Diet and stroke.

In industrialized countries, stroke is the most frequent life-threatening neurological disorder. The mortality trend for stroke appears to be similar to that of coronary heart disease (CHD) in different countries. Thus the dietary changes that protect from CHD, may also protect from stroke. The purpose of the present paper is not to review exhaustively the associations between foodstuffs and stroke. It is rather to emphasize a few important relationships that may be conducive to efficient recommendations in Public Health. The intake of saturated fat, considered as the main environmental factor for CHD, does not appear to be also closely related to stroke. It has even been observed in the Framingham prospective study, that saturated fats were associated with a protective effect on stroke. The multivariate analysis of the ecological study reported in the present paper suggests that the villain for stroke could be the high intake of linoleic acid, the main polyunsaturated fatty acid prescribed through the world, to most of the CHD patients. Observation and intervention studies suggest that the fatty acid with the most efficient protective effect on stroke is alpha-linolenic acid (ALA) as for CHD clinical manifestations. Also similarly to CHD, fruit, vegetables and folic acid, may have important protective effect on stroke. Finally, at very moderate intake, alcohol may be related to a similar lowering on the risk of stroke as on that of CHD. Nevertheless alcohol, at high intake for intoxication (binge drinking) has been associated with up to a 10 fold increased in the risk of stroke. Finally, the diet recommendations suggested by the present analysis are similar to those used in the Lyon Diet Heart Study and in Finland, in the last 20 years. In both of these intervention studies mortality from CHD, cancer and stroke have been markedly reduced by more than 50 %.