Healthy eating

and stroke
Stroke Helpline: 0303 3033 100
or email: helpline@stroke.org.uk

Eating a healthy, balanced diet can help reduce your risk of a

stroke. This guide suggests some simple ways you can change
your diet to reduce your blood pressure, stay a healthy weight,
and lower cholesterol.

If you have had a stroke or transient Five healthy eating tips to help reduce
ischaemic attack (TIA or mini-stroke), your risk of stroke
you should be given some advice about
healthy eating. People with swallowing 1. Fruit and vegetables should make up a
problems should have advice from a third of your daily diet. Eat at least five
speech and language therapist and portions a day.
dietitian on healthy and safe ways to
eat and drink. If you have trouble eating 2. Starchy foods should make up another
enough to keep your weight up, ask your third of your daily diet. Go for more
GP or dietitian for help. If you need to wholegrains in foods like brown rice,
reduce your weight, you can get advice wholegrain bread and breakfast cereals.
from your GP, and there are some great
resources online such as NHS OneYou and 3. Aim to eat some protein every day.
NHS Choices. Healthy sources of protein can be found in
fish, pulses, nuts and seeds, lean meat and
meat alternatives like tofu and textured
vegetable protein.

4. Cut down on full-fat milk, cream and

cheese, fatty meat, processed meats, and
solid fats like butter and margarine.

5. Limit salt to a teaspoon day (or 6g). This

includes hidden salt in ready-made and
processed foods.

Look inside this guide for some practical

tips for changing your diet.

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Healthy eating and stroke

Fruit and vegetables The mineral potassium can help prevent

high blood pressure. Eating more fruit and
Eating five or more portions of fruit and vegetables is a good way to increase your
vegetables a day can reduce your risk of potassium levels. Bananas, nuts, mushrooms
stroke by up to 30%. Every extra portion and potatoes are rich sources, but all
you eat reduces your risk even further. Try vegetables and fruit contain potassium.
gradually increasing the number of portions Over-the-counter potassium supplements
you eat. You could start taking a piece of should only be taken on medical advice,
fruit to work, add a salad to your lunch or try as they can be harmful if you have kidney
making a simple homemade vegetable soup. problems or take some types of blood
pressure medication.
What is a portion of fruit or vegetables?
Tips for eating five a day
• One portion weighs 80g.
• For fruit, this could be an apple or two • Replace crisps and chocolate with healthy
plums, a handful of berries, or three snacks, like a piece of fruit, raw carrot
heaped tablespoons of fruit salad sticks with some humous, or some dried
• 30g or one heaped tablespoon of dried fruit and unsalted nuts.
fruit counts as a portion. • Choose a colourful variety of fruits and
• A glass of fruit juice (150ml) counts as a vegetables. This will help you to get a
maximum of one daily portion. This is range of vitamins and minerals including
because it is low in fibre and contains a lot antioxidants. Think about green leafy
of natural sugars, which may affect blood vegetables, orange and red fruit and
sugar levels. vegetables like carrots and peppers, and
• For vegetables, one portion is three dark purple foods like aubergines and
heaped tablespoons whether raw, cooked blueberries. Potatoes are classed as a
or tinned. A dessert bowl of salad counts starchy food, not a vegetable, but the skin
as one portion. provides useful fibre and potassium.
• Canned fruit and veg count towards your
What are the benefits? five a day. Choose fruit in juice rather than
syrup, and vegetables in water without salt
Vitamins and minerals or sugar.
Fruit and vegetables contain a range of • Frozen vegetables and fruit are full of
vitamins, minerals and nutrients. the same nutrients and fibre as fresh. Try
adding some frozen berries to porridge,
These include antioxidants such as vitamins or frozen chopped vegetables to a home-
A, C and E and beta-carotene, which work to made pasta sauce.
prevent damage to your arteries. You don’t
need to take supplements to get enough
antioxidants unless they are prescribed by
your doctor. It’s a good idea to try to eat
a range of foods containing the vitamins
you need. To get more antioxidants, aim to
eat a variety of different coloured fruit and
vegetables. You could try carrots, apricots,
berries, broccoli or red peppers.

