Diet and Exercise, Cheaper Than Drugs in Stroke Prevention [Video]


Adopting a healthier diet and regular exercise have been touted as effective routes to stroke prevention by many health professionals, and they are much cheaper than taking drugs. The American Heart Association predicted that the cost of stroke care and treatment will  more than double in the next 20 years, raising the price from over $71 billion in 2010 to more than $183 billion. Hispanic men and women have the highest projection of increase, with the cost of treating stroke in Hispanic women tripling by 2030.

A recent Chinese study, led by Dr. Yan Qu from the Medical College of Qingdao University in China, analyzed 20 previous studies that examined the relationship between stroke risk and plant-based diets among different populations in the world in the past couple of decades. Some studies show significantly lowered risk of stroke associated with a high intake of vegetables and fruits. Some of the studies did not show any associations.

Qu wrote in an email to Reuters that a high fruit and vegetable intake could have an indirect effect in reducing stroke risk by reducing blood pressure, cholesterol levels, and other stroke risk factors. He also said that specific nutrients in certain foods may reduce the risk of stroke. Overall, people in the analysis who ate the most fruits and vegetables lowered their chances of having a stroke by 21 percent. The researchers found that stroke risk drops by almost one-third for every 200 grams of fruit intake per day, and 11 percent with every 200 grams of vegetables. Green leafy vegetables, apples, pears, and citrus fruits were directly linked to reduced stroke risk.


However, no stroke prevention plan is complete without regular exercise combined with diet. Investing in either a gym membership, a qualified personal trainer, or some simple exercise equipment at home (i.e. dumbbells, medicine balls, kettlebells, jump rope) could be cheaper than taking drugs or having surgery. In fact, a recent study published in the October 2013 issue of the British Medical Journal showed that regular exercise could be better than drugs in determining stroke mortality.

Dr. John Ioannidis from Stanford University’s School of Medicine and Dr. Huseyin Naci from LSE Health in the U.K. analyzed 16 meta-analyses (12 drug and four exercise). Although they found no significantly detectable differences between exercise and drug interventions for heart disease and pre-diabetes secondary prevention, they found that exercise was more effective than drug treatments in stroke patients. However, the number of exercise studies was much fewer than the drug studies, possibly leading to different outcomes than with a larger sampling.

Ioannidis and Naci noted that there were 57 exercise trials, with a total of more than 14,700 participants. Based on the evidence available, exercise may be just as beneficial as drug treatments in reducing stroke mortality.

The timing of exercise intervention is also another factor to consider in lowering risk stroke. A systematic review and meta-analysis of 11 studies published in the June 2012 issue of BMC Neurology examined the effectiveness of early cardiovascular exercise within six months after a stroke. Although the researchers concluded that stroke survivors had increased their walking distance and oxygen uptake, they were not clear about the amounts and types of exercise that patients need to do to prevent further stroke complications.

Even though exercise and diet are cheaper alternatives to drugs, those who are at risk of stroke and are type 2 diabetics should not toss away their medications just yet. According to the John Hopkins Medicine website, overweight, type 2 diabetic patients between the ages of 45 and 76 did not reduce their risk of stroke or heart attack after they had lost weight. This study was based on the Look AHEAD clinical trial that studied over 5,000 overweight, diabetic patients over a period of 11 years.

This does not mean that diabetics who are at risk of stroke and heart disease should not adopt a healthier diet and lifestyle, said Dr. Jeanne Clark, M.D., and Dr. Frederick Brancati, M.D., from the Johns Hopkins University School of Medicine. Patients had lower blood sugar, blood pressure, and depression levels with proper diet and exercise.

By Nick Ng
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American Heart Association
British Medical Journal
BMC Neurology
John Hopkins Medicine

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