroke, we must first address the different types of stroke, stroke risk factors, and primary and secondary stroke prevention. Whether you are at risk of a stroke, are recovering from a stroke, or are caring for someone following a stroke, this article is for you.
Table of Contents
- Types of Strokes
- Who Can Have a Stroke?
- Stroke Risk Factors
- 6 Foods That Prevent Stroke
- Diet for Stroke Patients
- Protecting Yourself from Stroke with Nutrition
Types of Strokes
The Centers for Disease Control and Prevention state that stroke is the third leading cause of death. It is also the #1 cause of serious, long-term disability in the United States. On average, someone has a stroke every 40 seconds, which can be one of three types.
The three types of strokes include the following:
- Ischemic Strokes account for 87% of all strokes. These occur when a blood vessel supplying blood to the brain is obstructed, which slows or interrupts normal blood circulation.
This is most often due to atherosclerosis, the accumulation of plaque in your arteries that narrows and damages blood vessels. (I talk more about atherosclerosis here). Ischemic strokes can also be caused by a blood clot traveling from another part of the body to the brain.
About 15% of these types of strokes are caused by a condition called atrial fibrillation or Afib. (I talk more about Afib and the prevention of Afib attacks here).
- Hemorrhagic Stroke is when a blood vessel in the brain ruptures and blood is spilled into surrounding tissues. This can be caused by an aneurysm, in which a blood vessel is weakened and causes an enlargement that can rupture and cause a stroke.
It can also be caused by an arteriovenous malformation, in which the blood vessels are abnormally formed and may cause a hemorrhagic stroke. Lastly, a hemorrhagic stroke can be triggered by having very high uncontrolled blood pressure. Hypertension can weaken blood vessels in the brain and cause bleeding.
- Transient Ischemic Attack (TIA) or “mini-stroke” is a stroke that lasts a few minutes. It can happen when a clot temporarily blocks the blood supply to the brain. Symptoms are the same as a stroke but do not last as long. Since it is short, many people ignore it, which isn’t advised as it does indicate an underlying problem that warrants attention.
In fact, a TIA is often an indicator that a future stroke is imminent and requires immediate medical and lifestyle attention — so don’t ignore one. Approximately one-third of people who have a TIA will experience another stoke, with the risk highest in the first 48 hours.
All three of these strokes have the same symptoms. It’s important to take them seriously and follow up to determine and address the underlying triggers.
The National Stroke Association uses the acronym FAST to help recognize symptoms of a stroke in yourself or others, which are defined below.
- F for Face: This assesses drooping on either side of the face.
- A for Arms: This assesses if you can keep your arms lifted or if one lowers on its own.
- S for Speech: This assesses if you have any trouble talking or slurring of speech.
- T for Time: This indicates the urgency of a stroke. Call 9-1-1 immediately if any of these symptoms occur.
Other stroke symptoms may include sudden confusion, difficulty walking or seeing, and severe headaches. FAST also reminds you that the faster the stroke is identified and treated, the better chance of reducing long-term, severe disability.
Who Can Have a Stroke?
Understanding the risk factors and symptoms of a stroke is critical because they can occur at any age. An estimated 10-15% of all strokes occur among young people, who have higher death and long-term disability risk.
Furthermore, your risk of having a stroke increases after you have already experienced one. One 2020 UK-based study found that while some risk of 5-year stroke recurrence decreased in the early 2000s, the risk has remained unchanged over the last decade. The authors noted that most cardioembolic or hemorrhagic strokes that reoccur are of the same type of stroke. This finding suggests that there are not enough preventive practices in place.
Studies show that primary prevention to reduce stroke risk factors is imperative and integral in both adults over and under 65 years of age. The three most common risk factors for stroke in the young are current smoking habits, abnormal lipid values, and high blood pressure.
Identifying risk factors, which we will discuss next, is a crucial step in stroke prevention because you can target these factors directly. This also includes bringing abnormal lab work to optimal levels, which can be done with the help of a cardiology dietitian.
Stroke Risk Factors
The Centers for Disease Control and Prevention indicate that up to 80% of strokes are preventable through science-based lifestyle medicine. Research has shown that the most common type of stroke, an ischemic stroke, is preventable.
