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Stroke is Increasing in Young People

circulation imageStroke is the fourth leading cause of death in the U.S. and a leading cause of long-term disability.1 Similar to type 2 diabetes, stroke has been considered a disease of old age, but now this lifestyle disease is afflicting younger people as well. These diseases come about due to the accumulated effects of years of poor diet and lifestyle habits. As the standard American diet has deteriorated, these damaging effects are amplified and have begun to start earlier in life. Today’s young adults were raised in the era of processed and fast foods, and as a result they will face an even greater risk of chronic disease as they age than their parents are facing today.

Nutrient-poor diets and sedentary behavior have fueled rising obesity rates and increased prevalence of risk factors for heart disease and stroke. A 2012 survey found that half of overweight teenagers and more than one-third of normal-weight teenagers had at least one cardiovascular risk factor. Twenty-three percent of teens overall were prediabetic or diabetic, 22 percent had high or borderline high LDL cholesterol, and 14 percent had hypertension or prehypertension.2 Among 24-32 year-olds, it has been reported that 19 percent have hypertension. In light of these numbers, it is worth noting that hypertension is the primary risk factor for stroke, with elevated blood pressure responsible for 62% of strokes.1,3,4,5

With increased prevalence of these risk factors, an increase in the incidence of heart disease and stroke would be expected. Indeed, a report published in Neurology in September 2013 noted that about 15 percent of ischemic strokes (the most common type of stroke) occur in young adults and adolescents.6 That 15 percent adds up to about 119,000 strokes per year in people under the age of 45. Attention was brought to the rise in stroke among younger people in 2013 by news reports that 27 year-old actor Frankie Muniz (of “Malcom in the Middle”) has suffered his second ‘mini-stroke,’ about one year after his first.

A transient ischemic attack (TIA), known as a mini-stroke, occurs when a blood clot temporarily blocks an artery leading to the brain. A TIA lasts only a few minutes and produces temporary stroke-like symptoms that may last several hours, such as numbness or weakness of the face or an arm or leg, confusion, or trouble speaking. Though blood flow resumes relatively quickly, before there is any lasting damage to the brain, a TIA is an indicator of poor cardiovascular health and a predictor of future stroke. TIAs are also known as “warning strokes,” since about one-third of people who experience a TIA will have a stroke within one year.7 When a TIA occurs in a young person, this is a sign significant arterial damage has already occurred, which will only escalate over time without dietary changes.

Today, children become addicted to junk food at a young age and begin to show cardiovascular risk factors as teenagers, but we can start to reverse these trends by instilling healthy habits in our children from an early age. We can also protect ourselves from stroke by focusing on health-promoting foods. Higher intake of fiber-rich, mineral-rich, and antioxidant-rich foods — those central to a Nutritarian eating style — are associated with decreased risk of stroke, and higher intake of red and processed meat and soda are associated with increased risk.8,910-13


1. Go AS, Mozaffarian D, Roger VL, et al: Heart Disease and Stroke Statistics--2013 Update: A Report From the American Heart Association. Circulation 2013, 127:e6-e245.
2. May AL, Kuklina EV, Yoon PW: Prevalence of Cardiovascular Disease Risk Factors Among US Adolescents, 1999-2008. Pediatrics 2012, 129:1035.
3. 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.
4. Nguyen QC, Tabor JW, Entzel PP, et al: Discordance in National Estimates of Hypertension Among Young Adults. Epidemiology 2011.
5. Neale T: 1 in 5 Young Adults May Have Hypertention. In MedPage Today.
6. Singhal AB, Biller J, Elkind MS, et al: Recognition and management of stroke in young adults and adolescents. Neurology 2013, 81:1089-1097.
7. American Stroke Association. TIA (Transient Ischemic Attack) [http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/TIA/TIA-Transient-Ischemic-Attack_UCM_310942_Article.jsp]
8. Chen GC, Lv DB, Pang Z, et al: Red and processed meat consumption and risk of stroke: a meta-analysis of prospective cohort studies. Eur J Clin Nutr 2013, 67:91-95.
9. Bernstein AM, de Koning L, Flint AJ, et al: Soda consumption and the risk of stroke in men and women. Am J Clin Nutr 2012.
10. Threapleton DE, Greenwood DC, Evans CE, et al: Dietary Fiber Intake and Risk of First Stroke: A Systematic Review and Meta-Analysis. Stroke 2013.
11. Larsson SC, Orsini N, Wolk A: Dietary magnesium intake and risk of stroke: a meta-analysis of prospective studies. Am J Clin Nutr 2012, 95:362-366.
12. Karppi J, Laukkanen JA, Sivenius J, et al: Serum lycopene decreases the risk of stroke in men: A population-based follow-up study. Neurology 2012, 79:1540-1547.
13. Rautiainen S, Larsson S, Virtamo J, et al: Total Antioxidant Capacity of Diet and Risk of Stroke: A Population-Based Prospective Cohort of Women. Stroke 2011.

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