Stroke is a leading cause of long-term disability and the fifth leading cause of death in the United States. Self-reported incidents of stroke increased 14.6% among people ages 18 to 44 and about 15.7% among people ages 45 to 64 from 2011-2013 to 2020-2022.
Granted the rates of hypertension and obesity, risk factors of stroke, have increased in both youth and middle-aged adults. Depression increases the risk of stroke.
Depression Increases Your Risk
There is strong evidence that depression is associated with increased risks of total stroke, fatal stroke, and ischemic stroke from decreased blood flow within the brain.1 In a systematic review and a meta-analysis of prospective cohort studies consisting of 317,540 participants, researchers from the Harvard School of Public Health studied the association between depression and risk of total and subtypes of stroke. Pooled analysis showed that depression was associated with:(2)
- 45 percent increased risk for total stroke
- 55 percent increased risk for fatal stroke
- 25 percent increased risk for strokes resulting from when the blood supply to a portion of brain has been interrupted or obstructed.
It should be noted that depressed individuals often have difficulty in incorporating good lifestyle practices. Also depression increases the risk for undesirable clotting by increasing platelet stickiness. Unfortunately, it also substantially reduces blood flow to the front brain.
What Can Help?
Have a thorough evaluation by health care professionals.
Some lab work to consider could include TSH (thyroid stimulating hormone), CBC (complete blood count), vitamin B12, folate, vitamin D, electrolytes, kidney and liver function, fasting blood sugar, and perhaps toxicology testing, and a physical exam. Depending upon your age, and medical history, your health care provider may order additional testing.
Have your diet checked for nutritional adequacy by a registered dietician. Don’t just rely on supplementation unless your dietary history or lab work shows you are deficient. Taking excessive amounts above the recommended daily allowance may produce undesirable side effects. Whole plant foods have an arsenal of antioxidants and anti-inflammatory compounds that combat inflammation inside the brain, which is common in major depression. Peripheral inflammation, commonly seen in obesity, diabetes, and autoimmune conditions, also elevates stroke risks. For a list of foods that fight depression, visit this link.
A Positive Attitude Helps
After controlling for many probable confounders, a Finnish study showed that individuals who had less dispositional pessimism had a 48% less risk of stroke compared to those who had high levels of pessimism.2
Optimism protects against stroke. Researchers from the University of Michigan looked at the results of standard optimism tests for 6,044 men and women. All were free of stroke at the study’s start. The optimism score was on a 16-point scale. After adjusting for age, each unit increase in their optimism score reduced stroke risk by about 9 percent. Even when the researchers also adjusted for other factors such as smoking, alcohol use, race, gender, hypertension, mental illness, body mass index, and level of physical activity, the association between optimism and reduced risk of stroke remained robust.(4) By cultivating gratitude and focusing on life’s positives, we encourage optimism.
Emphasize whole plant-based foods.
If you are eating an omnivorous diet, changing your dietary habits to emphasize whole fruits, vegetables, nuts, whole grains, legumes, and monounsaturated fats (olives, avocados, almonds) can help you. One such diet that is easy to transition into is the Mediterranean Diet. Researchers found that men aged 18–25 years experienced an improvement in depression symptoms after switching to a Mediterranean-type diet.3
A systematic review of 61 peer-reviewed, observational studies found that a high total intake of fruits and vegetables may promote higher levels of optimism and self-efficacy.4 What is self-efficacy? The term refers to an individual’s belief in his capacity to execute behaviors necessary to achieve his performance goals.
High consumption of fruits and vegetables is linked to reduced levels of psychological distress, ambiguity, and fatalistic thinking if one has cancer, and protects against depressive symptoms.5 Be sure to include some raw plant foods. Why? Bananas, apples, citrus, berries, grapefruit, kiwifruit, carrots, lettuce, cucumbers, and green leafy vegetables, particularly spinach, have been linked to better mental health.6 Aim for six to eight servings of fruits and vegetables a day for optimal mental health.
Caveats: If you are going entirely plant-based, be sure that you have adequate amounts of vitamin B-12, and vitamin D, and watch your iodine level, if you do not use iodized salt.
Fiber is Your Friend!