Wondering how to avoid a stroke? Healthy lifestyle habits like regular physical activity, stress management, not smoking, and eating a nutrient-rich diet can help prevent blood clots and strokes. These practices can support normal circulation and cardiovascular health, keeping plaque from building up and blood from coagulating when it’s not supposed to.
There are modifiable and unmodifiable stroke risk factors. Unmodifiable stroke risk factors are the ones you don’t have any control over, including:
- Family history of a stroke or transient ischemic attack
On the other hand, there are modifiable risk factors for stroke, which are controllable through science-based lifestyle implementation, such as:
- High blood pressure
- Atrial fibrillation (Afib)
- Uncontrolled blood sugar levels
- High LDL cholesterol
- Overweight or obesity
- Lack of physical activity
- Unmanaged stress and depression
- Unhealthy diet
- Inflammation from chronic disease
- Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as over-the-counter ibuprofen, naproxen, and prescription NSAIDs
6 Foods That Prevent Stroke
If you are looking to prevent strokes or lower your risk of a second stroke, what should you eat?
Below is a list of six foods that can help reduce your risk of having a stroke as well as help support stroke recovery. Note that this is not an exhaustive list but one for inspiration.
Many other foods need to be incorporated into your overall diet to help with primary and secondary stroke prevention. But these are some foods that provide the nutrients you need for overall wellness.
Flaxseeds are a rich source of alpha-linolenic acid (ALA), a plant-based omega-3 fatty aci. They are also a source of lignan and phytosterols, plant compounds that have been shown to reduce inflammation. Flax seeds decrease several pro-inflammatory agents in the body, which reduces inflammation associated with plaque buildup in the arteries. Lowering inflammation and atherosclerosis reduces your risk of heart attacks and stroke.
Because flaxseeds contain soluble and insoluble fiber, they may also help with bowel regularity. Why does that matter with stroke risk?
The Ohsaki cohort study looked at 45,000 men and women aged 40-79 years old over 13 years to assess bowel movement frequency and risk of dying of cardiovascular disease. Those who defecated 1 time every 2-3 days had a 21% increased risk of dying from cardiovascular disease. And those who defected 1 time or less every 4 days had a 39% increased risk of dying from heart disease, especially from a stroke.
Having regular bowel movements is imperative to primary and secondary stroke prevention. To reap the full benefits of flaxseeds, they should be consumed ground. Once ground, they should be stored in the freezer to avoid oxidation and protect their potent antioxidant properties.
You can sprinkle ground flaxseeds on oatmeal, yogurt, and breakfast cereal or add them to smoothies. Use it to make a vegan egg replacer. Start by mixing 1 Tbsp ground flaxseed with 2 Tbsp water to make the equivalent of one egg in recipes for baked goods.
Kefir is a fermented milk drink made using a culture of yeasts with bacteria, similar to thin yogurt. Made from kefir grains, it’s a rich source of vitamin D and probiotics, which play a role in heart function and primary and secondary stroke prevention.
Kefir is known to have a sour flavor that may be an acquired taste for some people. Many people enjoy drinking it on its own. Others add it to smoothies, or cold soups that don’t require heating. It can even be used in place of milk on cereal.
In one large population study, white fruit and vegetable consumption decreased the risk of stroke by 9% for every 25gm/day increase in these specific foods — primarily apples and pears. Why? Apples are a rich source of dietary fiber and a flavanol called quercetin.
Quercetin has been shown to:
- Improve endothelial function (what lines the insides of the heart and blood vessels), which allows for better blood flow and therefore decreases blood pressure.
- Increase nitric oxide production, allowing blood vessel dilation and, therefore, better blood flow.
- Lower oxidative stress, allowing for lower inflammation and better blood flow. Optimizing your arterial function is imperative in primary and secondary stroke prevention.
Apples are a perfect handheld snack for any time of the day. Pair apple slices with nut or seed butter for a dose of fiber, protein, and omega-3 fats.
Garbanzo beans, or chickpeas, are a rich source of vitamin B6, as well as fiber and protein. Research has found that a diet that regularly incorporates legumes, like chickpeas, is associated with better cardiovascular outcomes.
You can find chickpeas either dried or canned. If dried, all you have to do is soak them overnight before cooking them the next day. If canned, simply drain and rinse them before using them. Add chickpeas to salads and soups, mash them with ingredients to make chickpea salad sandwiches, or try them seasoned and roasted for a crunchy snack.
