Modifiable Risk Factors that Explain 90% of Stroke Risk! ‘Interstroke Study’

A modifiable risk factor is a health risk which is in your control. Age, gender and genetics are non-modifiable factors as we cannot change them. A modifiable risk factor however, can be eliminated with the correct lifestyle.

A recent study of 6,000 people from 22 countries called 'Interstroke' evaluated risk factors of stroke. The study showed that 10 risk factors are associated with 90% of the incidence of stroke and that most of these can be changed by lifestyle.

A stroke can be devastating resulting in death or a lifetime of physical impairment. The good news from this study is that many strokes can be predicted and the resultant burden of the disease reduced by following certain measures. Of the modifiable risk factors, blood pressure (hypertension) control was identified as the most important.

Five modifiable risk factors of hypertension, current smoking, abdominal obesity, diet and physical activity accounted for 80% of stroke.

When additional risk factors such as having Type 2 Diabetes, a high alcohol intake, psychosocial issues, abnormal apoliproprotein ratios and cardiac causes (such atrial fibrillation or flutter, previous myocardial infarction or valve disease) are taken into account these 10 risk factors account for 90% of the risk of stroke (1).

The following are key strategies for significantly reducing the risk of stroke:

• Maintain a healthy weight
• Limit your salt, processed and takeaway food intake
  
• Eat a balanced diet of vegetables, fruit, fish, poultry, meat, nuts and seeds, low fat dairy and whole grain carbohydrates
  
• Limit alcohol intake. Aim for no more than 2 standard drinks per day
  
• Go to your GP for a check up regularly
  
• Monitor your cholesterol levels
  
• Quit smoking
  
• Measure your waist regularly
  
• Exercise daily - aim for at least 30 minutes
  
• Get treatment for depression or stress

Unlike cardiac disease where there can be a lifetime of medication in order to reduce risk factors, the above strategies are all about leading a healthy lifestyle and that is free.

(1) O'Donnell. M. J, Xavier. D, Liu L, et al. Risk factors for ischemic and intracerebal haemorrhagic stroke in 22 countries (The Interstroke Study): Lancet 2010; DOI: 10.1016/S01140-6736(10)60834-3. Available at: http://www.thelancet.com/

Five Tips for Easier Weight Loss

When it comes to changing your lifestyle, it's human nature to look for the easiest option. So why not make the easiest option the healthiest option? Here are five tips to get you started:

1. Write a meal plan Create a weekly meal plan that accommodates your daily appointments, work commitments and children’s activities. On nights where time is precious, schedule in leftovers from the night before. Leftovers are a better option than takeaway meals as they are more nutritious and lower in calories - and they will save you money. No plan = no organisation, and no organisation = stress. And stress can make weight loss very difficult!

2. Include snacks in your meal plan To maintain your metabolism you need to eat every 2-3 hours (see our post about meal timing for weight loss). When choosing snack foods, plan nutritious foods from the five food groups, and make sure you serve yourself enough to leave you feeling satisfied for at least two hours. See our article on healthy snack ideas.

3. Write a shopping list – and stick to it! Compile a shopping list from your weekly meal plan. Shop once or twice a week to keep your pantry and fridge stocked with the ingredients you need. If you follow your list when shopping, you will be less likely to make impulse purchases.

4. Organise your pantry and fridge Keep commonly used foods in easily accessible spots in your fridge and pantry. And place calorie dense foods such as biscuits, chips and chocolate at the back of the top shelf of your pantry away from sight.

5. Plan your exercise When you are busy exercise can be the first thing to disappear from your 'to do' list. By scheduling exercise sessions on a weekly planner or diary, you are reserving this time to work on your health and fitness before you fill it with other duties. You make time for events such as medical appointments, work meetings, and coffee with friends – why not make an appointment with yourself (or with a friend or personal trainer) to exercise? It's just as important! Schedule slot for exercise and adjust your other commitments to accommodate it.

