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The INDEPENDENT, September 21, 2011
An apple or a pear every day may help protect against strokes
Apples and pears may keep
strokes away.
That’s the conclusion of a
Dutch study published in
Stroke: Journal of the American
Heart Association, in which re-
searchers found that eating a
lot of fruits and vegetables with
white flesh may protect against
stroke.
While previous studies have
linked high consumption of
fruits and vegetables with lower
stroke risk, the researchers’
work is the first to examine as-
sociations of fruit and veg-
etable color groups with stroke.
The color of the edible por-
tion of fruits and vegetables re-
flects the presence of benefi-
cial phytochemicals such as
carotenoids and flavonoids.
Researchers examined the
link between fruits and veg-
etable color group consump-
tion with 10-year stroke inci-
dence in a population-based
study of 20,069 adults, with an
average age of 41. The partici-
pants were free of cardiovascu-
lar diseases at the start of the
study and completed a 178-
item food frequency question-
naire for the previous year.
Fruits and vegetables were
classified in four color groups:
• Green, including dark leafy
vegetables, cabbages and let-
tuces
• Orange/Yellow, which were
mostly citrus fruits
• Red/Purple, which were
mostly red vegetables
• White, of which 55 percent
were apples and pears
During 10 years of follow-up,
233 strokes were documented.
Green, orange/yellow and
red/purple fruits and vegeta-
bles weren’t related to stroke.
However, the risk of stroke inci-
dence was 52 percent lower for
people with a high intake of
white fruits and vegetables
compared to people with a low
intake.
Each 25 gram per day in-
crease in white fruits and veg-
etable consumption was asso-
ciated with a nine percent low-
er risk of stroke. An average
apple is 120 grams.
“To prevent stroke, it may be
useful to consume consider-
able amounts of white fruits
and vegetables,” said Linda M.
Oude Griep, M.Sc., lead author
of the study and a postdoctoral
fellow in human nutrition at Wa-
geningen University in the
Netherlands. “For example,
eating one apple a day is an
easy way to increase white
fruits and vegetable intake.
“However, other fruits and
vegetable color groups may
protect against other chronic
diseases. Therefore, it remains
September is Cholesterol Awareness Month
Have you had your choles-
terol levels checked?
September is National Cho-
lesterol Awareness Month — a
good time to find out what your
cholesterol numbers are, to
learn about your risk for high
cholesterol and what you can
do to keep your levels in check.
More than 98 million Ameri-
cans 20 and older have high
blood cholesterol — one of the
most controllable risk factors
for heart disease and stroke,
according to the American
Heart Association.
High cholesterol doesn’t al-
ways have symptoms. So it’s
important to have your doctor
check your cholesterol levels
starting at least by age 20, and
earlier if you have a family his-
tory of heart disease.
The two types of cholesterol
are high-density lipoprotein, or
HDL (“good” cholesterol), and
low-density lipoprotein, or LDL
(“bad” cholesterol).
Too much bad cholesterol or
not enough good cholesterol
can increase your risk for heart
disease or stroke. The ideal
cholesterol level for most peo-
ple is less than 200 mg/dL.
The amount of triglycerides
(or blood fats) in blood is an-
other important barometer of
your health; high levels are as-
sociated with coronary heart
disease, diabetes and fatty liv-
er disease. Your doctor can
measure your triglyceride lev-
els with the same test for cho-
lesterol. A normal triglyceride
level should be less than 150
mg/dL.
Your liver and other cells in
your body make about 75 per-
cent of blood cholesterol. LDL
cholesterol is produced natu-
rally by the body, but many
people inherit genes from their
mother, father or grandparents
that cause them to make too
much. The other 25 percent
comes from the foods you eat.
The kinds and amounts of
foods you eat, weight, physical
activity and exposure to tobac-
co may affect your cholesterol
and triglyceride levels. These
factors may be controlled by:
• Eating a heart-healthy di-
etary pattern.
• Engaging in physical activ-
ity.
• Controlling your blood
pressure.
• Maintaining a healthy
weight.
• Not smoking and avoiding
being around others who do.
The American Heart Associ-
ation has information and tools
about cholesterol and how to
reduce your risk for heart dis-
ease and stroke at www.
heart.org/cholesterol.
of importance to consume a lot
of fruits and vegetables.”
Apples and pears are high in
dietary fiber and a flavonoid
called quercetin. In the study,
other foods in the white catego-
ry were bananas, cauliflower,
chicory and cucumber. Pota-
toes were classified as a
starch.
Previous research on the
preventive health benefits of
fruits and vegetables focused
on the food’s unique nutritional
value and characteristics, such
as the edible part of the plant,
color, botanical family and its
ability to provide antioxidants.
U.S. federal dietary guide-
lines include using color to as-
sign nutritional value. The U.S.
Preventive Health Services
Taskforce recommends select-
ing each day vegetables from
five subgroups: dark green,
red/orange, legume, starchy
and other vegetables.
Before the results are adopt-
ed into everyday practice, the
findings should be confirmed
through additional research,
Oude Griep said. “It may be too
early for physicians to advise
patients to change their dietary
habits based on these initial
findings,” she said.
An accompanying editorial
notes that the finding should be
interpreted with caution be-
cause food frequency ques-
tionnaires may not be reliable.
In addition, “the observed re-
duction in stroke risk might fur-
ther be due to a generally
healthier lifestyle of individuals
consuming a diet rich in fruits
and vegetables,” writes Heike
Wersching, M.D., M.Sc., of In-
stitute of Epidemiology and So-
cial Medicine at the University
of Münster, in Germany.
Study co-authors are: W.M.
Monique Verschuren, Ph.D.;
Daan Kromhout, M.P.H., Ph.D.;
Marga C. Ocké, Ph.D.; and Jo-
hanna M. Geleijnse, Ph.D. Au-
thor disclosures are on the
manuscript.
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