Women who adhere to a healthy diet and lifestyle may be less likely – by more than half – to experience a stroke than those who do not, according to a new study.

Because stroke is a major cause of disability and mortality, a growing body of research is focusing on preventative factors. Hypertension is a leading and well-documented risk factor for stroke, so researchers in Sweden chose to look at contributing factors such as diet, alcohol consumption, smoking, physical activity, and adiposity as ways to modify blood pressure and by extension, the risk of stroke.

In order to investigate the association between lifestyle and risk of stroke, researchers in Sweden chose to look at five healthy lifestyle behaviors in a population of 31,696 Swedish women. The women at baseline had completed a 350-item questionnaire including items about diet and lifestyle and were determined to be free from cardiovascular disease and cancer. The women had an average age of about 60 and were followed for an average of 10 years.

Defining the terms of a low-risk style for the study were a healthy diet (top 50% of a Recommended Food Score – eating healthy foods such as fruits, vegetables and low-fat dairy products), moderate alcohol consumption (5–15 grams/day, or about 3-9 drinks per week), never smoking, being physically active (walking/bicycling at least 40 minutes per day and exercising more vigorously at least 1 hour per week), with a body mass index below 25 kg/m2. Incidents of were identified from the Swedish National Patient Register and the Swedish Cause of Death Register.

In comparing women in the study population who exhibited none of the five healthy factors, women with all five factors showed a 54-percent lower risk of stroke.

The study found that the most of the women had two or three of the healthy factors; only 589 women had all five healthy factors, while 1,535 had none.

There were 1,554 strokes among study participants, and researchers found that the risk of stroke decreased steadily with each additional healthy lifestyle factor.

Women who had a healthier diet were 13 percent less likely to have a type of stroke called a cerebral infarction than those whose diet was not as healthy. Cerebral infarction, caused by a blockage in a blood vessel preventing blood and oxygen from reaching an area of the brain, is the most common cause of stroke and accounts for up to 80 to 85 percent of all strokes. The researchers found that there was no relationship between the healthy factors and the risk of hemorrhagic stroke, however. This form of stroke can occur when there is bleeding in and around the brain, and accounts for about 15 to 20 percent of all strokes.

In looking at the larger picture, those with healthier diets showed a rate of 28 strokes per 10,000 per year compared to 43 strokes per 10,000 women per year among those with a less healthy diet.

In their conclusions, the researchers wrote that “These findings indicate that a low-risk lifestyle can substantially reduce the risk of stroke, especially cerebral infarction.”


  1. Larsson, Susanna C., Agneta Åkesson, and Alicja Wolk. “Healthy diet and lifestyle and risk of stroke in a prospective cohort of women.” Neurology (2014): 10-1212.


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