Preventing a Stroke with Diet, and Nitric Oxide?

 


We usually write about the nutritional power of natural nitrates present in leafy vegetables and how they impact how you feel and perform. 

But since low nitric oxide levels are associated with many health challenges, we want to address one of them today.  Find out in this article everything about nitric oxide and stroke.

  1. What Causes Stroke?

  2. How To Lower Risk Of A Stroke, According To The American Stroke Association

  3. What Is The Best Diet To Prevent Stroke?

  4. How to Lower Risk of Stroke With Food

  5. Can supplements prevent stroke?

  6. Nitric Oxide and Stroke

What Causes Stroke?

Strokes are scary. It’s hard to say when they might happen, what events lead to one, and what will happen afterwards.  The statistics are grim: the World Health Organization reports that middle age is a common time to get a stroke, every year 15 million people around the world personally face a stroke, and 2 of 3 can become permanently disabled or die. That sounds like a real life nightmare.

Just because it’s scary shouldn’t mean we don’t talk about it. When it comes to something that can hit someone so suddenly with such force, we ought to be spending MORE time thinking about what we can do to lower our risk.

High blood pressure is at the core of 84% of strokes; diabetes and cardiovascular disease are other common contributors. 

You may see the common thread here: poor heart health.

There’s no guaranteed way to stop a stroke and certainly no one-size-fits-all fix for preventing strokes, but there is plenty of research to show that a few key changes in what you eat and what you do go a long way.

How To Lower Risk Of A Stroke, According To The American Stroke Association

The good news is that getting to a healthier blood pressure, cholesterol, and blood sugar includes getting more active with family and friends, finding time to relax, and trying out more types of foods.

The most recent 2014 position statement form the American Heart Association and American Stroke Association uses every chance they can to point to diet and lifestyle interventions first, before resorting to drugs that might help.

Physical activity is the number one way to improve your health and decrease the risk of stroke. Playing tennis may be better than a round of golf in this setting, since moderate and intense exercise appear to be more protective according to the research

But regardless, find something you love that gets your heart rate up, and make the time for it every week. You might even be surprised to feel the other differences exercise can make, for example when you look at aging, immune health and inflammaging, a possible underlying feature of most ー if not all ー chronic diseases.

 

What Is The Best Diet To Prevent Stroke?

The best diet is the one you can stick to.

I say that to my clients all the time. First get a healthy diet onboard, and then once that becomes your bread and butter every day, then start to fine-tune your diet to get you the results you want.

I can say “lower your salt, increase your potassium, and decrease tobacco and alcohol”, but how do you really do that? Seek out professional help to start drinking and smoking less; we all know it’s more than just a matter of quitting cold turkey, which can even be dangerous.

But when it comes to what to eat to stop a stroke, there are some basic guidelines that can help anyone.

  • Eat More Fruit and Vegetables

  • Some fruits and veggies are high in potassium. Potassium works against sodium and may help lower blood pressure. Besides this, plants are full of vitamins and minerals, antioxidants, anti-inflammatory polyphenols, and phytonutrients ー each of which can play a role in creating clean energy and improving your health every day.

  • Eat More Nitrate-Rich Veggies

  • We’re not talking about processed meats that have high added nitrates - those might be linked with cancer. We’re talking about some of the most powerful superfoods in existence: green and red leafy veggies. The nitrates in these vegetables help your blood vessels relax, which may help lower blood pressure. Arugula, chard, spinach, bok choy, and other green and red veggies are the highest levels. The often-cited beets are also a good nitrate source, but honestly they hardly make the list when compared to these other veggies. Head over to our article on Eating To Optimize Nitric Oxide for our complete list.

  • Load Up On Extra Virgin Olive Oil and Almonds

  • Research shows that the Mediterranean Diet ー a mainly whole-foods diet with generous amounts of olive oil, fish, and nuts ー is an ideal option to harness your health and support getting more active. A huge research study showed that a Mediterranean Diet supplemented with either a handful of nuts  or 3-4 tablespoons of extra virgin olive oil per day was shown to decrease risk of all kinds of stroke by 35 - 46%!

  • Eat Less Processed Foods

  • We’ve covered the negative effects that processed foods can have on your waistline and your immune health here. When I eat whole foods I feel the effect on my mental clarity and physical ability within hours, but that might not be the case for everybody.  Next time, try the salad instead of the tater tots and let me know how you feel the next day!

  • Eat Less Salt and Try “Light Salt”

  • Eating out less, eating less processed foods like breads, sweets, and pizza, and using a little less salt are the go-to ways to lower how much sodium you eat. Sodium raises blood pressure, and potassium works against this, so potassium-enriched “light salt” is also a good strategy for improving your health.

     


    How to Lower Risk of Stroke With Food

    DASH diet and Mediterranean diets are the most commonly recommended diets for total heart, brain, and body health. When we boil it down to just the top foods for neuro-vascular health, our list of best heart healthy foods looks like: 

    • Fish (salmon & sardines) are the richest sources of vitamin D, anti-inflammatory omega-3 fatty acids, magnesium, bioavailable calcium, and a host of other super nutrients.

    • Organ meats (especially liver) are so full of nutrition that I call them “nature’s multivitamin”. Especially important here are the B-vitamins like B12 and niacin, vasodilators like tyrosine, the richest natural source of heart healthy CoQ10, and almost every other vitamin and mineral.

    • Vegetables, especially green and red leafy vegetables which are high in vitamin K, potassium, natural nitrates, minerals like calcium and iron, and other vitamins. Brassicas veggies like kale, brussels sprouts, and broccoli even have sulforaphane, a master inflammation regulator.

    • Dark colored berries like aronia and wild blueberries are rich in anthocyanins, an antioxidant that has unique protective properties for your brain health.

