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21 April 2011

Stroke and your diet

There are a number of important changes that you can make to improve your health and some of these are directly related to your eating habits.

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Step 1: Understanding the relationship between stroke, artery disease and food

Stroke is the result of either clogging of the arteries in or to the brain or rupture of arteries in the brain. Blockage of or bleeding from arteries in the brain can lead to a stroke.

Though there are some risk factors associated with stroke and artery disease that you can't change (like your age and your genes), there are still a number of important changes that you can make to improve your health.

Some of these factors are directly related to your eating habits:

  • High blood pressure: It is estimated that approximately 40% of strokes can be attributed to high blood pressure (hypertension).
  • Smoking: A smoker has a 50% greater chance of suffering a stroke.
  • Heart disease: Several heart conditions increase a person’s risk of having a stroke. These conditions include a previous heart attack causing congestive heart failure, heart-valve disease and irregular, rapid heartbeat (such as atrial fibrillation).
  • A “mini-mini stroke” or Transient Ischaemic Attack (TIA): Although a TIA lasts only a few minutes and leaves no permanent damage, between 15 and 20% of people who have a stroke previously had one or more TIAs.
  • Diabetes increases the severity of atherosclerosis or clogging of the blood vessels.
  • Obesity.
  • Use of stimulant drugs (amphetamines and cocaine).
  • High blood cholesterol levels.
  • Women who get migraines, smoke and take oral contraceptives have a high risk of having a stroke.

Step 2: Adopting new healthy habits to prevent stroke 

Controlling the risk factors that can be managed is the first step in preventing a stroke. These precautionary measures include those that should be followed to prevent a heart attack:

  • Follow a healthy diet low in salt, fat and cholesterol.
  • Don't smoke.
  • Control your weight, so it is normal for your height and build.
  • Exercise regularly.
  • Monitor your blood pressure regularly and have regular blood tests for cholesterol.
  • Make sure you take in potassium, magnesium, Vitamin E and essential fatty acids contained in fish-oils, which are good for preventing strokes. Selenium may also protect one against a stroke.
  • Women who are at high risk should not use birth-control pills.
  • Patients who have had a stroke should drink moderately – in other words, have no more than one alcoholic drink a day.
  • Maintain strict control of blood sugar in persons with diabetes mellitus.
  • Daily intake of low-dose aspirin can prevent strokes.
  • High risk patients with hyperlipidaemia need cholesterol-lowering statin therapy in conjunction with a low fat diet.

Step 3. The do’s and don’ts of eating for healthy blood vessels 

Scientists suggest a step-wise approach to lower fat intake: First to lower your fat intake to 30% of your total energy intake, then to 25% and even (with the help of a dietitian) to 20% if necessary.

The do’s 
Try to buy food with a fat content lower than 3 g/100 g.

1. Fats, oils and nuts: 

  • Limit your total fat intake to 40 – 70 g (three to four tablespoons) per day
  • Rather use the following fats, oils or nuts: Sunflower, canola, olive and soya oils
  • Soft margarines, non-stick vegetable sprays
  • Almonds, pecan, hazelnuts and peanuts in moderation

2. Meat, fish and poultry: 
Remember that meat, fish and poultry contain protein but also a lot of visible and hidden fats.

Keep the following in mind:

  • Lean cuts only
  • Portion sizes to 90 to 120g a day – about the size of your palm
  • Eat chicken without the skin
  • Eat fish at least twice a week
  • Shellfish is fine except prawns, shrimps and caviar; Tinned fish should be in water or brine

3. Lentils and dry beans: 

  • All types of lentils, peas and beans
  • Baked beans and other tinned beans are fine

4. Eggs: 

  • Use a maximum of three egg yolks a week
  • Cut down on other foods containing cholesterol if you do eat egg yolk

5. Milk and milk products: 

  • Low-fat and skim milk
  • Low-fat and fat-free yoghurt
  • Low-fat and fat-free cottage cheese
  • Low-fat buttermilk

6. Breads and cereals: 

  • Brown bread and wholewheat bread
  • Oats, oat bran and maize meal
  • High-fibre (low fat) breakfast cereals
  • Low-fat wholewheat crackers
  • Rice and pasta

7. Fruit and vegetables: 

  • Eat at least five portions of fruit and vegetables each day
  • Choose fresh fruits instead of fruit juices
  • Use avocado and olives in moderation

8. Beverages: 

  • Tea and coffee without sugar
  • Diet cold drinks, sugar-free squash
  • Use sweetened cold drinks in moderation
  • Use fruit juice in moderation
  • If you drink alcohol, no more than two drinks a day (1 drink = 340ml beer or 120ml wine or 25ml spirits). Avoid if you have high blood pressure or are overweight

9. Desserts: 

  • Choose fresh fruit, jelly, skim-milk custard
  • fat-free or low-fat yoghurt, fruit ices, fruit yoghurt