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 Healthy eating and stroke

Fibre Wholegrains
Fibre is vital for lowering cholesterol, keeping Wholegrains are linked to a lower risk of
blood sugar levels stable, and managing stroke. They can also help us avoid type 2
your weight. Adults should aim to eat 30g of diabetes, heart disease and weight gain.
fibre every day.
To make white flour or white rice, the brown
Fibre is found in plant-based foods, not meat outer skin of the grain is removed. This
or dairy. The amount of fibre in food can skin is where most of the fibre, vitamins
often be found on the label. You may hear the and minerals are stored. So that’s why
terms insoluble and soluble fibre being used. wholegrain foods tend to contain more
vitamins and minerals than refined products
• Soluble fibre delays the time it takes for like white bread and white pasta.
you to digest food, making you feel fuller Wholegrains are a good source of B-vitamins
for longer. It can regulate blood sugar and folic acid, as well as both types of fibre.
levels and help reduce cholesterol. It does
this by binding to excess cholesterol and Tips for eating more wholegrains
fatty substances in the gut, stopping them
from going into your bloodstream. One • Start off by adding wholegrains into some
kind of soluble fibre is beta-glucan, which of your main meals. Try brown rice instead
is found in grains like oats, barley and rye. of white, brown pasta and wholewheat
Fruit, vegetables, beans, pulses and peas couscous.
are other good sources of soluble fibre. • Look for wholegrain breakfast cereals.
• Insoluble fibre shortens the time it takes • Choose wholegrain bread, and try bread
for food to move through the bowel, and made with rye and other grains.
can also improve the balance of good • Oats can help lower cholesterol. Oat bran,
bacteria in the gut. This can improve the rye and barley all help too. Try eating a
health of your gut. To boost your intake, couple of oatcakes as a snack, or adding
eat the skin on fruit and vegetables. Go for barley into a stew.
wholegrain varieties of starchy foods like
pasta and bread, and cook potatoes with If you are unable to eat gluten or wheat,
the skin on. alternative grains include buckwheat, corn,
rice, quinoa and millet.

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Healthy eating and stroke

Protein Fat
You need roughly two portions of protein We all need some fat in our diet because it
every day. As a guide, one portion of protein is a valuable source of energy and it helps
is the amount that will roughly cover the the body absorb certain nutrients. It can also
palm of your hand. For most people, this is provide substances called essential fatty
about 70g of meat, 140g fish, or two medium acids that the body can’t make itself.
eggs.
Types of fat and what they do
Protein is found in food like meat, fish, eggs, • Unsaturated fats are mainly found in fish
pulses and beans, dairy products, nuts, and and in plant-based foods, like nuts and
meat alternatives like soya products. seeds or the oils that come from them.
You may see words like ‘polyunsaturated’
Aim to keep your intake of saturated fat low and ‘mono-unsaturated’ on food labels.
by choosing lean cuts of meat and taking the Unsaturated fats tend to be oils, not solid
skin off poultry. fats. Eating small amounts of unsaturated
fats can help you reduce cholesterol, and
Aim for one or two servings of fish per week avoid blocked arteries and blood clots
including one of oily fish like mackerel, which can cause strokes.
salmon or trout.
• Omega 3 and omega 6 fatty acids are
Beans and pulses are a good alternative types of polyunsaturated fat, known as
to meat and fish. They also contain soluble essential fatty acids. They tend to be found
fibre that can help lower your cholesterol. in oils from fish or plants. They play an
Beans and pulses also contain vitamins and important role in the body, helping to keep
minerals, and three heaped tablespoons artery walls healthy, and regulating blood
can count as a maximum of one of your clotting. They play a part in lowering
five a day. blood pressure and having a steady heart
rate. They can help reduce the risk of a
Nuts are a source of protein as well as stroke and heart attack by improving
healthy fats. They are high in calories, so you levels of ‘good’ cholesterol and reducing
only need a small handful. ‘bad’ cholesterol. A good source is oily
fish, but they are also found in nuts and
seeds such as walnuts and flax seeds, and
soya products.

• Saturated fats are usually solid, like

butter, lard or coconut oil. They can raise
cholesterol in your blood, which can lead
to blocked arteries and an increased risk
of stroke.

