All Posts tagged stroke

Antioxidants lower stroke risk

Eating a diet high in antioxidants may protect against ischemic stroke, an Italian cohort study showed.

People who had a diet high in total antioxidant capacity — an index that takes into account several different antioxidants and their interactions — had a 59% reduced relative risk of ischemic stroke (HR 0.41, 95% CI 0.23 to 0.74), according to Nicoletta Pellegrini, PhD, of the University of Parma in Italy, and colleagues. But there was no such relationship with hemorrhagic stroke, they reported in the January issue of the Journal of Nutrition. In fact, the highest intake of the antioxidant vitamin E was associated with a greater risk of hemorrhagic stroke (HR 2.94, 95% CI 1.13 to 7.62).
Considering evidence suggesting that oxidative stress and systemic inflammation are involved in the pathogenesis of ischemic stroke, the researchers noted that “a high-total antioxidant capacity diet could be protective as a consequence of its ability to deliver compounds with antioxidant activity and with a demonstrated anti-inflammatory effect.” But, they acknowledged that the mechanism for such activity was unclear may “go beyond the antioxidant activity of the numerous total antioxidant capacity contributors present in foods and beverages.”

Pellegrini and her colleagues set out to explore the relationship between dietary total antioxidant capacity and the risk of stroke among 41,620 people participating in EPICOR, the Italian segment of the European Prospective Investigation into Cancer and Nutrition (EPIC). None had a history of stroke or MI at baseline. Dietary intake was assessed with a food frequency questionnaire. In the study population, more than half of the total antioxidants consumed came from coffee, wine, and fruit. Through a mean follow-up of 7.9 years, there were 112 ischemic strokes, 48 hemorrhagic strokes, and 34 other types of strokes. After adjustment for energy intake, hypertension, smoking status, education, nonalcoholic energy intake at recruitment, alcohol intake, waist circumference, body mass index, and total physical activity, individuals eating a diet in the highest tertile of total antioxidant capacity had a reduced risk of ischemic — but not hemorrhagic — stroke.

Looking at individual antioxidants, the researchers found that participants consuming the highest amounts of vitamin C had a reduced risk of ischemic stroke (HR 0.58, 95% CI 0.34 to 0.99). Controlling for vitamin C intake did not negate the overall association between antioxidants and ischemic stroke, which ruled out the nutrient as the sole driver of the relationship. High intake of vitamin E, on the other hand, was associated with nearly triple the relative risk of hemorrhagic stroke. However, “it must be stressed that the small number of cases observed in this population strongly limits the validity of statistical observations on hemorrhagic stroke,” noted the researchers, who called for further studies.

Aside from anti-inflammatory effects, it is possible that the association between antioxidants and ischemic stroke risk can be explained by the interaction between polyphenols — the major contributors to total antioxidant capacity — and the generation of nitric oxide from the vascular endothelium. That interaction leads to the vasodilation and expression of genes that may be protective for the vascular system, according to the researchers. In addition, coffee — the main source of antioxidants in the study population — reduces blood pressure, which is a recognized risk factor for ischemic stroke, the researchers wrote.

They noted some limitations of the study, including the low numbers of cases when different types of stroke were analyzed, the measurement of total antioxidant capacity at baseline only, and the inability to rule out confounding effects of other dietary components, like sodium and potassium.

Source: Del Rio D, et al “Total antioxidant capacity of the diet is associated with lower risk of ischemic stroke in a large Italian cohort” J Nutr 2011; 141: 118-123.

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Red meat increases women stroke risk

Women consuming too much red meat may have a higher risk of stroke than women eating less, says a new study. Red meat is high in saturated fat and cholesterol; both are risk factors for cardiovascular disease, heart attack, and stroke. The United States Centers for Disease Control and Prevention suggests lowering saturated fat intake and eating more fresh fruits and vegetables to help reduce your risk of stroke. Writing in the journal Stroke, researchers examined nearly 35,000 Swedish women, ages 39 to 73. None of the women had heart disease prior to the start of the study in 1997.

