Dr Sarah Brewer April 08, 2019

A stroke is often thought of as affecting older people, yet around a third of the 100,000 strokes that occur each year in the UK happen to people of working age between 20 to 64 years. The good news is more people are surviving stroke than ever before and there are over 1.2 million stroke survivors in the UK.

Recovering from a stroke

Following a stroke, different people require different amounts of rehabilitation and support to return to a life that is as normal as possible. Physiotherapy, speech therapy and occupational therapy will help to restore some lost movement, speech disturbance and mobility. Try to stay patient as rehabilitation is often slow and frustrating, but it is important to remain positive as you regain your confidence. Emotional support from family and friends is vital. Together, set a daily routine that you can stick to with regular times to exercise and learn new skills. Around a third of people who survive a stroke make a significant recovery within one month. However, the brain continues to learn how to rewire itself as other parts of the brain take over some of the tasks of cells damaged by stroke. This means improvements can continue for months or even years afterwards.

Diet and stroke

You can aid your recovery and reduce your risk of another stroke through diet and lifestyle approaches. Studies looking for dietary links with stroke have found that a high consumption of nuts, fruits, vegetables, dairy foods, fish and tea, and moderate consumption of coffee and chocolate have a protective effect against stroke, while a high consumption of red and/or processed meat was associated with increased stroke risk1. Artificially sweetened beverages such as fizzy diet drinks also appear to increase the risk of ischemic stroke, with those with high intakes have almost a three-fold higher risk than those with low intakes, so these are best avoided2.

You may be advised to follow a Mediterranean style diet to help prevent a recurrent stroke as this is especially beneficial for the circulation3. This way of eating provides plenty of fruit and vegetables, nuts, seeds, olive oil, garlic, tomatoes and oily fish, together with wholegrains and less processed carbohydrates.

Fruit and veg

Increasing your intake of fruit and vegetables to 5 or 6 portions daily was found to reduce the risk of stroke by up to 30% as they contain antioxidant vitamins, potassium, calcium, magnesium, fibre and other substances that lower blood pressure and cholesterol levels. Even if you don’t manage to eat five servings of fruit and veg a day, increasing your usual intake by just one serving per day can lower your risk of a stroke by around.

Opt for fish

Eating fish once or twice a week can reduce the risk of a stroke by reducing inflammation and helping to reduce abnormal blood clotting. A recent review of the latest evidence found that those with the highest intake of oily fish were 12% less likely to experience a stroke than those with the lowest intakes, while those with the highest of lean fish were 19% less likely to experience a stroke4. Other studies have not found a significant benefit, however, so more research is needed to confirm this.

Guard against iron deficiency

Researchers have found that a lack of iron doubles the risk of an ischaemic stroke. This is partly because lack of iron makes the blood more sticky to promote the formation of unwanted blood clots, and partly because iron deficiency anaemia reduces the amount of oxygen that is carried in the circulation to supply brain cells. Iron is found in meat (in the most easily absorbed form of haem-iron) and in plant foods such as wheatgerm, wholemeal bread, green vegetables and dried fruit. The latest UK National Diet and Nutrition Survey found that 27% of women and 2% of men have worryingly low levels of iron (below the amount needed to prevent deficiency disease). Ask your doctor if you could be iron deficient. Vitamin C helps to boost iron absorption5.

Guard against calcium deficiency

Calcium helps to lower blood pressure as it is needed for interactions between nerve signals and blood vessels that cause them to dilate. Ten studies involving 371,495 people found that a high dairy calcium intake was significantly associated with an approximately 24% reduction of stroke risk6. NB It’s also important to ensure good intakes of vitamin D (eg from oily fish) and vitamin K2 (eg from cauliflower and green vegetables) as these regulate the deposition of calcium away from arteries towards the bones.

Cut back on salt

It’s also important to reduce your intake of salt as a high salt intake has harmful effects on the circulation, causing blood pressure to rise. The results from 12 studies, involving 225,693 people, who were followed for up to 19 years, shows that a high salt intake increased the risk of a stroke by 34% compared with a low salt intake7.

Helpful supplements

Omega-3 – are a useful option for those who do not eat the recommended 2 servings of fish per week, of which one is oily.

Vitamin C – is needed to make collagen to repair blood vessels and acts as an antioxidant to reduce inflammation. Research suggests that people with high dietary intakes of vitamin C were 9% less likely to have a stroke than those with low levels. When blood levels were tested, those with the highest blood levels of vitamin C had a 38% lower risk of stroke. For each 100 mg/day increase in dietary vitamin C intake, the risk reduced by 17%8. Vitamin C is found mainly in fruit and veg, especially citrus, berries, kiwi, mango, bell peppers and dark green leaves. Supplements are also available, including combinations of vitamin C with other fruit antioxidants known as citrus bioflavonoids.

Vitamin D – helps to regulate the deposition of calcium in bones to reduce the amount of calcium laid down in artery walls. This helps to improve blood pressure control and maintain healthy blood flow to the brain. Data from 10 studies, involving over 58,000 people found that those with the highest vitamin D blood levels were up to 82% less likely to have a haemorrhagic stroke than those with low levels9.

Magnesium – helps to lower blood pressure and reduces arterial spasm. The results from eight studies, involving 304,551 people, found that those with the highest magnesium intake had an 11% reduced risk of stroke. Magnesium is found in beans (especially soy), nuts, wholegrains, seafood and dark green leaves. Even so, the latest National Diet and Nutrition Survey found that, overall, 13% of adults have intakes below the lower reference nutrient intake (LRNI) putting them at risk of deficiency symptoms.

N.B. If you are taking any prescribed medicines, it is important to speak to your doctor before taking supplements.

Other lifestyle tips to aid stroke recovery

  • If you smoke do your utmost to stop.
  • Keep alcohol intake within recommended limits.
  • Maintain a healthy weight.
  • Exercise regularly – your physiotherapist can provide advice on the best types of exercise depending on your mobility.
  • If you have high blood pressure, monitor it at home and visit your doctor if it is not at your goal level despite taking any anti-hypertensive medication.

For more information on stroke and a range of other heart conditions, visit our heart health hub, where you’ll find a number of articles to help you maintain a healthy heart.


References
1Deng, C (2018). Stroke and food groups: an overview of systematic reviews and meta-analyses, Public Health Nutr.
2Pase, MP (2017). Sugar and artificially sweetened beverages and the risks of incident stroke and dementia: a prospective cohort study, Stroke
3Isabel, C (2016). Stroke prevention, Presse Med
4(2018). Effects of fatty and lean fish intake on stroke risk: a meta-analysis of prospective cohort studies, Lipids Health Dis
5Kaiafa, G (2017). Anemia and stroke: Where do we stand?, Acta Neurol Scand
6Tian, DY (2017). Calcium intake and the risk of stroke: an up-dated meta-analysis of prospective studies, Asia Pac J Clin Nutr.
7Li, XY (2012). High salt intake and stroke: meta-analysis of the epidemiologic evidence, CNS Neurosci Ther.
8Guo-Chong, C(2013). Circulating Vitamin C and Risk of Stroke: A Meta Analysis of Prospective Studies, Heart Assoc
9Brøndum-Jacobsen, P(2013). 25-hydroxyvitamin D and symptomatic ischemic stroke: an original study and meta-analysis, Ann Neurol

Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn't possible, supplements can help. This article isn't intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.

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