Saturated fats are mainly found in meat

and dairy products, including fatty cuts of
red meats, many processed meat products
(like sausages and meat pies), butter,
cream and cheese. Palm oil, coconut oil
and ghee are also high in saturated fat.

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 Healthy eating and stroke

• A good way to reduce your risk of stroke is What is cholesterol?

to reduce the amount of saturated fat you
eat and replace it with small amounts of Cholesterol is a vital substance in our bodies,
unsaturated fats such as vegetable or nut but if there is too much in your blood it can
oils. Some foods also contain healthy fats, cause heart disease and stroke. Cholesterol is
like salmon, sardines and avocado. a fatty material called a lipid, which is found
naturally in your blood.
• Trans fats are artificial fats which are
mostly found in processed foods like Cholesterol is a major part of all our body
cakes, biscuits and margarine. Trans fats cells, the tiny ‘building blocks’ which we are
can raise the ‘bad’ cholesterol and reduce made of. It also plays a part in our digestive
the ‘good’ cholesterol in your blood and and hormone systems.
increase your risk of stroke and heart
disease. They are made from liquid oils Where cholesterol comes from
that are turned into a solid fat by a process Your body produces most of the cholesterol
called hydrogenation. They are usually it needs in the liver. Eating too much
called hydrogenated fats on food labels. saturated fat leads to the liver producing
more cholesterol than you need. This enters
Use the label your bloodstream, and can cause build-ups
Food labels and packets are a good way of fatty deposits in your arteries, known as
of knowing what the fat content is in food atheroscerosis.
before you buy it.
Arteries can become narrowed and stiff
• Foods that have a high fat content have because of the deposits. This can eventually
more than 20g per 100g. lead to a clot forming and travelling to the
• Foods that have a low fat content have 3g brain, causing a stroke.
or less per 100g.
• To cut out trans fat, avoid foods that have You don’t need to avoid eating foods that
hydrogenated fat and hydrogenated contain cholesterol, such as eggs and
vegetable oil on the list of ingredients. seafood. But you should try to keep the
overall amount of fat you have low, especially
saturated and trans fats.

Triglycerides
Triglycerides are another type of fat found
in your blood. Triglycerides are made in your
liver but you can also find them in food like
meat and dairy. Like cholesterol, it can cause
deposits in the arteries.

‘Good’ and ‘bad’ cholesterol

Cholesterol moves around the body by
attaching itself to proteins in the blood. This
mixture of cholesterol and protein is called
a lipoprotein, and there are two types. Each
type has an important role, but it’s important
to have the right balance of both in your body.

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Healthy eating and stroke

‘Bad’ cholesterol How is cholesterol measured?

LDL (low density lipoprotein) has the job Cholesterol levels are checked with a blood
of moving cholesterol to where it’s needed test. For one type of test (a full lipid profile
in your cells. But if there is too much LDL test), you can’t eat or drink anything other
cholesterol in your blood, it can end up as than water for 12–14 hours before the test. A
fatty deposits in your arteries, increasing your blood test can give information about your
risk of stroke. doctor what your total levels of cholesterol,
lipoprotein and triglycerides.
‘Good’ cholesterol
HDL (high density lipoprotein) has the job Cholesterol is measured in mmol/L, which is
of taking cholesterol away from the cells the amount of cholesterol per litre of blood.
and back to the liver where it is destroyed. Your total cholesterol level should be below
Because of this, it is known as good 5mmol/L. The LDL (bad cholesterol) should
cholesterol, and you should aim to increase be below 3mmol/L. This is the amount of
your levels of HDL. See ‘Tips for lowering cholesterol per litre of blood.
your cholesterol’.
The balance of total cholesterol to HDL
What causes high cholesterol? is worked out from your cholesterol level
For many people, high cholesterol levels are divided by your HDL level. This ratio should
a result of eating too much saturated fat, and be below four.
not enough unsaturated fats. There are other
causes such as: How often you should get your cholesterol
levels checked will depend on your age and
• smoking whether you have other health conditions. Your
• drinking too much alcohol doctor will be able to advise you. It is important
• being overweight to get your cholesterol checked every year if
• not exercising enough you are on cholesterol-lowering medication.
• familial hypercholesterolaemia
If you are over 40, overweight or have a
Familial hypercholesterolaemia family history of stroke, high blood pressure
Some people also have high cholesterol or other medical conditions such as heart
because of an inherited genetic condition disease or diabetes, visit your GP or practice
called familial hypercholesteroleamia (FH). nurse to ask for a test.
This is when you have a very high level of
cholesterol in your bloodstream which is not Your cholesterol results are used as part of
caused by diet or lifestyle. an assessment of your overall risk of stroke
and heart attack. Depending on your other
In the UK, it is likely that about 120,000 risk factors such as your weight, smoking,
people have FH, but most don’t know they diabetes, high blood pressure and family
have it. If you have a history of early deaths history, the doctor will advise you on ways to
from stroke or heart disease in your family it reduce your risk. This might include statins as
is vital to have a cholesterol test. FH can be well as healthy eating and exercise.
treated with cholesterol lowering drugs. If
your cholesterol is over 7.5mmol/L you will Cholesterol-lowering treatments
be assessed for FH. This guide can only give general information.
You should always get individual advice
about your own health and any treatment
you may need from a medical professional
such as a GP or pharmacist.

