Stroke



A stroke is a form of cardiovascular disease (CVD) that occurs in the brain. There are two types of stroke: ischemic (or embolic) and hemorrhagic. With ischemic strokes, there is a disruption in blood flow to the brain tissue by cholesterol plaque, clot or arrhythmia resulting in tissue damage and death. With a hemorrhagic stroke, a blood vessel in the brain starts bleeding, decreasing blood flow to the part of the brain it supplies, as well as causing accumulation of blood. Transient ischemic attacks (TIA) or “mini-strokes” produce the neurological symptoms of a stroke which resolves within 24 hours and are a risk factor for future strokes.

 
  • Overview
  • Action Plan
  • Ask The Doctor
  • Related Info
  • Success Stories

Overview


Stroke has high morbidity and mortality rates and is a major cause of disability in the U.S. Stroke symptoms can improve with a Nutritarian diet, however, prevention of CVD with a Nutritarian diet offers the greatest benefit.

An estimated 6.8 million Americans over the age of 20 have had a stroke. Stroke prevalence will increase 20.5% by 2030. Approximately 795,000 people have a new or recurrent stroke each year. On average, every 40 seconds, someone in the U.S. experiences a stroke. It is the leading cause of disability in the U.S. The direct and indirect cost of stroke in 2010 was $36.5 billion and will continue to increase each year if the poor diet and sedentary lifestyles of Americans aren’t addressed.1

Symptoms of a stroke include facial droop, visual changes, slurred speech, dizziness, loss of balance or coordination, and weakness or paralysis of extremities. A TIA can involve any of these symptoms that resolve within 24 hours.

The main cause of an ischemic or embolic stroke is the Standard American Diet, which is low in vitamins, minerals, and antioxidants but high in inflammatory animal products and refined/processed foods. This leads to inflammation, oxidative stress, and immune dysfunction that promote vascular damage. Strokes are associated with diseases that are a result of poor diet such as high blood pressure, high cholesterol, diabetes, atrial fibrillation, and chronic kidney disease. Tobacco use and a sedentary lifestyle also contribute to stroke risk. Hemorrhagic strokes have a different constellation of risks, including salt, medications, and alcohol use and a low cholesterol level versus a high cholesterol level for ischemic stroke.

 
References
  1. Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation 2014, 129:e28-e292.

Action Plan


Diet

  • A Nutritarian diet with a variety of green and non-green vegetables, fruits, beans, nuts, and seeds will supply the body with a large range of vitamins, minerals, and phytochemicals which will promote vascular health by decreasing inflammation, oxidative stress, and plaque burden.
  • Nuts and seeds are associated with lower rates of stroke and sudden cardiac death.
  • Patients should reduce or avoid animal products, as these supply the majority of trans and saturated fats in the diet. This promotes inflammation and damage to blood vessels.
  • Medications need to be adjusted, as glucose and blood pressure will lower drastically on a Nutritarian diet with little added salt.
  • Long term adherence to a Nutritarian diet will lower clot risk over time. The benefit: risk ratio for blood thinners will need to be evaluated by your physician.

Exercise

  • Together, a Nutritarian diet, salt reduction, and aerobic exercise can significantly lower the risk of CVD disease. Patients need a personalized exercise program that allows them to gradually increase exercise tolerance.
  • Post-stroke weakness may improve over time with continued therapy and strict adherence to a Nutritarian diet.

Tobacco cessation

Tobacco use increases CVD risk by increasing oxidative stress leading to arterial lining damage and hardening of the vessels. Smokers have a two- to fourfold increased risk of stroke compared to lifelong nonsmokers or those who quit smoking more than 10 years prior.1

 
References
  1. Shah RS, Cole JW. Smoking and stroke: the more you smoke the more you stroke. Expert Rev Cardiovasc Ther 2010, 8:917-932.

Ask The Doctor


The following are sample questions from the Ask the Doctor Community Platinum and higher members can post their health questions directly to Dr. Fuhrman. (All members can browse questions and answers.)

Q.

If one has had a stroke (after atrial fibrillation) and is advised by the cardiologist to take blood-thinners the rest of their life, is there still the possibility, in your opinion and experience, to get rid of the blood-thinner?

A.

Yes, if the person gets healthy with Nutritarian eating and gets rid of their stroke risk factors. That means they have to achieve a normal weight, blood pressure, and lipid profile without medications. At that point, the risk of the blood thinning agents can be greater than the supposed benefits.

 
Q.

Dr. Fuhrman has mentioned that those who follow a Nutritarian diet have to be particularly careful not to consume excess salt because we don’t have the "benefit" of atherosclerosis protecting us from that particular effect. What is the mechanism by which excess sodium causes bleeding strokes in people who don’t have atherosclerosis? Is high blood pressure always present? Is there a lowered risk when blood pressure is normal or low despite excess sodium?

A.

Yes, there would be less risk with lower blood pressure, however, frequently, after years and years of salt intake, the sympathetic tone in the central nervous system flips and you suddenly have high blood pressure. Then, people say, "that’s strange, I always had low blood pressure my entire life and now suddenly it is running high all the time." Then, cutting back or cutting out the salt is too late. In other words, just because you have low blood pressure now, does not mean you have permission to use excess salt.

In fact, this is how most people operate. They are told by the media and health professionals they only have to watch salt intake if they have high blood pressure. Then, later in life when they develop high blood pressure, they cut back on salt, but the blood pressure does not come down from all those years of self-abuse. So, now you have a correlation between low salt intake and higher risk of cardiovascular disease from all those individuals that had a high salt intake in their past but are not using much salt once they developed serious cardiovascular pathologies.