After ten years, results showed 4% of the study participants, 1,680 women, had a stroke. Those consuming the most red meat had the highest risk of stroke. Women in the top tenth of red meat intake, consuming at least 3.6 ounces each day, were 42% more likely to have a stroke, compared to women who ate just under one ounce of red meat daily.

Eating processed meat also increased stroke risk. Women eating 1.5 ounces of processed meat each day were 24% more likely to suffer a cerebral infarction, compared to woman consuming less than half an ounce of processed meat each day. Processed meat was not linked to any other form of stroke. Cerebral infarction is a type of stroke caused by a disturbance in the blood vessels supplying blood to the brain. Other types of stroke involve a rupturing of a blood vessel, called hemorrhagic strokes.

The scientists blame red meat and processed meat’s effect on raising blood pressure for the increased stroke risk. According to the World Health Organization (WHO), every year an estimated 17 million people die due to cardiovascular diseases, most notably stroke and heart attack. The WHO lists physical inactivity and unhealthy diet as the main risk factors for heart disease and major cardiac events.

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Tomatoes Fight Cholesterol

If you want to wage battle against cholesterol and other lipids (fat) that can contribute to vascular disease, then make tomatoes a big part of your diet. Scientists say this popular fruit contains a nutrient that can fight vascular disease such as stroke and arteriosclerosis.

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Tomatoes fight more than cholesterol and fat

Excessive levels of lipids, such as cholesterol and triglycerides in the bloodstream, a condition known as dyslipidemia, can lead to potentially deadly diseases such as arteriosclerosis, cirrhosis, and stroke. Scientists from Kyoto University and New Bio-industry Initiatives, Japan, report that a compound called 9-oxo-octadecadienoic extracted from tomatoes can boost oxidation of fatty acids and contribute to the regulation of lipid metabolism by the liver. These qualities indicate that 9-oxo-octadecadienoic acid can fight cholesterol and other lipids and therefore help prevent vascular diseases.

Vascular disease is a general term used to describe diseases that affect the blood vessels. The Vascular Disease Foundation offers information on nearly two dozen different conditions that fit this category, including abdominal aortic aneurysm, carotid artery disease, deep vein thrombosis, lymphedema, peripheral artery disease, and stroke.

Tomatoes are also valued for other health benefits. Much research has been dedicated to a potent antioxidant in tomatoes, lycopene, and its potential in the fight against various types of cancer, and especially prostate cancer. Tomatoes also contain excellent levels of other nutrients, including niacin, which helps lower cholesterol; and potassium, which reduces blood pressure and the risk of heart disease.

Dr. Teruo Kawada, who is from Kyoto University and who led the study, noted that “Finding a compound which helps the prevention of obesity-related chronic diseases in foodstuffs is a great advantage to tackling these diseases. It means that the tomato allows people to easily manage the onset of dyslipidemia through their daily diet.” To help the fight against cholesterol and other fats that contribute to vascular disease, enjoy more tomatoes.

SOURCES:
Kim YI et al. Molecular Nutrition & Food Research doi:10.1002/mnfr.201000264

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Fish diet lowers risk of stroke

Fish diet lowers risk of stroke

Women who eat more than three servings of fish per week are less likely to experience a stroke, a new study suggests. Specifically, fish-lovers in Sweden were 16 percent less likely to experience a stroke over a 10-year-period, relative to women who ate fish less than once a week. “Fish consumption in many countries, including the U.S., is far too low, and increased fish consumption would likely result in substantial benefits in the population,” said Dr. Dariush Mozaffarian of the Harvard School of Public Health. When choosing fish to eat, it’s best to opt for fish that are rich in omega-3 fatty acids, found most abundantly in fatty fish like salmon, mackerel and albacore tuna. “But any fish is better than none,” Mozaffarian noted.