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 Healthy eating and stroke

Statins Products that lower your cholesterol

Statins are the main type of medication Plant sterols and stanols are naturally found
given to reduce the risk of stroke and heart in a wide range of foods such as vegetable
attack. Statins reduce the levels of ‘bad’ oils, nuts, seeds, whole grains, fruits and
cholesterol being produced by the liver. This vegetables. They can help reduce cholesterol
helps prevent fatty deposits (atherosclerosis) in your blood when taken as supplements.
forming on the walls of your arteries. They You can buy dairy products like yoghurt
also reduce the chances of atherosclerosis and cream cheese fortified with stanols and
causing a stroke or heart attack. sterols. Although these can be expensive,
eating some every day can help to lower your
If you have had a stroke caused by a clot cholesterol.
(ischaemic stroke) or a transient ischaemic
attack (TIA or mini-stroke), you will be You can use them alongside cholesterol-
prescribed a statin to help prevent another lowering medication, but don’t stop taking
stroke or TIA. The aim will be to reduce your any cholesterol medication you may be
bad cholesterol by around 40%. taking. Although sterols and stanols can
reduce cholesterol, they do not reduce your
Types of statin stroke risk in the same was as statins.
There are many types of statins that your
doctor can prescribe. More common ones Tips for lowering your cholesterol
are Simvastatin, Fluvastatin or Atorvastatin.
Your doctor will decide which is the best • Cut down on foods high in saturated fat
one for you. If you have had an intracerebral such as:
haemorrhage you won’t normally be given • full-fat dairy: milk, cheese, cream,
a statin. Always read the information which yoghurt and butter
comes with your medication or ask your • fatty meat, meat products and lard
doctor or pharmacist if you are unsure. • pastries, biscuits and cakes
• foods high in coconut oil, palm oil
If you have any concerns about side effects, or ghee.
your GP can advise you on different types or • Eat foods high in fibre such as oats, beans,
different doses to try. If you are prescribed peas, pulses, nuts, fruit and vegetables.
statins, you will usually be advised to make • Eat oily fish such as salmon, mackerel,
some lifestyle changes too, such as following sardines, trout or tuna.
a low-fat diet and, if necessary, losing weight, • Eat five or more portions of fruit and
giving up smoking or reducing the amount of vegetables a day.
alcohol you drink. You may also need advice • Use olive oil for salad dressings, or an oil
from a dietitian – your doctor may refer you that is high in polyunsaturated fats like
to one. sunflower oil.
• Cholesterol from eggs, liver and kidneys
Other lipid-lowering drugs and some seafoods has little effect on
There are other types of lipid-lowering drugs your blood cholesterol levels.
available to people with high cholesterol who • On top of diet, you can help reduce your
can’t take statins. However, these may not risk of stroke by keeping active and
be given to someone who has had a stroke. exercising stopping smoking and cutting
The main alternative to statins are selective back on alcohol.
cholesterol absorption inhibitors such as
Ezetimibe, which may be given for familial
hypercholesterolaemia (FH).

