In the wake of a stroke, many things about your life may be different, including your diet. Changing the way you eat can help reduce your risk of having another stroke. A healthy diet will also ensure your body is getting the nutrients it needs to support neurological and physical healing.
“In almost any circumstance it’s good to reevaluate what you’re eating and your lifestyle after having a stroke,” says Jordan Chen, RD, a cardiovascular dietitian at Heart and Vascular Clinics (HAVC) in Manhattan, Kansas. Chen notes that a person’s diet and exercise habits are among the main factors that contribute to cardiovascular disease (CVD) and stroke, and that looking out for overall heart health is an important factor in reducing your risk for stroke.
Reading: Best food for stroke patients
“We can fix a stent in an artery, but it’s a temporary measure that needs to be coupled with lifestyle changes to prevent recurrence of not only stroke but heart disease,” says Andrew M. Freeman, MD, director of cardiovascular prevention and wellness at National Jewish Health in Denver and cochair of the American College of Cardiology’s Nutrition and Lifestyle Group, who notes that heart disease and stroke are closely linked.
Both Chen and Dr. Freeman recommend that people follow the basic rules of the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) ways of eating to ensure the best overall health and to reduce their risk of having another stroke. The DASH diet was specifically designed to reduce high blood pressure, the single biggest risk factor for having a stroke, according to the American Stroke Association (ASA). Both diets include large amounts of fresh vegetables, fruit, nuts, beans, legumes, fish and poultry in moderation, and very few servings of processed foods, dairy, red meat, and sweets. The American Heart Association (AHA) recognizes that both the Mediterranean and DASH ways of eating can have a big impact on a person’s risk of stroke.
“The biggest things to cut back on are sugar, salt, highly processed foods, saturated and trans fats, and fried foods, as well as snacky-type foods,” says Chen, referring to packaged snack foods, including pretzels and chips.
Here are some tips for what to eat and what to avoid to help you recover from a stroke.
Eat Whole, Mostly Plant-Based Foods and Lots of Veggies
Whole foods are those that are in as close to their natural state as possible once they reach your plate. Fruit, vegetables, nuts, seeds, beans, rice, and fish are all good examples of whole foods, says Freeman, who adds that when choosing vegetables, opt for more leafy greens, asparagus, peppers, onions, carrots, brussels sprouts, and other non-starchy vegetables over potatoes and corn. He also says to be careful of what kinds of toppings you put on vegetables.
“If you are going to eat salads and cover them in bacon and blue cheese, that negates their health benefits,” says Feeman. Instead, try adding vinegars to salads, including balsamic, and consider adding nuts or seeds to keep a meal of leafy greens healthy.
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Avoid Processed Foods, Salt, and Sugar
Processed foods are the opposite of whole foods. These foods typically come prepackaged and include options like cereal, crackers, certain breads, chips, and processed meats like luncheon meat and bacon.
Processed foods typically contain a lot of sugar and salt, which may contribute to plaque buildup that can cause an ischemic stroke, says Chen. She recommends rarely eating sugary foods such as desserts and pastries, and replacing sugary beverages with water — drinks that include added sugar are the single largest source of sugar in the American diet, according to the Harvard T.H. Chan School of Public Health. And according to the Centers for Disease Control and Prevention (CDC), half of all American adults drink at least one sugary beverage on any given day.
One study of California teachers, published in May 2020 in the Journal of the American Heart Association, found that women who consumed one or more sugary beverages — which included soda, energy or sports drinks, and fruit juice with added sugar — were 20 percent more likely to have a stroke than women who rarely drank sugary beverages. Excess sugar causes weight gain and type 2 diabetes, both risk factors for stroke. In fact, people who have diabetes are 1.5 times more likely to have a stroke than people who do not, according to the American Diabetes Association.
Another risk factor for stroke is high blood pressure, and salt is directly related to high blood pressure, according to the AHA. The AHA recommends consuming no more than 2,300 milligrams (mg) of sodium a day, and that can add up quickly, especially if you eat a lot of prepackaged foods or processed meats. Opting for whole foods over processed foods and seasoning meals with herbs, spices, or citrus instead of salt, is a good way to cut back on sodium intake.
Chen says not to be fooled by breads and crackers that are labeled “whole wheat,” which, she says, can be mistaken for healthy options but in reality often contain additives, salt, and sugar.
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Eat More Legumes
Legumes — a class of vegetables that includes beans, lentils, and peas — are a hallmark of both the DASH and Mediterranean diets. Both are excellent sources of protein, vitamins, and minerals and are low in fat, Freeman explains, adding that “Americans eat almost no legumes, but they are associated with all sorts of positive health benefits.”
According to the Mayo Clinic, legumes are typically low in fat and high in folate, potassium, iron, and magnesium. They are also cholesterol-free and high in fiber. Try making meatless burgers out of black beans or chickpeas, or incorporating legumes into soups and stews.
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Eat Fish and Poultry Instead of Red Meat
Studies show that eating either a plant-based diet or a diet that includes fish but no meat reduces a person’s risk for heart disease and stroke. In one study, published in September 2019 in the British Medical Journal, researchers evaluated nearly 50,000 people in the U.K. The team studied how people’s diets impacted their risk for ischaemic heart disease, a factor that can cause stroke and heart attack. They found that people who were vegetarians and those who ate fish but no meat were 13 percent less likely to have ischaemic heart disease than meat eaters.
Fish contains so-called healthy fats — unsaturated fats that include monounsaturated and polyunsaturated fats, both recognized as heart-healthy. “It’s okay to have some lean meat,” says Chen. “If you do, try to eat small amounts of fish and chicken, but it’s better to have most of your plate be vegetables.”
Avoid Saturated Fat and Snack on Seeds and Nuts
According to Freeman, a healthy diet should avoid saturated fats and limited amounts of fat in general: “When they do come into the diet, fats should be included in small amounts of nuts, olive oil, and canola if need be,” says Freeman, who recommends getting calcium from kale, spinach, and broccoli instead of full-fat dairy products, which also contain a lot of saturated fat.
Saturated fat raises cholesterol, which raises a person’s risk of stroke, he explains. The U.S. National Library of Medicine recommends getting no more than 10 percent of your daily calories from saturated fat. Based on a standard 2,000-calorie diet, this is equal to 16 to 20 grams (g) of saturated fat. For reference, a single slice of bacon contains roughly 9 g of saturated fat, so just two strips of bacon could push you over your healthy daily limit.
Coconut oil, palm oil, red meat, and dairy are also all high in saturated fat, says Chen. “Eating monounsaturated and polyunsaturated fats from fish, avocados, nuts, and seeds will be much better for your heart,” she says.
What to Do if You’re Having Difficulty Eating After Stroke
Chen also notes that some people may have difficulties chewing or swallowing after a stroke. In these cases, Chen says to work with your doctor, speech pathologists, and dietitians to develop the right consistencies of foods for you so you don’t become malnourished. Malnutrition in stroke survivors varies but is thought to be around 20 percent, according to a study published in December 2018 in the journal Neurocritical Care. Smoothies that are rich in vegetables and low-sugar fruit may be a good option in some cases, she says. Chen also recommends roasting or steaming vegetables to make them softer and easier to chew, and stewing meat for the same reason.
Additional reporting by Kaitlin Sullivan.
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