 

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“Indeed, these fatty acids likely underlie the benefits of fish on stroke risk”, said study author Dr. Susanna Larsson of the Karolinska Institute in Stockholm. “These fatty acids may reduce the risk of stroke by reducing blood pressure and blood (fat) concentrations.”

This is not the first study to suggest that people who eat more fish have a lower risk of stroke, and experts already recommend a fishy diet to reduce the risk of cardiovascular problems, Mozaffarian added. “This study supports current recommendations.” Earlier this year, for instance, a study showed that middle-aged and older men who eat fish every day are less likely than infrequent fish eaters to develop a suite of risk factors for heart disease, diabetes and stroke.

In the current study, published in the American Journal of Clinical Nutrition, Larsson and her colleagues looked at 34,670 women 49 to 83 years old. All were free of cardiovascular disease and cancer at the beginning of the study, in 1997. During 10 years of follow-up, 1,680 of the women (4 percent) had a stroke. Stroke caused by blockage of an artery that supplies blood to the brain — also known as a “cerebral infarction” or “ischemic stroke” — was the most common event, representing 78 percent of all strokes in the study. Other types of strokes were due to bleeding in the brain, or unspecified causes.

Women who ate more than three servings of fish per week had a 16 percent lower risk of stroke than women who ate less than one serving a week. “Not a small effect,” Mozaffarian said, noting that it was roughly equivalent to the effect of statin drugs on stroke risk. Furthermore, the researchers asked women about their diets only once, using a questionnaire, which might have caused errors that would underestimate the link between a fishy diet and stroke risk, he explained. “So, the true risk reduction may be larger.”

Interestingly, women appeared to benefit most from eating lean fish, when other research shows fatty fish is better for health. This finding may stem from the fact that most fatty fish, such as herring and salmon, is eaten salted in Sweden, Larsson explained. “A high intake of salt increases blood pressure and thus may increase the risk of stroke,” she said. “So the protective effects of fatty acids in fatty fish may be attenuated because of the salt.”

Indeed, when it comes to fish, not all have equal benefits, Mozaffarian noted – for instance, he said, research has not shown any cardiovascular benefits from eating fast food fish burgers or fish sticks. In addition, women of childbearing age should avoid certain types of fish known to carry relatively high levels of pollutants, such as shark and swordfish, Mozaffarian cautioned. “This is a very, very short list of fish to avoid or minimize — there are many, many other types of fish to consume,” he said. “Women at risk of stroke are generally beyond their child-bearing years, and so for these women, all types of fish can be consumed.”

Larsson and her team speculate that certain nutrients in fish, such as fatty acids and vitamin D, might explain its apparent benefits. The Swedish study cannot prove cause and effect for high fish consumption and lowered stroke risk, however. For instance, fish consumption could be a sign of a generally healthier lifestyle or some other mechanism at work. Last December, Larsson and colleagues published data from the same group of women in the journal Stroke showing that those who eat a lot of red meat may also be putting themselves at increased risk of stroke.

SOURCE: bit.ly/dKunk8 American Journal of Clinical Nutrition, online December 29, 2010.

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Stress affects more women than men

About one in seven Britons feels under extreme stress, a survey suggests.We can reasonably conclude that these numbers will be similar right here in Australia. Experts say stress raises blood pressure, putting people at greater risk of stroke. A poor diet and lack of exercise also contribute to the chances of suffering a stroke. Stroke is the third leading cause of death in the United States. Over 143,579 people die each year from stroke in the United States. Stroke is the leading cause of serious, long-term disability in the United States. Each year, about 795,000 people suffer a stroke. About 600,000 of these are first attacks, and 185,000 are recurrent attacks. Almost one in five women and one in 10 men feel their stress levels are out of control, according to the poll of 2,000 people in Britain.

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The survey, by the Stroke Association and the engineering company Siemens, found almost a fifth of people said they took no exercise. A similar number said they exercised for 30 minutes once a week. More than a quarter of people aged 45 to 54 said they never exercised, despite suffering the highest stress levels. Almost half said they were under more than “moderate stress”. Overall, 40 per cent of those surveyed said they were unaware of the link between exercise and lowering the risk of stroke.