Some people avoid them because they tend to stain, but beets are jam-packed with potassium and folate, which are cardioprotective. They’re also a naturally rich source of dietary nitrates, which help support healthy blood vessels and circulation.
Research shows that beets can help support healthy blood pressure levels, which are a significant risk factor for stroke. When dietary nitrates from foods like beets are consumed, they are converted to nitric oxide, which is a colorless gas that helps keep your blood vessels dilated.
Add grated beets to your salads and sandwiches. Try them steamed or roasted in the oven or cook and blend them into a flavorful dip.
Studies show that muscle potassium will not normalize unless magnesium is sufficient, so it’s important to get enough of this nutrient from foods like quinoa. One cup of quinoa has 118 mg of magnesium, which is 30% of the recommended dietary intake. It’s also a good source of protein and fiber.
Try quinoa anywhere you’re used to using rice or other grains. You can prepare it with broth for a savory dish or milk for a mildly sweet breakfast dish. Quinoa works nicely in grain salads, added to soups, or as a filling in burritos.
Diet for Stroke Patients
Nutrition is key for preventing and recovering from a stroke, as well as supporting cardiovascular health in general. Eating a healthy, nutrient-rich diet is one of the most important and impactful things someone can do after having a stroke. After all, food is how we fuel our bodies to protect our health from the inside out.
If you are a stroke patient or are caring for one, below is a simple list of food for stroke patients that may be helpful. Use this list as a benchmark for the types of foods to eat for stroke recovery. Feel free to adjust this list accordingly for personal needs and preferences.
- Water as the predominant beverage
- Whole grains, like quinoa, brown rice, whole-wheat pasta, barley, amaranth, millet, and oats
- Fruits, like bananas, apples, oranges, pears, peaches, grapes, berries, tomatoes, and avocados
- Vegetables, like broccoli, cauliflower, spinach, kale, potatoes, sweet potatoes, eggplant, carrots, peppers, and mushrooms
- Nuts, like cashews, walnuts, almonds, pecans, pistachios, and Brazil nuts
- Seeds, like flaxseeds, chia seeds, hemp seeds, pumpkin seeds, and sunflower seeds
- Legumes, including beans, peas, lentils, and peanuts
- Fatty fish, like tuna, salmon, mackerel, and herring
- Lean proteins, such as soy foods and poultry
Protecting Yourself from Stroke with Nutrition
Nutrition has a vital role in primary and secondary stroke prevention. Eighty percent of heart attacks and strokes are preventable through science-based nutrition and lifestyle medicine. As a Preventive Cardiology Dietitian, I devote my energy and time to science-based practice. I use this knowledge and experience to help you create a personalized plan for optimal health and longevity, free of chronic disease or complications.
I work very closely with all my clients to achieve adequate macronutrient, vitamin, and mineral intakes for their bodies to thrive. My goal with all my programs is to reduce inflammation (the hallmark of most diseases), optimize blood values, and most importantly for you to FEEL GREAT every day.
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** This article is for informational purposes and not a substitute for individualized medical advice or treatment. Always seek the advice of a qualified health professional with any questions you may have regarding your health.
1. American Stroke Association. “Stroke Symptoms.” https://www.stroke.org/en/about-stroke/stroke-symptoms. Accessed April 25, 2020.
2. Flach C, Muruet W, Wolfe CDA, Bhalla A, Douiri A. Risk and Secondary Prevention of Stroke Recurrence: A Population-Base Cohort Study. Stroke. 2020;51(8):2435-2444. doi:10.1161/STROKEAHA.120.028992
3. American Stroke Association. “Ischemic Stroke (Clots).” https://www.stroke.org/en/about-stroke/types-of-stroke/ischemic-stroke-clots Accessed April 25, 2020.
4. American Stroke Association. “Hemorrhagic Stroke (Bleeds).” https://www.stroke.org/en/about-stroke/types-of-stroke/hemorrhagic-strokes-bleeds Accessed April 25, 2020.
5. American Stroke Association. “TIA (Transient Ischemic Attack).” https://www.stroke.org/en/about-stroke/types-of-stroke/tia-transient-ischemic-attack. Accessed April 25, 2020.
