Diabetes Self-Management Blog

According to the National Stroke Association, stroke, or “brain attack” is the third leading cause of death in the United States, killing about 137,000 people each year and leaving many seriously disabled. While the incidence of strokes has fortunately decreased, the sad reality is that almost 800,000 strokes will occur this year.

Strokes can happen to anyone, at any age, at any time. Eighty seven percent of strokes are ischemic strokes, which occur when arteries get blocked by clots or pieces of plaque, resulting in the death of brain cells. Hemorrhagic strokes, which happen when a blood vessel in the brain bursts, account for only 13% of strokes, but they cause 30% of stroke deaths.

Diabetes and Stroke
When it comes to diabetes, we often talk about the link between diabetes and heart disease, and the increased risk for a heart attack. But you should be aware that stroke is more common in people with diabetes than in those without the condition; two out of three people with diabetes die from stroke or heart disease. Risk factors for stroke include:

• Having high blood pressure
• Smoking
• Having cholesterol and blood fat levels out of target range
• Having a history of stroke or mini-strokes, called transient ischemic attacks (TIAs)
• Having a family history of stroke or TIAs

Lower Your Risk
Keeping your diabetes “numbers” (A1C, blood glucose, blood pressure, lipids) in range can help you lower your risk of stroke. If you’ve been prescribed medicine, take it. Also, controlling your weight, staying physically active, and eating right will help, too. Luckily, the steps that you take to prevent stroke can help you prevent heart disease and possibly other health problems.

Foods That Can Help
In addition to taking medicine, staying active, and doing all the other things you know you should do, you might consider some of the following, which may help you lower your risk of stroke even further:

Olive oil. Chances are, you cook with olive oil and drizzle it on your salad. If so, keep it up, because a study that looked at adults age 65 and older showed that those who regularly used olive oil in their diet had a 41% lower risk of stroke compared to those who never used olive oil.

Coffee. Are you a woman? Do you like coffee? If you answered “yes” to both questions, you may already be lowering your stroke risk. In a study of 35,000 women aged 49 to 83, women who drank more than one cup of coffee every day lowered their stroke risk by up to 25% compared to women who drank less coffee. Coffee seems to offer other health benefits, as well. But it’s too soon to actually recommend coffee drinking for this reason. And we still don’t know if the same findings apply to men.

Omega-3 fatty acids. Omega-3 fatty acids are essential fatty acids (fats that are required for good health but not made by the body) found in a variety of foods, including fatty fish (salmon, mackerel, tuna, herring), vegetable oils (canola, soybean), flaxseed, and nuts. Omega-3s are important for a number of reasons, but in terms of stroke prevention, they can help prevent blood clots and lower LDL (“bad”) cholesterol, which, in turn, means that there is less plaque build-up in artery walls. Aim to eat at least two fish meals each week, and squeeze nuts, canola oil, and perhaps some ground flaxseed (good on cereal) in your eating plan often.

Fruits and vegetables. No surprise here. You may have heard of the DASH diet, which is aimed at helping people lower blood pressure. But it goes further than that. The DASH diet, which focuses on plenty of fruits and vegetables, legumes, whole grains, lean protein foods, and healthy fats, helped women in the Nurses’ Health Study lower their risk of stroke by 18% compared to women who ate more of a typical “American” diet. It makes sense, as lowering blood pressure and cholesterol lowers the risk for both heart attack and stroke.

Mediterranean diet. In a similar vein, researchers have found that people following the Mediterranean diet (also rich in fruits, vegetables, legumes, nuts, and healthy oils, and fairly low in red meat and sodium), have fewer strokes and a longer life expectancy (along with less heart disease, cancer, Alzheimer, and Parkinson disease).

What else can you do to lessen your chances of having a stroke? You’re likely doing these things already, or at least are aware of them:

• Cut back on salt and high-sodium foods.
• Eat less saturated fat, found in whole-milk dairy foods, red meat, and fast foods.
• Be more active, aiming to do physical activity most days of the week.
• Go easy on alcohol. In some studies, drinking more than two alcoholic beverages per day raised stroke risk by 50%.
• Don’t smoke.
• Know your numbers. Ask for your blood pressure result each time it’s checked, and keep tabs on your cholesterol, triglycerides, and A1C.

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Comments
  1. Thanks for mentioning the Mediterranean diet. Reduced stroke and heart disease are primary reasons I recommend the Mediterranean diet for general public.

    The Stroke Association is a couple years behind the times if they still say stroke is the 3rd leading cause of death in the U.S. That was true for many decades.

