Category Archives: Stroke

Resistance Training Cuts Risk of Diabetes and Cardiovascular Disease in Middle-Aged Women

That's a dumbbell in her right hand. I work-out with those myself.

That’s a dumbbell in her right hand. I work-out with those myself.

I don’t have access to the full scientific report, but I’ve posted part of the abstract below.

The biggest problem with the study at hand is that physical activity apparently was surveyed only at the start of this 14-year study. Results would be much more robust if activity was surveyed every year or two. My overall activity level seems to change every two or three years. How about you?

Moving on.

“Compared to women who reported no strength training, women engaging in any strength training experienced a reduced rate of type 2 diabetes of 30% when controlling for time spent in other activities and other confounders. A risk reduction of 17% was observed for cardiovascular disease among women engaging in strength training. Participation in both strength training and aerobic activity was associated with additional risk reductions for both type 2 diabetes and cardiovascular disease compared to participation in aerobic activity only.

CONCLUSIONS: These data support the inclusion of muscle-strengthening exercises in physical activity regimens for reduced risk of type 2 diabetes and cardiovascular disease, independent of aerobic exercise. Further research is needed to determine the optimum dose and intensity of muscle-strengthening exercises.”

PMID 27580152

Source: Strength Training and the Risk of Type 2 Diabetes and Cardiovascular Disease. – PubMed – NCBI

Steve Parker, M.D.

PS: Cardiovascular disease includes heart attack, cardiac death, stroke, coronary angioplasty, and coronary artery bypass grafting.

Mediterranean diet could prevent 20,000 deaths in Britain each year 

 

Italian seaside tangentially related to this post

Italian seaside tangentially related to this post

The Telegraph has the details:

“Some 20,000 lives could be saved each year if Britons switched to a Mediterranean diet, according to a new study.

The Medical Research Council (MRC) and Cambridge University followed nearly 24,000 people in the UK for up to 17 years to see how their diet affected the health of their heart.

They discovered that people who followed a diet high in fruits, vegetables, whole grains, nuts, fish and olive oil lowered their risk of cardiovascular disease by up to 16 per cent. The researchers estimate that 12.5 per cent of cardiovascular deaths, such as heart attacks and strokes,  could be prevented if everyone switched to the Mediterranean diet. There are around 160,000 heart deaths each year so 20,000 deaths could be avoided just by eating more healthy foods.”

Source: Mediterranean diet could prevent 20,000 deaths in Britain each year 

A Pharmacist Asks: Should we use PCSK9 inhibitors?

PCSK9 inhibitors are a new class of drug that dramatically lowers LDL cholesterol. LDL is the “bad cholesterol” implicated in blocked arteries that cause heart attacks and strokes. PCSK9 inhibitors are injected every several weeks. They are expensive.

Pharmacist Catherine writes:

“We know this drug lowers LDL cholesterol.  But what we really care about (or should care about) is whether this medication lowers the risk of having a heart attack or a stroke.  This data isn’t yet available.   From what data I could easily access, it seems that the PCSK9 inhibitors can halve your risk of having heart attack over one year.  This might sound good, but when you look at actual numbers, not so good.  Of the ~4500 people studied, about 2% in the control group had an ‘event’ (heart attack, stroke or other cardiovascular event) compared to about 1% in the treatment group.  And the difference between the groups was only about 60 people.  The study size just simply isn’t big enough, nor has it run for long enough to really tell if these medications are worth it.  A bigger study is in progress, but we won’t get the results before 2017.   Even then, we may not have the long-term risk/benefit data.  A systematic review on the medications in 2014 concluded that there is currently insufficient data to show benefit.”

Source: Should we use PCSK9 inhibitors? | Lifestyle Before Medication

I also want to know the effect of these drugs on death rates. As they say, “more studies are needed.”

Hey, guess what? The Mediterranean diet prevents heart attacks and strokes, and extends lifespan.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

Mediterranean Diet Prevents Cardiovascular Disease

From American Family Physician:

“Cardiovascular disease (CVD) is the leading cause of death in the United States. One-third of these deaths may be preventable through healthy lifestyle choices including diet and physical activity. The Mediterranean diet is associated with reduced cardiovascular mortality [deaths], whereas the Dietary Approaches to Stop Hypertension (DASH) eating plan is associated with a reduced risk of coronary artery disease.”

Source: Diet and Physical Activity for Cardiovascular Disease Prevention – American Family Physician

There are at least a couple versions of the DASH diet. The most common one is low in total and saturated fats and cholesterol, moderate in low-fat dairy products, high in fruits and vegetables, low in salt, low in sweetened beverages, moderate in whole grains, and low in animal protein but has substantial amounts of plant protein from nuts and legumes.

The Mediterranean diet also has several versions. My favorite ones are here:

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

Stroke Falls to 5th Leading Cause of Death in U.S.

For most of my medical career, stroke was the third leading cause of death in the U.S., behind heart disease and cancer. Just a few years ago, chronic lower respiratory tract disease surpassed stroke.

Stroke continues to fall in rank and fell recently to fifth place, overtaken by accidents (unintentional injuries).

Even non-fatal strokes can be devastating.