The don’ts
Avoid the following foods

1. Fats and oils:

  • Butter
  • Hard brick margarine, brick cooking fat, lard
  • All fried food
  • Coconut and biscuits containing coconut
  • Mayonnaise

2. Meat, fish and poultry:

  • Fatty beef, pork and mutton
  • Processed meats such as salami and polony
  • Organ meats such as offal, liver and kidneys
  • Tinned meat and pies
  • Take-aways such as fried chicken and hamburgers
  • Deep fried foods

3. Milk and milk products:

  • Full cream milk
  • Condensed milk
  • Cream, artificial cream, coffee and tea creamers
  • Full-fat ice cream and yoghurt
  • Full fat cheeses

Breads and cereals:

  • White bread and rolls
  • Refined breakfast cereals
  • Salted, high-fat savoury snacks
  • Biscuits, cakes, puddings, chocolates, fudge etc
  • Crisps, corn crisps, other savoury snacks

Preparing your food:
The way you prepare meat can also decrease the fat content considerably - grilling and frying in a non-stick pan with little or no oil (use Spray and Cook to coat the pan) will save plenty of fat. You can also boil or stew meat dishes (potjie) the day before serving, let the stew cool completely and remove the layer of fat that collects on top of the liquid.

When you roast meat, use very little oil to coat the bottom of the container, cook the meat at a lower temperature and when the roast is done, drain off all the fat that has collected in the bottom of the pan and get rid of it. Keep a large bottle handy in the kitchen to collect this fat that oozes out of roasts and throw it away on a regular basis. This not only prevents the drains from getting clogged up but spares the arteries of your family from a similar fate!

Step 4: Your basic daily guide to eating correctly to prevent a stroke

Food group Daily/weekly servings Serving sizes Examples/notes Significance for artery health
Fats, oils 3 per day 1 Tbsp margarine, oil. Canola, sunflower, olive oil, soy oil, soft or tub margarines with a high polyunsturated/monounsaturated fatty acids content. Avoid hard or block margarine, commercial cakes, biscuits and pies. Try to limit your total fat intake to less than 3 Tbsp per day, including all hidden fats in meat/oil used for food preparation and nuts.
Grains 6-7 per day 1 slice of bread; 1/2 C cooked rice, pasta or cereal; 1/2 C dry cereal. Whole wheat, pita bread, bagel, cereals, oatmeal. Major source of energy and fibre.
Red meat Maximum 3-4 portions per week Palm sized (90-120g) beef, venison, ostrich, pork, chicken, with all visible fat trimmed and chicken's skin removed. Buy only lean meat. Venison has a lower fat content than commercial beef and lamb. Modern day pork is one of the lowest-fat meats available, provided you cut off the fat layer. Turkey contains less fat than duck and chicken. Good source of protein, but meat contains a lot of hidden fats.
Fish 3-4 portions per week 120 - 150g Tuna, trout, salmon, mackerel and other fish. Add only a teaspoon or two of butter or saturated fat. Use herbs, lemon juice, freshly ground black pepper, dry white wine, or tomato to give fish dishes added flavour without the fat. People who eat fish at two or more meals a week, have a reduced incidence of heart disease, believed to be due to the Omega-3 fatty acids found in fish that protect the heart and blood vessels.
Vegetables 4-5 per day 1C leafy vegetables; 1/2 C cooked vegetables: 2/3 C (170ml) vegetable juice. Tomatoes, potatoes, carrots, peas, squash, broccoli, turnip, greens, spinach, artichokes, sweet potatoes, beans, cabbage. Rich sources of potassium, magnesium and fibre.
Fruits 4-5 per day 2/3 C fruit juice; 1 medium fruit; 1/4 C dried fruit; 1/2 C canned fruit. Apricots, oranges, grapefruit, mangoes, melons, peaches, pineapple, prunes, raisins, berries. Sources of potassium, magnesium and fibre.
Low fat (2%) or fat-free dairy products 2-3 per day 200ml milk, 1 C yoghurt, 1 Tbsp cheese Skimmed/fat free milk, skim/fat free buttermilk, fat free yoghurt. Eat even low fat cheeses (ricotta, mozzarella, Camembert and Brie and Weighless cheeses) in moderation. Major source of protein and calcium, but stay away from full-cream and even "low-fat" products.
Nuts, seeds and legumes 3-4 per week 1/3 C nuts, 2 Tbsp seeds, 1/2 C cooked legumes Almonds, pecan, hazelnuts, walnuts. Source of magnesium, potassium, protein and fibre. Also high fat content. Count as part of your daily fat portion.
Eggs Maximum 3-4 per week 1 egg Cook eggs with as little added fat as possible. Rather poach, boil, microwave, scramble with low fat milk, or fry in Spray and Cook in a non-stick pan. Source of protein and fat.

(Source: The Heart and Stroke Foundation South Africa)

- (Health24, updated April 2011)

 
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