"An apple a day keeps the doctor away." Sometimes old sayingshave some truth to them. This old saying could be changed to"A serving of fruit a day keeps the heart attacks and strokesaway." And, it turns out, the more servings the better!
Many studies have shown that eating fruits and vegetables isgenerally a healthy thing to do. This habit also reduces therisk of suffering from heart disease. In this issue of Neurology,a group of physicians in France looked for evidence that eatingfruits and vegetables also decreases the risk of suffering stroke(or brain attack).1 More information about stroke can be foundon the next page.
The researchers performed a meta-analysis of studies that examinedwhether or not fruit and vegetable intake lowered the risk ofstroke. A meta-analysis uses information from existing studiesdone in a similar way to answer the same question. The goalof meta-analyses is to combine all of the information from thesestudies to get more accurate results than are possible fromany of the individual studies.
This particular meta-analysis included studies with the followingcharacteristics:
Prospective studies (for example, a group of subjects is selectedand watched for a decade).
Studies including stroke or brainattack.
Studies in which the amount of fruit and vegetablesconsumedcould be calculated (portions per day).
The researchers found seven studies between 1970 and 2004 withthese characteristics. They studied a total of 232,049 patients(90,513 men and 141,536 women), with ages between 25 and 103years. Five studies were from the United States, one was fromEurope, and one was from Japan.
Figure. Risk reduction of stroke byconsumption of daily portions of fruit and fruit-vegetables.Risk reduction of stroke for one portion increment per day of"fruit and vegetable" (top) and fruit (bottom). Results forvegetable consumption are not shown, since some articles showeda positive effect (benefit) but one showed a negative effect.Results for vegetable consumption are considered nonsignificantwith respect to risk of stroke.
The combined information from the seven studies showed thateating fruit reduced the risk of having a stroke. Each additionalserving of fruit consumed per day decreased the risk of strokeby 11%. When looking at "fruit and vegetable" intake together,each additional serving eaten per day decreased the risk ofstroke by about 5% (half of the reduction in risk of strokeprovided by eating fruit). The reduction in the risk of strokeby intake of vegetables alone was not large enough to be consideredimportant.
How could eating fruit and vegetables prevent stroke?
This positive effect of eating fruit may be due to the positiveeffect it has on blood pressure and high cholesterol. High bloodpressure and high cholesterol are strong risk factors for stroke.The results also suggest that the more fruit, the better!
A stroke, or brain attack, is caused by the sudden loss of bloodflow to the brain or bleeding inside the head. A stroke cancause brain cells to die. This damage can cause paralysis, speechproblems, loss of feeling, memory and reasoning problems, coma,and possibly death. Fortunately, there are effective ways toprevent stroke. If you develop a stroke, seeking immediate medicalattention can help reduce your chances of death and disability.
Every year, about 750,000 people in the United States suffera stroke and about 160,000 die. Stroke is the nation’snumber three killer after heart disease and cancer. Stroke isthe number one cause of adult disability.
Call 911 immediately if you or someone you know experiencesany of the above warning signs. Jot down the time the symptomsstarted. Sometimes these warning signs last for only a few minutesand then stop. But, even if that happens or if you feel better,call 911 for help.
Risk factors for stroke that can be treated or changed:
There are two types of stroke or brain attack. Ischemic strokeis caused by an interruption of blood flow to the brain. Hemorrhagicstroke is caused by bleeding inside the brain.
Eighty percent of all strokes are ischemic. Ischemic strokecan be caused by narrowing of the large arteries to the brain,also known as atherosclerosis. If a clot forms in the neck vessels,pieces can break off and block a brain blood vessel. Clots mayalso form in the heart and travel by blood flow to the brainvessels, where they become lodged.
Hemorrhagic stroke is caused by the bursting of a blood vesselin the brain. It accounts for 20% of strokes. Subarachnoid hemorrhageoccurs when there are weak spots on brain arteries (aneurysms)that burst and cover the brain with blood. Blood vessels inthe brain can also burst if they are weakened by high bloodpressure, diabetes, and aging.
Immediate medical care is critical for the person who is havinga stroke or brain attack. New treatments work only if givenwithin a few hours after the onset of a stroke. For example,a clot-busting drug must be given within 3 hours of stroke onset.
Some risk factors—age, sex, race, and a history of strokein the family—cannot be changed. However, many otherscan be controlled. Most controllable risk factors relate tothe health of the heart and blood vessels. The following canhelp prevent stroke:
Having regular medical checkups
Controlling high blood pressure
Not smoking, and stopping if you do
Treating heart disease,especially an irregular heartbeat calledatrial fibrillation
Improving diet: Avoid excess fat, salt, and alcohol
Exercising
Controlling diabetes
Seeking immediate medical attentionfor warning signs of stroke
Dauchet L, Amouyel P, Dallongeville J. Fruit and vegetable consumption and risk of stroke: a meta-analysis of cohort studies Neurology 2005;65:1193–1197.[Abstract/Free Full Text]
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