    But in 2009, stroke slipped to 4th place as chronic lower respiratory tract diseases took 3rd.

    -Steve

    Posted by Steve Parker, M.D. |
  2. Thanks, Steve. Interestingly, though, the CDC also lists stroke as the third leading cause of death, based on 2009 stats. Chronic lower respiratory disease is listed as 4th.

    Posted by acampbell |
  3. I had a stroke before I had diabetes. After they told me to cut my sodium in take to 1500 mg a day. That is a chore but it is still to much for me. If I eat more than 700 to 800 mg a day my blood pressure goes right up.

    I was in the hospital recently and I told everyone I saw that I needed lots less sodium than they were feeding me. On the third night I awoke with a horrible headache. They gave me pain meds (which done’t work for this kind of pain very much). Early in the morning when they took my blood pressure it was 195/96. it was 220/110 when I had my stroke.

    They asked my why, if I was taking my blood pressure meds and I was, was it so high? Sodium intake. Luckily I was allowed to go home that day. but that hospital says low sodium is 2000 mg. Yikes.

    At home I eat only natural food, absolutely no processed foods. It is the only way I can keep my BP down.

    Posted by Lynda |
  4. What is it in coffee that helps lower stroke risk? I can’t drink it because it makes my heart race. Even tea does that. I just can’t drink beverages with caffeine in them. My mother was told to drink de-caf after she had two strokes so if it is the caffeine that helps prevent strokes, the doctor was in error.

    Posted by Becky |
  5. Hi Becky,

    Researchers aren’t sure yet what it is in coffee that may lower stroke risk. It could be caffeine or it could be antioxidants or other substances in coffee that have a protective effect. The study didn’t look at decaf coffee, so we don’t know if decaf offers the same benefit. Remember, though, that many other, more important factors can help lower stroke risk, such as controlling blood pressure and blood glucose, losing weight, if you need to, and not smoking.

    Posted by acampbell |
  6. Just wanted to let you know that guys read this too.

    Posted by Bob |
  7. That’s great, Bob! Thanks for letting me know.

    Posted by acampbell |
  8. In Dec. 2011, I was diagnosed w/ “Congenital Heart Prblem, which meant I had to cut down on my SALT intake (no more than 1500mg/ day, I was already an “old” Type I diabetic, so I have been living my life on a “reduced” if non-existent sugar intake. I AM WINNING. I’m careful about what I eat when I eat out (many of the FAST Food places I visit now have “Nutritional value menus
    which I use to select the “lowest value sodium dishes to order, while keeping an eye on sugar content. I try to eat at home most of the time, where I can cook what I want I’m big on fresh fruit and vegetables. I snack regularly during the day (non-salted pistachios are a favorite.
    i WATCH my weight, and I’m feeling great.
    Any comments will be appreciated.

    Posted by Bob Weiss |
  9. Thanks, Bob. It seems like you have a plan that works for you, and you make a great point about cooking meals for yourself: you have control over what you prepare and how much you eat. And pistachios make a great snack, by the way, as long as you can limit the portion!

    Posted by acampbell |
  10. Here’s the link to CDC showing that chronic lower respiratory tract disease surpassed stroke in 2009: http://www.cdc.gov/nchs/fastats/deaths.htm

    137,353 lung problem deaths versus 128,842 stroke-related.

    Huge government beaurocracies often have trouble keeping up with their data. That’s my job.

    Sorry to bore most of you!

    -Steve

    Posted by Steve Parker, M.D. |
  11. hi,
    my dad recently went through a stroke(mini stroke, that’s what they call it) he is an old patient of diabetes and is undergoing physiotherapy for more than a month now.he’s having loads of medicine, both for diabetic and stroke. i dont see much improvement even after the therapy,i would be really grateful if someone recommends me some healthy food he can have at home. something which is easy to make and available. :)

    Posted by hazel |
  12. For Hazel:

    All I can do is share what I did in my case - 30 year type 2 and had stroke in 2007.

    First off, one needs to get the calories from carbs - bread, grains, rice, starches hauled back.

    The second key tennent is portion control.

    I ended up cutting my diet back to 1200 calories.
    Vegetables and proteins

    Skip pasta, look into mediterranean style diets.
    See Dr. Parker’s mediterranean web site.

    Others may have actual targeted dishes for you.

    Up ones exercise if at all possible - ie walking.
    I ended up walking 1 and 1/2 miles walking and initally was using walker in early stages.

    Check with Amy Campbell here at this web site.

    Posted by jim snell |
  13. thanx alot jim snell :)

    Posted by hazel |

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