A stroke occurs whenever the brain gets damaged by a diseased artery supplying blood to that part of the brain. The average age for stroke is getting younger and younger every year, meaning stroke is no longer exclusively a disease of older people.

Unfortunately, as the average American’s weight increases, so too does their risk of metabolic syndrome and stroke.

For most stroke patients I see, I remind them that they don’t really have a primary neurological problem. Stroke doesn’t work the same way as multiple sclerosis or ALS, which primarily affect the nervous system. Instead, I point out that they actually have damage to their arteries, which is a vascular problem, and their stroke is just a symptom. The arteries become damaged by the inflammation, cholesterol, and high blood pressure that comes with unhealthy living.

It all usually centers around metabolic syndrome. This is a combination of high blood pressure, prediabetes/diabetes, a bad cholesterol profile, and a large waist. One doesn’t have to have all these risk factors to meet criteria for metabolic syndrome; just three will do.

All these conditions increase the risk of damage to anything in the body that is supplied by arteries – not only stroke, but also heart attack, heart failure, and kidney disease. Decreased blood flow to the arms and legs, retinal damage, dementia, erectile dysfunction, and even hair loss in the lower parts of the legs can also occur. All of these become starved for blood, which normally keeps organs healthy and functioning.

It’s unusual to see a person with stroke and none of these other diseases. Most stroke risk is self-induced and can be modified by changing one’s lifestyle. This is accomplished primarily through diet. Remember, exercise is great for you, but it’s not going to help you lose weight the way diet control does. “Calories in equals calories out” is an outdated and incorrect paradigm. You’re probably more likely to have healthy arteries if you’re a couch potato vegan than a calorie guzzling gym-aholic.

So what can you do to reduce your stroke risk?

Some things are out of our immediate control – you can’t change your genes or the environment. However, stroke risk is reduced by healthy living. These are at the core of not only stroke prevention, but the prevention of many other medical problems.

  • Getting adequate sleep
  • Doing things that make you happy
  • Eating a healthy diet
  • Exercising regularly

There are a lot of “healthy” diets out there. Some that have shown evidence specifically for stroke prevention are the Mediterranean, Nordic, and DASH diets. It’s not clear which is best, but what ties all these diets together are a few key principles:

  1. Eating more plants and less animal products
  2. Avoiding processed food with a lot of sugar, salt, and other additives
  3. Minimizing the consumption of simple sugars and white carbohydrates (white bread, white pasta, white rice, white potatoes, sugary snacks)

I uniformly recommend a predominately plant-based diet with minimal processed foods to all my patients regardless of what medical problem they may have. Some people doubt the importance of these dietary interventions, but the bottom line is that they have nothing to lose by trying it. At best, a healthy diet has no harmful side effects and will minimize or even reverse the need for blood pressure and cholesterol medications. At worst, it will do nothing.

We eat processed food and animal products only because they taste good, not because our body needs them in any way. This doesn’t mean one should avoid all sugar and go 100 percent vegan. There are no bad foods, just better and worse foods. Having wild caught grilled salmon is probably better than a marbled steak. But a quinoa salad with a vinaigrette dressing is even better. An organic, low sugar gummy snack would be better than a pint of ice cream, but not as good as a whole piece of fruit. A cup of fruit and low-fat yogurt is better than a sugary, vegan cookie. It’s not about being perfect --  it’s about making better choices most of the time.

Tips to make healthy eating easier:

  • Don’t keep food that’s bad for you in the house. If it’s out of sight, it’s out of mind. You’re also less likely to make a trip to the store just for one snack.
  • Avoid grocery shopping when you’re hungry or tired.
  • Try eating five different colors a day to get a variety of nutrients. (Food dyes don’t count!).
  • Plan to have healthy meals with others. This makes spending time with friends a priority in an increasingly digital world. Plus you keep each other accountable for the dietary choices you make.
  • Bring lunch to work or school. Not only is it cheaper, but you’re also less likely to grab a slice of cafeteria pizza.
  • Opt for plants and whole grains that provide protein instead of relying on meat, dairy, or eggs every day. These options can provide all the protein you need every day.
  • Make it a point to have something that you love once in a while even if it isn’t the healthiest choice! If you completely avoid things that make you happy, a very restrictive diet still controls your life


Ali Saad, MD

Dr. Ali Saad is a neurologist with the Norman Prince Neurosciences Institute, specializing in vascular neurology.