1. Apples and Oranges: the Mediterranean Diet for Stroke Patients
Linda Means, MS, RD, LD
October 26, 2017

2. Disclosure
No Disclosures

3. Objectives Describe the key components of the Mediterranean Diet
10/26/2017
Objectives
Describe the key components of the Mediterranean Diet
Identify the health benefits associated with the Mediterranean Diet
Identify the modifiable risk factors for ischemic stroke

4. Hypertension (HTN)
HTN or high blood pressure (BP)is one of the most prevalent forms of cardiovascular disease
HTN occurs in approximately (1) of every (3) adults in the US
Untreated HTN can lead to myocardial infarction, stroke, renal failure, and death

5. Modifiable Risk Factors
High blood pressure is the main modifiable risk factor for ischemic stroke
Excess weight
Physical inactivity
Unhealthy eating patterns

6. Research Has Shown
Higher levels of sodium intake are associated with an increased risk of stroke
Higher levels of potassium intake are associated with lowering BP
A meta-analysis of prospective studies concluded that intake of fresh, processed, and total red meat amount is associated with an increased risk of ischemic stroke

7. Diet Pattern to Lower BP
Randomized trials show that diets such as the Mediterranean and DASH style diets reduce stroke risk
A meta-analysis of more than 1.5 million adults demonstrated that following a Mediterranean Diet was associated with a reduced risk of cardiovascular mortality

8. Key Components of the Mediterranean Diet
Eat primarily plant-based foods, such as fruits and vegetables, whole grains, legumes, and nuts
Replace saturated fat and trans fat with healthy fats, such as olive or canola oil
Use herbs and spices instead of salt to season foods
Limit red meat to no more than a few times per month
Eat fish and poultry at least twice per week
Drink red wine in moderation (optional)
Include being physically active

9. Fruits and Vegetables
Eat a variety of fruits and vegetables; whole and fresh are best
Aim for minimally processed items without added sugars or salt

10. Nuts Nuts are good sources of fiber, protein, and healthy fats
Nuts are high in calories, so consume in moderation (limit to a handful per day)
Avoid candied, honey-roasted, and heavily salted varieties

11. Grains Choose fiber-rich whole grains for most grain servings
Make at least half of the grains consumed each day whole grains ( the whole grain will be the first ingredient listed on the food label)

12. Healthier Fats
Focus is not on limiting total fat consumption but on choosing healthier fats
Replace saturated fat and trans fat ( such as butter, stick margarine, animal fat, hydrogenated fat) with healthier fats such as olive and canola oil

13. Fish – at Least Twice a Week
Choose fatty fish containing omega-3 fatty acids, such as mackerel, lake trout, herring, albacore tuna, and salmon

14. Red Meat Limit red meat to a few times per month
Choose lean cuts of meat and limit portion sizes
Avoid sausage, bacon, and other high fat, processed meats

15. Dairy
Choose fat-free or lowfat dairy products to reduce intake of saturated fat
Limit intake of higher fat dairy products such as whole or 2% milk, cheese, and ice cream

16. Sodium
Choose foods with less sodium and prepare foods with little or no salt
Aim for no more than 2300 mg of sodium per day = 1 teaspoon of salt
Reducing daily intake of sodium to mg/day is desirable as it can lower BP even more

17. Alcohol
Alcohol, in moderation, has been associated with a reduced risk of heart disease in some research studies
The Mediterranean Diet typically includes a moderate amount of wine, usually red wine
More than this amount may increase the risk of health problems
Check with your physician before adding alcohol to your daily meal plan

19. Moderation as Defined by the AHA
No more than 5 ounces of wine daily for women
No more than 10 ounces of wine daily for men under age 65

21. Healthy Weight – AHA Guidelines
Achieve and maintain a healthy weight
Engage in regular exercise 3-4 times per week, for an average of 40 minutes each time, of moderate to vigorous activity

22. Summary The Mediterranean Diet is a healthy and enjoyable way to eat
10/26/2017
Summary
The Mediterranean Diet is a healthy and enjoyable way to eat
Make gradual changes in your eating pattern until you have included all of the key components of the Mediterranean Diet

23. References
Meschia JF, Bushnell C, Boden-Albala B, et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the AHA/American Stroke Association. Stroke. 2014; 45:
Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the AHA/American Stroke Association. Stroke.2014; 45:
Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics update: a report from the AHA. Circulation. 2016: 133(4)e38-e360.

24. 10/26/2017
References
Lennon SL, DellaValle DM, Rodder SG, et al Evidence Analysis Library based nutrition practice guidelines for the management of hypertension in adults. Journal of the Academy of Nutrition and Dietetics. 2017; 117:
Thompson AM, Eshelbrenner CL, Reynolds K, et al. Antihypertensive treatment and secondary prevention of cardiovascular disease events among persons without hypertension: a meta-analysis. JAMA. 2011; 305:
Healthy Living- Mediterranean Diet; AHA. http.//heart.org/HEARTORG/HealthyLiving/HealthyEating/Mediterran ean_Diet_UCM_:306004_Article.jsp#.WcQzrWfruJa. Accessed 9/21/17.