Healthy Eating on a Budget

You don't have to compromise your health to reduce your food bill. Here are some tips to help you buy low fat and nutritious food without paying top dollar:

Shop from a list Make a meal plan at the start of each week and decide what you need to purchase to make your meals. If you can be organised at the beginning of the week you won't need to shop at smaller, more expensive food stores. And if you have a weekly menu plan and ingredients to hand, you will be less likely to eat out at restaurants or buy take away foods on the way home from work.

Shop at fresh fruit and vegetable markets Fresh fruit and vegetables from specialty markets last longer (and taste better) than items purchased at large supermarket chains. Purchase fruit and vegetables that are in season (see the seasonal availability of fruits and vegetables).

Don't shop when you are hungry If you are hungry when you shop, you are more likely to buy items you don't 'need'.

Buy in bulk Buy non perishable items such as cereal and pasta in bulk at large supermarkets.

Shop online You'll be less likely to make impulse purchases if you shop online. And if you shop online from home you can check what is in your fridge and pantry to save doubling up! Woolworths and Coles have shops online.

Prepare meals yourself Buy fresh ingredients and prepare meals yourself rather than buying takeaway foods or pre-prepared items. By preparing your own food you can save calories - and dollars. Take a look at the following items that become more expensive as the amount of processing increases:

Potatoes (150g)
Potatoes 25c
Frozen chips 50c
150g potato crisps $2.99

Oats (40g)
Rolled oats 10c
Corn Flakes25c
Breakfast bar 95c

Chicken (100g)
Frozen whole chicken 35c
Raw whole chicken 50c
BBQ chicken 70c
Pre-made chicken kebabs $1.80

Apple (100g)
Apple 40c
Packet of sultanas 90c
Fruit bar $3.20

There are lots of online resources for quick and healthy recipes, including the National Heart Foundation Recipe Guide.

So it's no more expensive to eat healthy food - it just takes a bit of preparation and planning.

Fast Weight Loss: Why it Doesn't Work

Fasting diets generate fast but false results. Here's why:

You lose fluid, not fat And any fluid lost will return as soon as the fast is completed, in other words you'll re-gain any weight that you lost.

Lowered metabolism During fasting your metabolism slows by up to 40% to prepare for starvation, so when you eat normally again your body burns fewer calories and you gain weight.

Hunger and lethargy Fasting leads to hunger and cravings - not what you need when you are trying to lose weight! And when you drastically cut your calorie intake you will feel weak, making it even more difficult to maintain your resolve to lose weight.

Yo yo dieting Fasting often leads to cycles of weight loss and weight gain called 'yo yo' dieting. 95% of people who go on fast weight loss diets regain any weight lost - plus more - within two years (1).

Abstinence leads to binging When your food intake is restricted you experience physical and emotional deprivation. This compels you to eat, which commonly leads to overeating or binging. As a result, you are likely to feel sensations of guilt and failure. This often becomes a cycle which is difficult to break and has devastating effects on your self esteem (1).

Nutritional deficiencies Prolonged fasting may lead to nutritional deficiencies. For example, if you don't consume enough calcium you may be at risk of osteoporosis, or if you don't consume enough fibre you may experience constipation.

Poor Health Fast weight loss is bad for your health because it:
- Increases your risk of medical complications such as gallstones, gout and constipation (2)
- Lowers your immunity
- Leaves you deficient in important vitamins and minerals.

Impracticalities Fast weight loss involves restricting food intake to the point where you are constantly hungry and lack the nutrients you need to maintain physical health and energy levels. This situation can't be sustained in the long term. Plus fasting makes it difficult to carry out normal social interactions - people who are dieting often avoid social situations and family mealtimes, leading to feelings of isolation and loneliness.

Some people claim that fasting can help rid your body of 'toxins' (i.e. the food you eat). 'Toxins' occur naturally in your body, and your body has fantastic systems to cleanse itself (your kidneys and liver).

Healthy Weight Loss

A sensible weight loss goal is 0.5 - 1kg per week, and the best way to achieve this is to make healthy changes to your eating and exercise habits. These changes should always be sustainable - that way you will lose weight and keep it off.

References:
1. Why Diets Don't Work, Eating Disorders Foundation of Victoria
2. Rapid Weight Loss Linked to Gallstones, Flinders Medical Centre