6. Rowat A, Graham C, Dennis M. “Dehydration in Hospital-Admitted Stroke Patients: Detection, Frequency and Association.” Stroke 2012; 43; 857-859. Doi: 10.1161/STROKAHA.111.640821.
7. Ueno Y, Miyamoto N, Yamashiro K, Tanaka R, Hattori N. Omega-3 Polyunsaturated Fatty Acids and Stroke Burden. Int J Mol Sci. 2019;20(22):5549. doi:10.3390/ijms20225549
8. Saber H, Yakoob MY, Shi P, et al. Omega-3 Fatty Acids and Incident Ischemic Stroke and Its Atherothrombotic and Cardioembolic Subtypes in 3 US Cohorts. Stroke. 2017;48(10):2678-2685. doi:10.1161/STROKEAHA.117.018235
9. D’Elia L, Barba G, Cappuccio F, Strazzullo P. “Potassium Intake, Stroke, and Cardiovascular Disease: A Meta-Analysis of Prospective Studies.” Jrnl Am Coll Card. 2011: 57; 10: 12010-1219. Doi 10.1016/j.jacc.2010.09.070
10. DiNicolantonio, J. J., Liu, J., & O’Keefe, J. H. (2018). Magnesium for the prevention and treatment of cardiovascular disease. Open Heart, 5(2), e000775. https://doi.org/10.1136/openhrt-2018-000775
11. He FJ, Nowson CA, MacGregor GA. Fruit and vegetable consumption and stroke: meta-analysis of cohort studies. Lancet. 2006;367(9507):320-326.
12. Honkura K, Tomata Y, Sugiyama K, Wantanabe T, Zhang S, Sugawara Y, Tsuji I. “Defecation frequency and cardiovascular mortality in Japan: The Ohsaki cohort study.” Atherosclerosis (Mar 2016). 246; 251-256. Doi: 10.1016/j.atherosclerosis.2016.01.007
13. National Heart, Lung, and Blood Institute. “Stroke.” https://www.nhlbi.nih.gov/health-topics/stroke. Accessed April 25, 2020.
14. Poole K, Loveridge N, Barker P, Halsall D, Rose C, Reeve J, Warburton E. “Reduced Vitamin D in Acute Stroke.” Stroke 2005: 243-245. Doi: 10.1161/01.STR.0000195184.24297.cl1.
15. Seth, A., Mossavar-Rahmani, Y., Kamensky, V., Silver, B., Lakshminarayan, K., Prentice, R., Van Horn, L., & Wassertheil-Smoller, S. “Potassium intake and risk of stroke in women with hypertension and nonhypertension in the Women’s Health Initiative.” Stroke, 45(10), 2874–2880. https://doi.org/10.1161/STROKEAHA.114.006046
16. Smajlović D. Strokes in young adults: epidemiology and prevention. Vasc Health Risk Manag. 2015;11:157–164. doi:10.2147/VHRM.S53203
17. Threapleton DE, Greenwood DC, Evans CE, et al. Dietary fiber intake and risk of first stroke: a systematic review and meta-analysis. Stroke. 2013;44(5):1360-1368
18. Bouchenak M, Lamri-Senhadji M. Nutritional quality of legumes, and their role in cardiometabolic risk prevention: a review. J Med Food. 2013;16(3):185-198. doi:10.1089/jmf.2011.0238
19. Bonilla Ocampo DA, Paipilla AF, Marín E, Vargas-Molina S, Petro JL, Pérez-Idárraga A. Dietary Nitrate from Beetroot Juice for Hypertension: A Systematic Review. Biomolecules. 2018;8(4):134. doi:10.3390/biom8040134
20. Bailey JC, Feelisch M, Horowitz JD, Frenneaux MP, Madhani M. Pharmacology and therapeutic role of inorganic nitrite and nitrate in vasodilatation. Pharmacol Ther. 2014;144(3):303-320. doi:10.1016/j.pharmthera.2014.06.009
21. Larsson S, Orsini N, Wolk A. “Dietary magnesium intake and risk of stroke: a meta-analysis of prospective studies.” Am J Clin Nutr. 2012;95:(2) 362–366, https://doi.org/10.3945/ajcn.111.022376.