Reduce your risk of stroke by maintaining normal blood pressure, not smoking, exercise regularly, living at a healthy weight, limiting your alcohol consumption, don’t get diabetes, and limit your age to 55. It’s also important to seek medical attention if you have a TIA (transient ischemic attack).

I also think the Mediterranean diet helps.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

Mediterranean Diet Linked to Lower Stroke Risk in Women

…but we knew that already. A new study involving California teachers confirmed prior findings. The Mediterranean diet reduced ischemic stroke risk by up to 18%. Ischemic strokes are your typical strokes, much more common than bleeding in the brain (hemorrhagic strokes).

Stroke is the 4th or 5th leading cause of death in the U.S. Why not lower your risk by following the Mediterranean diet?

MedPageToday has the details.

Steve Parker, M.D.

Even If You Already Have Cardiovascular Disease, the Mediterranean Diet Helps

…to prevent future events—like heart attacks and strokes—and to prolong life. Details are at the American Journal of Clinical Nutrition.

Do Fruits and Vegetables Prevent Disease? Which Ones?

Potential answers are in the American Journal of Clinical Nutrition (2012).  I quote:

For hypertension, coronary heart disease, and stroke, there is convincing evidence that increasing the consumption of vegetables and fruit reduces the risk of disease. There is probable evidence that the risk of cancer in general is inversely associated with the consumption of vegetables and fruit. In addition, there is possible evidence that an increased consumption of vegetables and fruit may prevent body weight gain. As overweight is the most important risk factor for type 2 diabetes mellitus, an increased consumption of vegetables and fruit therefore might indirectly reduces the incidence of type 2 diabetes mellitus. Independent of overweight, there is probable evidence that there is no influence of increased consumption on the risk of type 2 diabetes mellitus. There is possible evidence that increasing the consumption of vegetables and fruit lowers the risk of certain eye diseases, dementia and the risk of osteoporosis. Likewise, current data on asthma, chronic obstructive pulmonary disease, and rheumatoid arthritis indicate that an increase in vegetable and fruit consumption may contribute to the prevention of these diseases. For inflammatory bowel disease, glaucoma, and diabetic retinopathy, there was insufficient evidence regarding an association with the consumption of vegetables and fruit.

It bothers me that vegetables and fruits are lumped together: they’re not the same.

All of my diets—Advanced Mediterranean, Low-Carb Mediterranean, and Ketogenic Mediterranean—provide plenty of fruits and vegetables.

Berry Science, or Berriology

Mmm, mm, good! And they’re low carb

The Mediterranean diet was originally found to be a healthy diet by comparing populations who followed the diet with those who didn’t.  The result?  Mediterranean dieters enjoyed longer lifespans and less heart disease, cancer, strokes, diabetes, and dementia.

Over the last 15 years, researchers have been clarifying exactly how and why this might be the case.  A study from Finland is a typical example.

The traditional Mediterranean diet provides an abundance of fresh fruit, including berries.  Berries are a rich source of vitamin C and polyphenols, substances with the potential to affect metabolic and disease processes in our bodies.

The Finnish researchers studied 72 middle-aged subjects, having half of them consume moderate amounts of berries, and half consume a placebo product over 8 weeks.  Compared with the placebo group, the berry eaters showed inhibited platelet funtion, a 5% increase in HDL cholesterol (the “good” cholesterol), and a 7-point drop in systolic blood pressure.

What does platelet function have to do with anything?  Platelets are critical components of blood clots.  Blood clots can stop life-threatening bleeding, but also contribute to life-threatening strokes and heart attacks.  Inhibition of platelet function can decrease the occurence of blood clots that cause heart attacks and strokes.  That’s why millions of people take daily aspirin, the best known platelet inhibitor.

Cardiovascular disease is a group of conditions that include high blood pressure, heart attacks, poor circulation, and strokes.  Berry consumption in this small Finnish study resulted in favorable changes in blood pressure, HDL cholesterol, and platelet function.  These changes would tend to reduce the occurence and severity of cardiovascular disease.

So berries don’t just taste good, they’re good for us.  If price is a concern, focus on the berries that are in season or use frozen berries.

Steve Parker, M.D.

Reference: Erlund, I., et al, Favorable effects of berry consumption on platelet function, blood pressure, and HDL cholesterol.  American Journal of Clinical Nutrition, 87 (2007): 323-331.

Fat or Fit: Which Is Healthier?

Men live longer if they improve or maintain their fitness level over time, according to research out of the Cooper Clinic in Dallas, Texas. Part of that improved longevity stems from reduced risk of death from cardiovascular disease such as heart attack and stroke.

Compared with men who lose fitness with aging, those who maintained their fitness had a 30% lower risk of death; those who improved their fitness had a 40% lower risk of death. Fitness was judged by performance on a maximal treadmill exercise stress test.

Body mass index over time didn’t have any effect on all-cause mortality but was linked to higher risk of cardiovascular death. The researchers, however, figured that losses in fitness were the more likely explanation for higher cardiovascular deaths. In other words, as men age, it’s more important to maintain or improve fitness than to lose excess body fat or avoid overweight.

Steve Parker, M.D.

Reference: Lee, Duck-chul, et al. Long-term effects of changes in cardiorespiratory fitness and bodly mass index on all-cause and cardiovascular disease mortality in men. Circulation, 124 (2011): 2,483-2,490