Stroke is a leading cause of disability and death in the United States. About 795,000 people in our country have a stroke each year.1 The good news is you can take simple dietary steps to help prevent having a stroke.
A stroke occurs when blood flow to a portion of the brain is interrupted, preventing oxygen and nutrients from reaching brain tissue. About 87 percent are ischemic strokes, in which blood flow to the brain is blocked either by a clot or atherosclerotic plaque. The remaining 13 percent of strokes are hemorrhagic strokes, caused by bleeding in the brain due to the rupture of a blood vessel.1
Elevated blood pressure is the chief risk factor for both types of stroke; however, other causal factors differ between the two.1,2 There have been countless studies on dietary factors and their relationship to ischemic stroke risk. Within the past few years, new meta-analyses have strengthened these dietary links. In particular, higher fiber intake is associated with reduced risk, while higher red and processed meat intake is associated with increased risk.
Red and processed meats are calorie-dense, micronutrient-poor, saturated fat-rich foods. Another major concern regarding red and processed meats as it relates to heart disease and stroke is heme iron. The human body absorbs heme iron, the form of iron found in animal foods, more readily than nonheme iron from plant foods.
Iron is an essential mineral that transports oxygen in the blood and has many other crucial functions, but it can also promote free radical damage, called oxidative stress when excess is present. As a result, high body iron stores are associated with increased risk of chronic diseases that have an oxidative stress component: for example, diabetes, heart disease, and dementia.3-7
When it comes to increasing stroke risk, heme iron promotes oxidation of LDL cholesterol and elevates blood pressure. Several previous studies have found that higher heme iron (or red and processed meat) intake was associated with higher blood pressure, and higher nonheme iron intake (or plant food intake) was associated with lower blood pressure.8-12 However, it is not merely the high iron in meats that promote atherosclerosis; many other factors play a role, including their growth promoting effects.
Another recent meta-analysis reported on five studies of red and processed meat and stroke risk, and found substantial risk increases in ischemic stroke risk: for each 100 gram increment of red meat eaten daily there was a 13 percent increase in risk, and for every 50 grams daily intake of processed meat there was a 11 percent increase in risk. Processed meats are nutrient-poor and high in heme iron like red meat, but have additional sodium, which is likely why the authors found a steeper association of processed meats with stroke.13
Greater intake of high-fiber foods, such as beans, is consistently linked to lower blood pressure.14 Foods that are higher in fiber tend to have a lower glycemic load, which limits the rise in insulin after a meal; elevated insulin levels contribute to elevated blood pressure.
Also, high-fiber foods are usually rich in phytochemicals and minerals like potassium and magnesium, which help to keep blood pressure in a healthy range. 15-21 In addition to reducing blood pressure, high fiber foods improve several factors relevant to atherosclerotic plaque formation, such as cholesterol and triglyceride levels.22-24
A recently published meta-analysis on fiber intake and risk of stroke analyzed data from six prospective studies, including over 300,000 subjects.25 In this analysis, for every 10 gram increase in daily fiber intake, there was a 12 percent reduction in risk. A previous analysis of data from ten studies found that each 10 gram/day increase in fiber intake was associated with a 24 percent decrease in risk of death from heart disease.26
Ten grams is the approximate amount of fiber contained in 2/3 cup of beans or lentils, 2 cups of cooked collard greens, or 2 1/2 cups of blueberries. The average daily intake of fiber in the U.S. is a meager 16 grams,27 whereas a Nutritarian diet, depending on one’s caloric needs, provides about 60-80 grams of fiber daily.
I want to make it clear that it is the use of high fiber from whole foods that enable this degree of protection against stroke, not adding fiber to a standard American diet. It is more than just the fiber in fiber-rich foods that offers this protection.
The studies mentioned here add to the already huge body of evidence showing that whole plant foods are health-promoting, while red and processed meats are disease-causing. Between the excessive amounts of protein and heme iron, new findings on detrimental effects of red meat compounds Neu5GC28 and carnitine,29 and the volume of evidence linking red and processed meats to cancer and premature death,30-37 there is no question — these are dangerous foods. People who still desire to eat meat, should eliminate processed meats entirely and think of using red meat in their meal in small amounts as a condiment, only to be used once a week.
Mozaffarian D, Benjamin EJ, Go AS, et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation 2016, 133:e38-e360.
He FJ, MacGregor GA. A comprehensive review on salt and health and current experience of worldwide salt reduction programmes. J Hum Hypertens 2009, 23:363-384.
Luan de C, Li H, Li SJ, et al. Body iron stores and dietary iron intake in relation to diabetes in adults in North China. Diabetes Care 2008, 31:285-286.
Rajpathak SN, Crandall JP, Wylie-Rosett J, et al. The role of iron in type 2 diabetes in humans. Biochim Biophys Acta 2009, 1790:671-681.
de Oliveira Otto MC, Alonso A, Lee DH, et al. Dietary intakes of zinc and heme iron from red meat, but not from other sources, are associated with greater risk of metabolic syndrome and cardiovascular disease. J Nutr 2012, 142:526-533.
Ahluwalia N, Genoux A, Ferrieres J, et al. Iron status is associated with carotid atherosclerotic plaques in middle-aged adults. J Nutr 2010, 140:812-816.
Brewer GJ. Iron and copper toxicity in diseases of aging, particularly atherosclerosis and Alzheimer's disease. Exp Biol Med 2007, 232:323-335.
Kiechl S, Willeit J, Egger G, et al. Body iron stores and the risk of carotid atherosclerosis: prospective results from the Bruneck study. Circulation 1997, 96:3300-3307.