Sixteen high-quality studies, involving 855,671 subjects, showed that the total intake of fiber, vegetable fiber, and soluble fiber reduce the risk of ischemic stroke.6 Another study indicated that a higher intake of dietary fiber improved the survival of patients with stroke. For this reason, it is better to eat whole fruits and vegetables than to emphasize a juice diet.
Ultra-processed foods (UPFs) make depression worse.
Brain imaging studies show that depression is linked to consumption of UPFs.8 Higher UPF consumption was linked to brain shrinkage in mesocorticolimbic brain regions.7 So what is the significance of this area of the brain?
This specific dopamine pathway of several brain organs participates in cognition, reward, reinforcement, motivation, and emotional stability. Shrinking in this area increases the risk for depression. So, if you want to have more emotional stability, sharper cognitive abilities, more enjoyment, and greater motivation, skip the ultra-processed foods such as ice cream, flavored yogurt, pastries, biscuits, crackers, most commercial breads, sweetened cereals, snacks, prepared frozen meals, meat substitutes, instant sauces, and gravies. Watch out if the food product contains sweeteners, artificial sweeteners, food colorings or preservatives, emulsifiers, whey, protein isolates, MSG, and invert sugar.
People Need Good People
Researchers have found that risk of stroke, according to the 2006-2018 data from the Health and Retirement Study, participants who experience chronic loneliness had a 56% greater stroke risk than those who did not report chronic loneliness. This same study showed that individuals who experienced loneliness one time had a 25% increased risk of stroke.8
Considerations
Prehypertension, high blood pressure, diabetes, elevated cholesterol, and elevated triglycerides also increase one’s risk for stroke. Learning how to overcome depression can help lower the risk of stroke. Depression and stress increase the stickiness of platelets, making it easier for them to form undesirable clots. There is some evidence that treatment of depression may reduce one’s stroke risk. A healthful plant-based diet, exercise, hydrotherapy, and cognitive behavior therapy help anxiety and depression.
The good news is that the Wildwood Lifestyle Center’s Disease Reversal Program has winning strategies to help these conditions and thus reduce your risk for stroke, and a special program, Mental Health and Wellness, to help anxiety and depression.
Work Cited
https://www.cdc.gov/mmwr/volumes/73/wr/mm7320a1.htm?s_cid=mm7320a1_w
Sources
- Pan A., et al, Depression and the Risk of Stroke Morbidity and Mortality: A Meta-analysis and Systematic Review. JAMA 2011, Sept. 21, 306 (11), 1241-1249 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3242806/[↩]
- Herman N., et al., Low pessimism protects against stroke: the Health and Social Support (HeSSup) prospective cohort study, Stroke 2010, January 41(1), 189-190, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2884028/ [↩]
- Lassale, C., Batty, G.D., Baghdadli, A. et al. Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Mol Psychiatry 24, 965–986 (2019). https://www.nature.com/articles/s41380-018-0237-8 [↩]
- 5. Głąbska D, Guzek D, Groele B, Gutkowska K. Fruit and Vegetable Intake and Mental Health in Adults: A Systematic Review. Nutrients. 2020 Jan 1;12(1):115. https://pmc.ncbi.nlm.nih.gov/articles/PMC7019743/#B50-nutrients-12-00115 [↩]
- Brookie K.L., Best G.I., Conner T.S. Intake of Raw Fruits and Vegetables Is Associated with Better Mental Health Than Intake of Processed Fruits and Vegetables. Front. Psychol. 2018;9:487. https://pmc.ncbi.nlm.nih.gov/articles/PMC5902672/[[↩]
- Li DB, Hao QQ, Hu HL. The relationship between dietary fibre and stroke: A meta-analysis. J Stroke Cerebrovasc Dis. 2023 Aug;32(8):107144. doi: 10.1016/j.jstrokecerebrovasdis.2023.[↩]
- 8. Oren Contreras-Rodriguez, et al. Consumption of ultra-processed foods is associated with depression, mesocorticolimbic volume, and inflammation. Journal of Affective Disorders. volume 335.15 August 2023, Pages 340-348. https://www.sciencedirect.com/science/article/pii/S0165032723006365 [↩]
- Soh Y., et al., Chronic loneliness and the risk of incident stroke in middle and late adulthood: a longitudinal cohort study of U.S. older adults, Lancet vol. 73, 102639, July 2024 https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00218-9/fulltext[↩]