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Healthy eating and stroke

Sugar Salt
Some foods and drinks contain a lot of Why eat less salt?
added sugar, but you may not always realise Eating a lot of salt can increase your blood
which ones. You can put on weight if you pressure. Salt contains sodium which helps to
have more sugar than your body needs. keep your body fluids at the right level. If you
Excess calories are stored as fat. This have too much salt, the amount of liquid your
increases your risk of stroke, heart disease body stores increases and this raises your
and type 2 diabetes. blood pressure.

Foods which often contain added sugar Salt and high blood pressure
include: High blood pressure (hypertension) is the
single biggest risk factor for stroke. It causes
• Fizzy drinks and squash. the walls of your arteries to harden and
• Ready-made pasta sauces. narrow, which increases the risk of blood
• Popular cereals like muesli, cornflakes and clots forming. A clot can travel to the brain
granola. and cause a stroke (ischaemic stroke).
• Tomato ketchup and baked beans.
• Some foods sold as ‘low fat’ contain extra High blood pressure also puts a strain on the
sugar. walls of the arteries inside the brain, which
increases your risk of a blood vessel bursting
You should aim to eat no more than 30g and bleeding into the brain (a haemorrhagic
of sugar a day (the equivalent of seven stroke). By reducing the amount of salt you
teaspoons of sugar). This may sound a lot, eat, you can lower your blood pressure
but one can of fizzy drink may contain more and your risk of stroke. See our guide F06,
than eight teaspoons. High blood pressure and stroke, for more
information.
Check the label
Food labels will tell you how much sugar How much salt do I need?
is in food. It may be listed as sugar or You should eat no more than 6g of salt a day,
‘carbohydrates from sugar’. Other names or about a teaspoon.
for sugar include glucose, fructose, dextrose,
agave syrup, honey and corn syrup. If one There is a large amount of hidden salt found
of these are near the top of the ingredients in processed and ready-made foods. 75% of
list, it means the food contains a lot of sugar. the salt we eat is already in everyday foods
Many labels use a traffic light system to show such as bread, breakfast cereal and ready
if foods are high in sugar, fat and salt. meals. Many other everyday foods have a
Red means high, amber is medium and green high salt content, like tinned and packet
is low. soup, crisps, bacon and sausages.

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 Healthy eating and stroke

A quick and easy way to keep track of the Tips to help you cut down on salt
amount of salt you are eating is by reading
the salt or sodium content on the nutritional • Remember the maximum daily intake
labels on foods. recommended for adults is just one
teaspoon of salt.
To find out how much salt is in food, look for • Take salt off the dinner table.
a nutrition table on the packaging. This gives • Don’t add salt when cooking – instead
the amount of energy, salt, sugar and other flavour meals with garlic, chilli, herbs,
things in a product. Salt could be listed as spices, lemon or lime juice.
salt, or may be listed as sodium. Sodium is • Make your own sauces, pickles or chutney
always a smaller number than salt. to control how much salt goes in.
• Choose tinned fish in spring water instead
• A high amount of salt is more than 1.5g of brine.
per 100g, or 0.6g sodium. • Beware of added salt in foods like:
• A low amount of salt is 0.3g per 100g, or • Bread, which can have as much salt in
0.1g sodium. one slice as a packet of crisps and can
provide up to 20% of your daily salt
Tip: If you can only see a figure for intake.
sodium, multiply it by 2.5 to get the • Breakfast cereals like cornflakes, which
amount of salt. can be high in salt.
• Crisps, salted nuts and other salty
When comparing two similar products, try to snacks.
go for the one with the lowest salt content – • Cheese, butter and margarine.
small changes can make a big difference. • Processed meat like bacon and
One easy way to eat less salt is to stop sausages.
adding it to your food during cooking and at • Ready-made meals and soups.
the dinner table. If you regularly add salt to • Baked beans and ready-made pasta
food when cooking, try adding less or using sauces.
herbs, spices, garlic or lemon juice to add • Tomato ketchup and other sauces.
flavour instead. • Pickled foods.