James Beeby, of the Stroke Association, said: “The research is incredibly worrying and emphasises the need for people to be aware of the dangers of stroke. “It’s imperative that people take regular exercise and modify their diet to reduce the risk of suffering a stroke.” Siemens sponsors the British rowing team and provides some funding for the Stroke Association’s Stroke for Stroke campaign. Andreas Goss, the chief executive of Siemens in the UK, said: “Contrary to popular belief, stroke can affect people of any age.”

Originally Published in The Telegraph

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Stroke deaths higher where fried fish aplenty

The steep rate of death from stroke in a swath of Southern states often referred to as America's “stroke belt” may be linked to a higher consumption of fried fish in that region, new research suggests. A study published in the journal Neurology shows people living in the stroke belt — which comprises North Carolina, South Carolina, Georgia, Alabama, Mississippi, Tennessee, Arkansas and Louisiana — eat more fried fish and less non-fried fish than people living in the rest of the country, and African-Americans eat more fried fish than Caucasians. “Differences in dietary fish consumption, specifically in cooking methods, may be contributing to higher rates of stroke in the stroke belt and also among African Americans,” says study author Fadi Nahab, medical director for the Stroke Program at Emory University Hospital in Atlanta.

The research, part of a large government-funded study, Reasons for Geographic and Racial Differences in Stroke (REGARDS), involved 21,675 participants from across the country; the average age was 65. Of the participants, 21% were from the “stroke buckle,” the coastal plain region of North Carolina, South Carolina and Georgia where stroke mortality rates are even higher than they are in the rest of the stroke belt. Another 34% were from the rest of the stroke belt and 44% were from the other states.

Participants were interviewed by phone and then given an in-home physical exam. The questionnaire asked how often they ate oysters, shellfish, tuna, fried fish and non-fried fish. The American Heart Association recommends people eat fish high in omega-3 fatty acids—essential fatty acids humans get through their diet—at least twice a week, baked or grilled but not fried. Fewer than one in four overall ate two or more servings of non-fried fish a week. Stroke belt residents were 32% more likely to eat two or more servings of fried fish each week than those in the rest of the country.

African-Americans were more than 3.5 times more likely to eat two or more servings of fried fish each week than Caucasians, with an overall average of about one serving per week of fried fish compared with about half a serving for Caucasians. When it came to eating non-fried fish meals, stroke belt residents ate an average of 1.45 servings per week, compared with 1.63 servings eaten by people elsewhere.

“This is good stuff. It's a well-done study, but I think one thing to bear in mind is that it's not specifically a study of stroke risk. You're looking at a community and seeing how it's behaving on the whole,” says Daniel Labovitz, a stroke neurologist at Montefiore Medical Center in the Bronx. “This study can't tell you causation. It can't tell you there's a direct link between one thing and another, it just tells you they're associated,” says stroke neurologist Victor Urrutia, an assistant professor at Johns Hopkins University School of Medicine.

How might eating fried fish impact stroke?

It could be that frying the fish leaches out the omega-3s, says Jeremy Lanford, stroke director at Scott & White Healthcare in Roundrock, Texas. Or the increased fat calorie content from the frying oil may contribute to stroke, says author Nahab. He also notes that fish used for frying, such as cod and haddock, tend to be the types lower in healthy fats. More research is needed to tease out whether cooking methods affect stroke risk, Labovitz says. “In other words, is fried fish a problem, or is it another red herring?” he says.

The study was supported by the National Institute of Neurological Disorders and Stroke, the National Institutes of Health, and the Department of Health and Human Services. Funding was provided by General Mills for coding of the food frequency questionnaire.

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Five portions a day saves lives

What did the research involve?

