A stroke occurs when brain cells are robbed of oxygen. It results from either a blood clot impeding blood flow (ischemic stroke) or the bursting of a blood vessel (hemorrhagic stroke) in the brain. Strokes afflict 700,000 Americans each year, killing 157,000 of them, making it the third leading cause of death. Many studies suggest that fruits and vegetables protect against stroke. However, the strength of this effect is not clear.

A group of researchers set out to quantify just how much of an effect eating fruits and vegetables has on the risk of stroke. Their findings, published in the January 28, 2006 Lancet, reveal that, compared with people who eat less than three servings of fruits and vegetables each day, those who eat five servings or more had a 26% drop in their risk of stroke.

About the Study

The researchers combined and analyzed data from the eight best studies of dietary intake and stroke. In each study, participants had completed surveys about their eating habits and then had their health monitored for several years. For the current analysis, participants were grouped based on the number of fruit and vegetable servings they reported eating daily. The researchers then tallied the number of strokes that occurred in each group. Together, the eight studies provided data on 257,551 people for an average of 13 years, which yielded more powerful results than can be gleaned from a single, smaller study.

A clear trend emerged: the more fruits and vegetables people ate, the lower their risk for stroke. Compared to people who ate less than three servings of produce per day, those who ate three to five servings had an 11% drop in their risk, while those who ate five servings or more reduced their risk by 26%. Risk decreased for both ischemic and hemorrhagic stroke. Each study controlled for factors that affect stroke risk, such as age, smoking status, and blood pressure.

These findings may be limited by the survey methods used. Five studies asked about dietary habits only once; any changes over time were not accounted for. In addition, six studies used the food frequency questionnaire (FFQ), which requires an estimate of average yearly intake of each food. The accuracy of FFQs has been questioned, although it remains the preferred method of many researchers.

How Does This Affect You?

Should you eat more fruits and vegetables? Absolutely. The benefits go beyond stroke prevention by lowering the risk of cardiovascular disease, obesity , some forms of cancer , and other chronic diseases. The key here is whole foods. While nutrients such as folate and potassium are linked to many health benefits of produce, studies of nutrient supplements have not been impressive. In her commentary in The Lancet , Dr. Lyn Steffen explains, “It is likely that the combination of nutrients and compounds in foods has greater health benefits than the individual nutrient alone.”

Five to nine servings may sound daunting, but a serving is probably smaller than you think:

  • 1 medium-sized apple, orange, pear, or other piece of fruit
  • 1 cup of raw salad greens
  • ½ cup cut-up fruit or vegetables
  • ½ cup cooked beans (black beans, chickpeas, etc.) or peas
  • ¼ cup dried fruit
  • ¾ cup of 100% fruit or vegetable juice

Here are some ideas for boosting your intake:

  • Toss berries into cereal or oatmeal
  • Microwave frozen vegetables and mix with pasta sauce
  • Start meals with a salad
  • Add some crunch to a sandwich with apple slices
  • Mix frozen fruit with low-fat yogurt and ice for a smoothie
  • Use banana rather than jelly in a peanut butter sandwich
  • Chop vegetables, drizzle with olive oil and pepper, and roast in the oven