Drop the cookie: Ultra-processed food intake and risk for stroke
The relationship between intake of highly palatable, ultra-processed foods like soda, chips, and cookies is well established with the risk of weight gain and heart disease. New research now suggests these beverages and foods may pose a higher risk of having a stroke.
The new study published in the May 22, 2024, online issue of Neurology®, the medical journal of the American Academy of Neurology, shows a link between eating ultra-processed foods, memory loss, and stroke but doesn’t prove causation.
Foods categorized as “ultra-processed” include those high in added fat, salt, and sugar that are low in fiber and protein. Commonly consumed items include soda, sugary and salty snacks, ice cream, hamburgers, canned baked beans, commercial breads, flavored cereals, and condiments such as ketchup and mayonnaise. Minimally or unprocessed foods are meat such as beef, pork, and chicken, fruits, and vegetables.
"While a healthy diet is important in maintaining brain health among older adults, the most important dietary choices for your brain remain unclear," said study author W. Taylor Kimberly, MD, PhD, of Massachusetts General Hospital in Boston. "We found that increased consumption of ultra-processed foods was associated with a higher risk of both stroke and cognitive impairment, and the association between ultra-processed foods and stroke was greater among Black participants."
Researchers evaluated over 30,200 people aged 45 or older who identified as Black or white. Subjects were followed for roughly eleven years. Questionnaires were filled out about foods they ate and drank. Researchers estimated how much ultra-processed food people ate by calculating the grams per day and comparing it to the grams per day of other foods to find a percentage of their daily diet. That percentage was calculated into four groups, going from the least processed foods to the most processed foods.
Of all of the participants, researchers looked at 14,175 subjects for cognitive decline and 20,243 subjects for stroke. Neither group had a history of cognitive impairment or stroke.
By the close of the research, 768 people were diagnosed with cognitive impairment and 1,108 people had a stroke.
People who developed memory and thinking problems consumed 25.8% of their diet in ultra-processed foods for those in the cognitive group, compared to 24.6% for those who didn’t develop cognitive problems.
Researchers found that a 10% increase in the amount of ultra-processed foods eaten was associated with a 16% higher risk of cognitive impairment after adjusting for age, sex, high blood pressure, and other factors that could impact the risk of dementia,
A 12% lower risk of cognitive impairment was also found with eating more unprocessed or minimally processed foods.
In those in the stroke group, people who had a stroke during the study ate 25.4% of their diet in ultra-processed foods, compared to 25.1% for those who did not have a stroke.
Researchers found greater consumption of ultra-processed foods was linked to an 8% increase in risk of stroke, while a greater intake of unprocessed or minimally processed foods was linked to a 9% decreased risk of stroke after adjusting for other factors.
The impact of ultra-processed food intake on stroke risk was greater among Black subjects, with a 15% relative increase in risk of stroke.
"Our findings show that the degree of food processing plays an important role in overall brain health," Kimberly said. "More research is needed to confirm these results and to better understand which food or processing components contribute most to these effects."
One limitation of the study was that only participants who self-identified as Black or white were used in the study, so results may not be generalizable to individuals from other populations.1
Below are tips on reducing your risk for stroke and cognitive decline:
· Get a handle on blood pressure. Heed your healthcare provider’s advice on diet, exercise, stress reduction, and medication usage.
· Reduce soda and other sweetened drinks. Swap these out for flavored seltzer water, unsweetened tea, or water with lemon or lime.
· Choose unsalted or lightly salted nuts or seeds in place of chips and crackers.
· Enjoy seasonal fruit for potassium, fiber, vitamins, minerals, and phytochemicals that may offer protection against stroke and cognitive decline.
· Include more leafy greens in your meals as part of the MIND diet. 2
· Eat more healthy fats in your diet including avocado, canola, extra virgin olive oil, and oils from nuts and seeds. 3
· Treat high-sugar, high-fat desserts as “treats” and not everyday foods.
· Try frozen yogurt in place of ice cream to limit saturated fat in your diet.
· Manage blood sugar, which is a risk factor for stroke. Take frequent walking breaks throughout the day versus sitting to reduce blood sugar. 4
· Stay social. A recent study found that chronic loneliness significantly raises the risk for stroke. 5
Lisa Andrews, MEd, RD, LD
References:
1. Varun M. Bhave, Carol R. Oladele, Zsuzsanna Ament, Naruchorn Kijpaisalratana, Alana C. Jones, Catharine A. Couch, Amit Patki, Ana-Lucia Garcia Guarniz, Aleena Bennett, Michael Crowe, Marguerite R. Irvin, W. Taylor Kimberly. Associations Between Ultra-Processed Food Consumption and Adverse Brain Health Outcomes. Neurology, 2024; 102 (11) DOI: 10.1212/WNL.0000000000209432
2. de Crom TOE, Mooldijk SS, Ikram MK, Ikram MA, Voortman T. MIND diet and the risk of dementia: a population-based study. Alzheimers Res Ther. 2022 Jan 12;14(1):8. doi: 10.1186/s13195-022-00957-1. PMID: 35022067; PMCID: PMC8756695.
3. Delgado-Lista J, Alcala-Diaz JF, Torres-Peña JD, Quintana-Navarro GM, Fuentes F, Garcia-Rios A, Ortiz-Morales AM, Gonzalez-Requero AI, Perez-Caballero AI, Yubero-Serrano EM, Rangel-Zuñiga OA, Camargo A, Rodriguez-Cantalejo F, Lopez-Segura F, Badimon L, Ordovas JM, Perez-Jimenez F, Perez-Martinez P, Lopez-Miranda J; CORDIOPREV Investigators. Long-term secondary prevention of cardiovascular disease with a Mediterranean diet and a low-fat diet (CORDIOPREV): a randomised controlled trial. Lancet. 2022 May 14;399(10338):1876-1885. doi: 10.1016/S0140-6736(22)00122-2. Epub 2022 May 4. PMID: 35525255.