The researchers needed to obtain several sets of data to fill their model. Data for UK deaths from coronary heart disease, stroke and cancer were obtained from the Office for National Statistics, the General Register Office for Scotland and the Northern Ireland Statistics and Research Agency. Information on the population's intake of foods and nutrients was obtained from two sources: the average intake of fatty acids, fibre, and fruit and vegetables for 2005–7 was derived from the Expenditure and Food Survey, while estimates of salt intake came from the National Diet and Nutrition Survey, 2006.

The modelling also incorporated several meta-analyses of individual studies looking at diet and disease risk factors. The researchers looked at reviews that had pooled data from randomised trials, cohort studies or case-control studies, giving priority to meta-analyses of randomised trials. These different studies were combined in the model to calculate the change in risk of disease for an individual who changes his or her diet. To estimate the change in health outcomes with a change in diet at a population level, the model used the difference between current average consumption levels and recommended levels of different foods in the UK.

What were the basic results?

In a general summary of the main findings, the researchers calculated that:

About 33,000 deaths a year would be avoided if UK dietary recommendations were met. There would be a reduction in deaths from coronary heart disease of 20,800 (95% credible interval 17,845 to 24,069), a reduction of 5,876 for deaths from stroke (3,856 to 7,364) and a reduction of 6,481 for deaths from cancer (4,487 to 8,353). About 12,500 of these avoided deaths would be in people aged 75 or under. About 18,000 of the avoided deaths would be men and 15,000 would be women. More than 15,000 of the avoided deaths (nearly half the total figure) would be due to increased consumption of fruit and vegetables. Reducing average salt intake to 6g a day would avoid 7,500 deaths annually. The greatest number of deaths avoided would be in Northern Ireland and Scotland, whose populations are furthest from achieving dietary recommendations.

How did the researchers interpret the results?

The researchers say their study suggests that increasing average consumption of fruits and vegetables to five portions a day is the target likely to offer most benefit in terms of deaths avoided. They also say that reducing recommended salt levels to 3g daily and saturated fat to 3% of total energy would achieve a similar reduction in mortality.

They conclude that their calculations based on the Dietron model are robust, pointing out that their estimate of deaths avoided is lower than a previous government survey which calculated that 70,000 deaths a year could be avoided if government dietary recommendations were met. The estimates could be used in calculating the allocation of resources for interventions aimed at reducing chronic disease.

Conclusion

This well-conducted modelling study used various data sources to link consumption of different dietary components with disease risk factors (for example blood pressure, cholesterol and obesity) and subsequent mortality from coronary heart disease, stroke and cancer. The study supports previous research showing that diet plays a crucial role in health and that a diet with plenty of fruit and vegetables, fibre and low fat and salt levels can reduce the risk of chronic disease, in particular coronary heart disease. However, its predictions are made at the population level. A model such as this cannot predict individual risk, which will depend on many factors, including family history, smoking and other lifestyle habits.

It is important to note that the figures are based on the estimates and assumptions made when using a mathematical model, and not on reality. As the authors themselves note, the modelling technique they used may have led to “some degree of double counting” and that, therefore, their estimate of reduced mortalities if dietary recommendations were met is likely to be an overestimate. Also, the accuracy of the model depends to some extent on the quality of the meta-analyses that were included, and the quality of the individual studies that were pooled within these reviews in order to establish associations between diet and particular disease risk factors.

Overall, this study supports current dietary recommendations and even though it cannot predict how diet influences risk for individuals, it does indicate that keeping to dietary recommendations reduces the risk of disease.

Dietary recommendations include eating five portions of fruit and vegetables a day (about 440g) and 18g of fibre (provided by wholegrain foods and some fruit and vegetables). It is recommended that salt intake is limited to a maximum of 6g a day and that a third of total energy is provided by fats, with saturated fat comprising 10%. The researchers point out that in 2007, according to the estimated average intakes in the sources they used, none of the UK countries met these recommendations.

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Ten major advances in heart disease in 2010

The American Heart Association has compiled its annual list of the top 10 major advances in heart disease. “We have come far in the past decade, reducing heart disease deaths by more than 27 per cent,” said Ralph Sacco of the University of Miami. “But we know there is still much to be done in improving the lives of heart disease and stroke patients – and more importantly, in preventing these devastating diseases in the first place. Scientific research will help us lead the way,” said Sacco.