Steffen LM, Kroenke CH, Yu X, et al. Associations of plant food, dairy product, and meat intakes with 15-y incidence of elevated blood pressure in young black and white adults: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Clin Nutr 2005, 82:1169-1177; quiz 1363-1164.
Tzoulaki I, Brown IJ, Chan Q, et al. Relation of iron and red meat intake to blood pressure: cross sectional epidemiological study. BMJ 2008, 337:a258.
Wang L, Manson JE, Buring JE, Sesso HD. Meat intake and the risk of hypertension in middle-aged and older women. J Hypertens 2008, 26:215-222.
Miura K, Greenland P, Stamler J, et al. Relation of vegetable, fruit, and meat intake to 7-year blood pressure change in middle-aged men: the Chicago Western Electric Study. Am J Epidemiol 2004, 159:572-580.
Chen GC, Lv DB, Pang Z, Liu QF. Red and processed meat consumption and risk of stroke: a meta-analysis of prospective cohort studies. Eur J Clin Nutr 2013, 67:91-95.
Papanikolaou Y, Fulgoni VL, 3rd. Bean consumption is associated with greater nutrient intake, reduced systolic blood pressure, lower body weight, and a smaller waist circumference in adults: results from the National Health and Nutrition Examination Survey 1999-2002. J Am Coll Nutr 2008, 27:569-576.
Landsberg L. Insulin-mediated sympathetic stimulation: role in the pathogenesis of obesity-related hypertension (or, how insulin affects blood pressure, and why). J Hypertens 2001, 19:523-528.
Streppel MT, Arends LR, van 't Veer P, et al. Dietary fiber and blood pressure: a meta-analysis of randomized placebo-controlled trials. Arch Intern Med 2005, 165:150-156.
Houston MC. The importance of potassium in managing hypertension. Curr Hypertens Rep 2011, 13:309-317.
Houston M. The role of magnesium in hypertension and cardiovascular disease. J Clin Hypertens (Greenwich) 2011, 13:843-847.
DeFronzo RA, Cooke CR, Andres R, et al. The effect of insulin on renal handling of sodium, potassium, calcium, and phosphate in man. J Clin Invest 1975, 55:845-855.
Chiasson JL, Josse RG, Gomis R, et al. Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance: the STOP-NIDDM trial. JAMA 2003, 290:486-494.
Jenkins DJ, Kendall CW, Augustin LS, et al. Effect of Legumes as Part of a Low Glycemic Index Diet on Glycemic Control and Cardiovascular Risk Factors in Type 2 Diabetes Mellitus: A Randomized Controlled Trial. Arch Intern Med 2012:1-8.
Bazzano LA, Thompson AM, Tees MT, et al. Non-soy legume consumption lowers cholesterol levels: a meta-analysis of randomized controlled trials. Nutrition, metabolism, and cardiovascular diseases : NMCD 2011, 21:94-103.
Brown L, Rosner B, Willett WW, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr 1999, 69:30-42.
Anderson JW. Dietary fiber prevents carbohydrate-induced hypertriglyceridemia. Curr Atheroscler Rep 2000, 2:536-541.
Chen GC, Lv DB, Pang Z, et al. Dietary fiber intake and stroke risk: a meta-analysis of prospective cohort studies. Eur J Clin Nutr 2013, 67:96-100.
Pereira MA, O'Reilly E, Augustsson K, et al. Dietary fiber and risk of coronary heart disease: a pooled analysis of cohort studies. Arch Intern Med 2004, 164:370-376.
King DE, Mainous AG, 3rd, Lambourne CA. Trends in dietary fiber intake in the United States, 1999-2008. J Acad Nutr Diet 2012, 112:642-648.
Padler-Karavani V, Yu H, Cao H, et al. Diversity in specificity, abundance, and composition of anti-Neu5Gc antibodies in normal humans: potential implications for disease. Glycobiology 2008, 18:818-830.
Koeth RA, Wang Z, Levison BS, et al. Intestinal microbiota metabolism of l-carnitine, a nutrient in red meat, promotes atherosclerosis. Nat Med 2013.
WCRF/AICR Expert Report, Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective. 2007 [dietandcancerreport.org]
Lunn JC, Kuhnle G, Mai V, et al. The effect of haem in red and processed meat on the endogenous formation of N-nitroso compounds in the upper gastrointestinal tract. Carcinogenesis 2007, 28:685-690.
Kuhnle GG, Story GW, Reda T, et al. Diet-induced endogenous formation of nitroso compounds in the GI tract. Free Radic Biol Med 2007, 43:1040-1047.
Pan A, Sun Q, Bernstein AM, et al. Red Meat Consumption and Mortality: Results From 2 Prospective Cohort Studies. Arch Intern Med 2012.
Sinha R, Cross AJ, Graubard BI, et al. Meat intake and mortality: a prospective study of over half a million people. Arch Intern Med 2009, 169:562-571.
Major JM, Cross AJ, Doubeni CA, et al. Socioeconomic deprivation impact on meat intake and mortality: NIH-AARP Diet and Health Study. Cancer Causes Control 2011, 22:1699-1707.
Key TJ, Fraser GE, Thorogood M, et al. Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies. Am J Clin Nutr 1999, 70:516S-524S.
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Joel Fuhrman, M.D. is a board-certified family physician, seven-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient dense, plant-rich eating style.
For over 30 years, Dr. Fuhrman has shown that it is possible to achieve sustainable weight loss and reverse heart disease, diabetes and many other illnesses using smart nutrition. In his medical practice, and through his books and PBS television specials, he continues to bring this life-saving message to hundreds of thousands of people around the world.
*There is no guarantee of specific results. Results can vary. All material provided on the DrFuhrman.com website is provided for informational or educational purposes only. Consult a physician regarding the applicability of any opinions or recommendations with respect to your symptoms or medical condition.