For more information visit stroke.org.uk 9

Healthy eating and stroke

Tips to help you lose weight Food and medication

• Eat balanced meals with plenty of Some types of medication can be affected
vegetables, salad, wholegrain starches by the foods you eat. If you take statins, ask
and fruit, but low in salt, fat and sugar. your pharmacist if you need to avoid drinking
• Eat at least five portions of fruits and grapefruit juice. If you take warfarin, speak to
vegetables a day. your GP before changing your diet.
• Try to cook your own food if you can, as
you will know what’s in it, and you can
keep fat, sugar and salt low. Food labels
• Keep takeaways for occasional treats.
• Choose low fat options for milk, cheese, Most pre-packed foods have a nutrition label
yoghurts, spreads and salad dressings. on the packaging. These labels must include
• Choose leans cuts of meat and trim off information on energy (calories), protein,
visible fat. Replace fatty cuts of red meat carbohydrate, sugars, fat, saturated fat and
with leaner things like chicken and turkey, salt. They may provide additional information
and remove the skin. on fibre. All nutrition information is provided
• Look at food labels to check the fat and per 100g or 100ml, and sometimes per
sugar content. portion of the food.
• Steam, grill, bake, poach or simmer, rather
than frying your food. Many nutritional labels use the traffic light
• Try to eat only as much as you need. If you colour coding system (red, amber, green).
consume more calories than your body This tells you at a glance if the food has high,
needs, then the extra energy is usually medium or low amounts of fat, saturated fat,
stored as fat. sugars and salt.
• Use smaller plates and bowls to help
control your portion sizes. • Red = high.
• Try to do some form of exercise and • Amber = medium.
activity every day. This can help you burn • Green = low.
off calories or maintain your body weight.
• Drink sensibly and keep within The more green lights, the healthier
recommended alcohol limits. the food.
• Speak with your GP, practice nurse or
dietitian before starting any new diet. Did you know?
Ingredients are listed from the largest
amounts first to the smallest amounts last.
So the lower down the list of ingredients
something is, the less is in the food. If sugar
is near the top of the list, it’s likely to be a
high-sugar food.

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 Healthy eating and stroke

Where to get help and Other sources of help and

information information

From the Stroke Association British Dietetic Association

Website: bda.uk.com
Talk to us Tel: 0121 200 8080
Our Stroke Helpline is for anyone affected by Provides factsheets on various aspects of diet
a stroke, including family, friends and carers. and nutrition.
The Helpline can give you information and
support on any aspect of stroke. British Nutrition Foundation
Website: nutrition.org.uk
Call us on 0303 3033 100, from a Tel: 020 7557 7930
textphone 18001 0303 3033 100 or email They provide information on nutrition and
info@stroke.org.uk. healthy eating based on nutrition science.

Read our publications Consensus Action on Salt and Health

We publish detailed information about (CASH)
a wide range of stroke topics including Website: actiononsalt.org.uk
reducing your risk of a stroke and Tel: 020 7882 5941
rehabilitation. Read online at stroke.org.uk A charity that provides information on salt
or call the Helpline to ask for printed copies. and its effects on health.

My Stroke Guide Heart UK

My Stroke Guide is the stroke support tool Website: heartuk.org.uk
and online community from the Stroke Helpline: 0845 450 5988
Association. Log on at mystrokeguide.com. A charity that provides information on high
cholesterol and treatments. Their helpline is
staffed by specialist nurses and dietitians.

NHS One You

Website: nhs.uk
The website for the Public Health England
One You campaign. It offers advice on how
you can watch what you eat and explains the
positive effects of eating well.

Weightwise
Website: bdaweightwise.com
Provides hints and tips to help you manage
your weight.

For more information visit stroke.org.uk 11

Healthy eating and stroke

About our information

We want to provide the best information
for people affected by stroke. That’s why
we ask stroke survivors and their families,
as well as medical experts, to help us put
our publications together.

How did we do?

To tell us what you think of this guide, or
to request a list of the sources we used to
create it, email us at
feedback@stroke.org.uk.

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Always get individual advice

Please be aware that this information is
not intended as a substitute for specialist
professional advice tailored to your
situation. We strive to ensure that the
content we provide is accurate and up-
to-date, but information can change
over time. So far as is permitted by law,
the Stroke Association does not accept
any liability in relation to the use of the
information in this publication, or any
third-party information or websites
included or referred to.

© Stroke Association 2022

Version 2.2. Published September 2022
To be reviewed: December 2022
Item code: A01F08

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