The highlights of the top ten advances in cardiovascular research in 2010:

1. Tailoring treatment for people with diabetes to reduce their risk of cardiovascular disease
New research from the ACCORD Study Group offered insight into specific treatments that can reduce their risk of cardiovascular disease (CVD). The first study found that aggressive blood pressure control does not reduce CVD risk in people with type 2 diabetes at high risk for CVD. In a second study, a combination therapy with a statin plus a fibrate was no better at reducing risk than a statin alone in patients with type 2 diabetes at high risk for CVD.

2. New advances for patients who aren't candidates for conventional valve surgery
Two new studies have supported evidence that Transcatheter aortic valve implantation (TAVI) can improve symptoms and outcomes – including quality of life – even over the course of several years. While there are some risks associated with TAVI, including strokes and other major cardiovascular events, the catheter-based procedure offers significant progress in this area.

3. Improving the way we reverse sudden cardiac arrest
Significant studies reported that chest compression only, or ''Hands Only CPR'' for adults by bystander lay rescuers improves survival outcome. Public awareness campaigns resulted in increased use of hands only CPR, as well as improved survival rates. While the new procedure appeared successful in adults, it is important to note that using conventional chest compressions with rescue breathing is still important for children stricken with sudden cardiac arrest.

4. More options for reducing stroke risk in atrial fibrillation
For the first time in more than 20 years there are viable alternatives to the primary prevention of stroke for patients with atrial fibrillation (AF). Warfarin (Coumadin) has long been the standard anti-clotting drug used to reduce the risk of stroke for these patients. But it carries its own complications from bleeding, and managing the dose requires regular blood tests, making it difficult to manage for both patients and doctors. Now, several new drugs have been found to work as well as warfarin – and are simpler for patients to take – offering an important advance in this field.

5. Adjusting pacing therapies can improve outcomes for heart failure patients
New studies showed that adding additional resynchronization pacing to ICD therapy could lead to improved outcomes in an expanded group of heart failure patients. In addition, new types of ICDs (defibrillators without leads, for example) can offer options that reduce some of the risks associated with traditional devices.

6. Hopeful new procedure for infants with congenital heart disease
The Pediatric Heart Network's randomized trial of Norwood shunt types in infants with single-ventricle lesions showed that the type of shunt used makes a difference in outcomes. Better transplantation-free survival at 12 months is a possibility with this new understanding of the better shunt choice for these patients. This was the first large-scale randomized trial in congenital heart surgery, offering an approach that should provide answers to other questions in the future.

7. Finding the right anti-clotting (anti-platelet) therapy
New research from the PLATO investigators has found that ticagrelor may improve outcomes and reduce adverse events better than the current standard, clopidogrel. The CURRENT-OASIS 7 Trial is exploring the optimal dosing of clopidogrel and aspirin in patient undergoing invasive surgery. These studies will help providers better understand the situations where new choices and dosages may improve results for the patient.

8. Basic science findings offer insight into future progress
Several studies this year brought the future of medicine closer to the present with new insight into emerging technologies. Findings from stem cell therapy have shown improved quality of life and survival in several early studies of patients with chronic heart failure and support the development of future cell-based therapeutics. A large animal study defined the basic mechanisms for heart muscle regeneration initiated by specific types of stem cells. The results demonstrated that these stem cells repair scarred myocardium through promotion of the generation of new heart muscle and blood vessel).

9. Using science to support healthy lifestyle behaviours
New science examining lifestyle behaviours in adults and children, with particular emphasis on physical activity and consumption pattern, show that such conditions as obesity and hypertension are positively influenced by a change in diet with decreasing sodium levels. Results from the school setting suggest that the earlier one starts to adopt healthy behaviours the better the effect on health outcomes.