    • Soy products (especially natto) and soft cheeses which are rich in vitamin K2 and contribute to overall heart and bone health.

    • Green tea or coffee are associated with a 20% decrease in risk of stroke.

    • Extra virgin olive oil is associated with a 35% lower risk of stroke when combined with a healthy Mediterranean Diet

    • Nuts and seeds are a key piece of that 46% decreased risk of stroke seen in studies.

    Remember to always talk to your healthcare provider before making major changes to your diet, lifestyle, and supplement routine. Don’t forget that meditation, prayer, yoga, or another mindfulness practice can go a long way in reducing stress, raising glutathione, lowering blood pressure, and contributing to your quality of life.

     

    Can Supplements Prevent Stroke?

    The American Stroke Association clearly states that, outside of correcting nutrient deficiencies, there is no evidence that supplements can help prevent a stroke.

    A lack of evidence is not, however, the same as a lack of effect. There are a number of supplements that can affect the underlying causes of stroke, and possibly even play a role in the treatment of it. Overall, it looks like getting these nutrients from food is a better bet, but let’s take a closer look at the research.

    Antioxidant Vitamins And Stroke

    Study after study (after study) shows that vitamin A, vitamin E, vitamin C, and vitamin D do not protect against stroke. That said, if you are at risk of being deficient (particularly common for vitamin D and vitamin C, read more on how to get more vitamin D here), then you should change your diet up to be more nutritious.

    B Vitamins and Stroke

    Studies show different results when it comes to niacin (vitamin B3) supplementation.  Most show that niacin may reduce risk of stroke by about 4% compared to a placebo, but even that is up for question due to differing results from studies. Folate, another B vitamin, looks like it doesn’t help at all. Vitamin B12 is still up for question too, but we do know that people who are deficient in it (vegans, mostly) should be supplementing or finding it in whole foods (predominantly animal products).

    Omega-3 fatty acids (especially DHA), CoQ10, nattokinase (in the japanese food, natto), vitamin K, calcium, and N-acetyl cysteine have all also been considered, but their effect is uncertain.  In cases like this, it’s best to get your nutrition through foods. 

    Nitric Oxide and Stroke Prevention and Treatment

    Healthcare professionals focus on keeping patients stable and meeting their physiological needs during a “cerebrovascular accident”. This is usually in the form of controlling the flow of oxygen and nutrients - keep in mind it’s the sudden loss of blood flow to the brain that actually causes the symptoms of stroke.

    Levels naturally go down in the “ischemic” phase of “ischemic reperfusion injury”, where blood flow is stopped temporarily.  No blood flow, no nitric oxide, and this is a good thing as your body shifts its efforts to managing the damage that can come from a stroke. In the recovery phase endothelial nitric oxide appears to be critical for the affected regions of the brain to recover their oxygenation and blood flow.

    A research article from the National Stroke Association clearly shows that patients who have a stroke have low nitric oxide levels, and the lower the levels the more severe the outcomes. The researchers suggest that ways to increase nitric oxide could possibly be protective and should be studied further. 

    This comes as no surprise, since low nitric oxide and a dysregulated pathway by which it is made is a hallmark of endothelial dysfunction.  That means that if you have a heart condition or related disease, odds are that you also have low nitric oxide.

    One very well done study in humans showed that a high nitrate diet was able to increase brain oxygenation in the part of your brain responsible for critical thinking and executive functioning. Mouse studies confirm that nitrates can increase the growth of neurons, suggesting a role in delaying neurodegenerative disease via a vascular mechanism.

    Nitric oxide donors, from prescription drugs like glyceryl trinitrate, synthetic sodium nitrate, inhaled nitric oxide, or maybe even standardized, natural supplements like red spinach extract or beetroot powder, may play a role in controlling blood pressure changes during a stroke.

    On the other hand, a mouse study showed no differences for mice given synthetic sodium nitrate or sodium nitrate, when it comes to stroke outcomes.  

    One small study showed that post-stroke patients given a beetroot juice supplement did not have any difference in physical functioning compared to a group given the standard of care and a nitrate-deficient beetroot placebo. 

    A meta-analysis of five studies showed that even though a patch-delivered nitrate drug lowered blood pressure, it did not have any effect in the treatment of stroke. Unfortunately, we do not yet have any high quality research on using other nitric oxide boosters for stroke treatment.

    Counter to this, numerous studies, mostly in animals but also in humans, have shown the protective role that adequate nitric oxide and supplemental nitric oxide donors can have on stroke. Too much of certain types appears to have a damaging role, which goes to show how complex the brain can be! Yet, from mouse and human studies, we know that having enough nitric oxide at the right times in the right places helps recovery from stroke. How confusing!

    All this different research clearly shows that getting enough natural plant-based nitrates ー whether that’s arugula in your salad, chard and bok choy in your stir fry, or a red spinach, aronia berry, or beetroot supplement ー can be helpful for some parts of your brain, but it’s not a cure-all for everything. 

    For preventing stroke, natural nitrates may be a good way to promote brain and heart health as a way to raise nitric oxide to healthy levels, but in the treatment phase there is still plenty of research to be done before we can really know the best way to use nitrates and nitric oxide.

    If you liked this blog you might also enjoy some of our other articles:

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    Wishing you the best in your health and your safety,

    The Resync Team

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    Chen, Zhou-qing, et al. “The Role of Nitric Oxide in Stroke.” Medical Gas Research, vol. 7, no. 3, Oct. 2017, pp. 194–203. PubMed Central, doi:10.4103/2045-9912.215750.

    Estruch, Ramón, et al. “Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts.” The New England Journal of Medicine, vol. 378, no. 25, June 2018, p. e34. PubMed, doi:10.1056/NEJMoa1800389.

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