Mediterranean Diet Helps Prevent Stroke, AHA Guidelines Say

The so-called “Mediterranean diet” has been recommended as a way to control weight and prevent diabetes. Now, the American Heart Association (AHA) and the American Stroke Association (ASA) have issued new guidelines that say the diet should be encouraged to reduce a person’s risk of first-time stroke.

The Mediterranean or DASH diet (for Dietary Approaches to Stop Hypertension) emphasizes fruits, vegetables, whole grains, legumes, nuts, seeds, poultry, and fish. It limits red meats, sweets, and foods with saturated fats. The new AHA and ASA guidelines call for following this diet alongside other healthy lifestyle measures, such as adequate exercise, as a way to dramatically reduce one’s odds of suffering a stroke. The guidelines were published in the journal Stroke.

In a statement, James Meschia, MD, chairman of neurology at the Mayo Clinic and guideline writing committee chair, said, “We have a huge opportunity to improve how we prevent new strokes, because risk factors that can be changed or controlled—especially high blood pressure—account for 90% of strokes.”

Hypertension in particular is discussed in the guidelines. Patients are encouraged to have a blood pressure of no greater than 140/90 mm Hg; if higher, it should be treated with antihypertensive medication to achieve that target blood pressure.

The links among blood pressure, hypertension, diabetes, and obesity are so well-documented that the Mediterranean diet, supplemented with nuts and reduced sodium intake, tends to cut across guidelines connected to these diseases. The diet has been discussed at length at meetings of the US Dietary Guidelines Advisory Committee, which is making recommendations that will inform the 2015 Dietary Guidelines for Americans, the nation’s official nutrition policy.

Studies on the value of the Mediterranean diet have been published recently, including a trial in Spain that linked the Mediterranean diet to lower levels of type 2 diabetes mellitus. A study of active firefighters found those who consumed a Mediterranean-style diet (and might not normally do so) were less likely to gain weight and experience poor cardiometabolic effects, compared with those who consumed other diets, including those that included fast food. Both studies were discussed earlier this year in Evidence-Based Diabetes Management, a news publication of The American Journal of Managed Care.

Managed care companies are taking a closer interest in educating patients about taking a proactive interest in diet and exercise programs, as a way to hold down the soaring costs of healthcare. Dr Meschia has said that while antihypertensive medications are helpful, achieving a healthy blood pressure through diet and exercise is far preferable from a health perspective, in addition to being less costly.

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