10. Get With The Guidelines participation eliminates disparity gaps in care
Racial and ethnic disparities have been found in the quality of care delivered to patients with cardiovascular disease and achieving equity and addressing disparities has implications for quality, cost, risk management, and community benefit. These findings are the first to show that participating in a quality improvement program, such as Get With The Guidelines-Coronary Artery Disease, can eliminate racial and ethnic disparities of care while increasing the overall use of evidence-based care for heart attack patients.

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Low Level of “Good” Cholesterol Associated with Alzheimer’s

A low level of “good” cholesterol is a well-known risk factor for heart disease. A new study by investigators at Columbia University College of Physicians & Surgeons now suggests that a low level of good cholesterol may also raise the risk of developing Alzheimer's disease.

“Low levels of 'good' cholesterol (a.k.a. high-density lipoproteins or HDL) are very common in the United States,” says the study's lead author, Christiane Reitz, MD, PhD, assistant professor of neurology (in the Sergievsky Center and Taub Institute). “If raising HDL can lower a person's risk of developing Alzheimer's disease, that means we may be able to significantly reduce the rate of Alzheimer's disease in the population,” Reitz says, though she cautions that the finding still must be confirmed in other studies.

The study, which appears in the December issue of Archives of Neurology, is co-authored with Jose Luchsinger, MD, MPH, associate professor of medicine and epidemiology, and Richard Mayeux, MD, director of the Gertrude Sergievsky Center and Sergievsky Professor of Neurology, Psychiatry, and Epidemiology.

Previously, the relationship between HDL and Alzheimer's disease had been unclear. Some studies found an association, but others, including one of Reitz's own, found no connection. The new study, Reitz says, follows subjects for a longer period of time than previous studies, resulting in a more accurate account of the number of subjects who ultimately develop Alzheimer's.

After monitoring 1130 elderly residents of northern Manhattan for an average of four years, the researchers found a 40 percent higher incidence of Alzheimer's in residents with low HDL (less than 55 mg/dl). The reason that low HDL is associated with a higher rate of Alzheimer's isn't understood. One possibility is that it works through stroke. “We know low HDL raises the risk of stroke and that stroke is associated with Alzheimer's, so stroke may be the mediator,” Reitz says. “But there's also evidence that HDL works by itself to clear amyloid proteins [the proteins believed to cause Alzheimer's] from the brain.”

Because the study included a large number of African Americans and Hispanics, unlike previous studies that focused on whites, the finding may indicate that low HDL is linked to a high risk of Alzheimer's in many different ethnicities.

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Wholegrains help lower blood pressure

Starting the morning with a bowl of porridge and eating a whole-grain sandwich at lunchtime can help cut the risk of high blood pressure, according to new research. A study carried out by scientists from Aberdeen University which involved more than 200 volunteers revealed that eating three portions of whole-grain foods every day lowers the risk of high blood pressure, a major risk factor for heart disease and stroke. A good deal of research has suggested that a whole-grain diet is good for your health, but this study is one of the first to test the theory in a well-designed clinical trial.

Volunteers in the study ate three servings a day of whole-grain foods, which were either wheat, or a mixture of both wheat and oats. The whole-grain diets were compared with one that contained the same amounts of refined cereals and white bread. The study used foods widely available in supermarkets to make the diet easy to follow, without having to make any changes to their usual lifestyle. Apart from the whole-grain and the equivalent refined cereal foods, the volunteers were encouraged to continue with their normal food choices.

Dr Frank Thies, senior lecturer at The Rowett Institute of Nutrition and Health, who led the study, said: “We observed a decrease in systolic blood pressure of 5-6 mm Hg in the volunteers who ate the whole-grain foods, and this effect is similar to that you might expect to get from using blood pressure-lowering drugs. “This drop in systolic blood pressure could potentially decrease the incidence of heart attack and stroke disease by at least 15 and 25 per cent respectively. The scientists also added that wholegrain wheat and oat-based recipes should be on everyone's festive menu this Christmas.

The findings are published in the American Journal of Clinical Nutrition.

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