stroke risk?

[Birdy]

I have a family history of stroke. My brother suffered a stroke at age 40 from which he recovered, but takes lots of medications and has had ongoing health issues. My grandfather had a debilitating stroke in his fifties and had to quit practicing as a surgeon. Two of my great uncles died from stroke. So I recently came across this abstract by a researcher who has done a lot of work on diet (particularly vegan diets) and health outcomes: http://www.ncbi.nlm.nih.gov/pubmed/12944100

I'm not sure what to make of this. Could a vegan diet increase my risk of having a stroke? I don't have access to the journals so have only been able to read the abstract, not the actual study. It occurs to me that I don't know what kind of "vegan" diet the people in the referenced study were eating. With a starch centered diet, free of oils maybe there isn't an increased risk. Does anyone know of other studies that address this?

[f1jim]

Birdy, you have been with us since 2006. I assume you have at least perused the pages of the forum long enough to realize that vegans have been linked to better heatlh outcomes in most every legitimate bit of research that has been published. So without even reading anything but a very incomplete abstract of this study(?) you are worried a vegan diet may be dangerous?
My my, how easily we are lead away from the path of good health by a piece of paper that flaunts years of research on the role of IGF-1.
There is probably a reason you are having trouble finding the particulars on this bit of research. No articles in the mass media warning us about lack of IGF-1 in our diet? No gurus touting a high IGF-1 diet for excellent health? What gives?
It's going to be a long worrisome life if this is what it takes to get your anxiety up. Better tell the Seventh Day Adventists they are doomed. And those poor Okinawans that only got 5% of their calories from animal products should be going apoplectic.
I am going to sit down and rethink my diet tonight and try not to lose sleep over this bit of "news"
It's a bit like taking the truthful statement that we need cholesterol for many body processes and making the jump to needing to consume dietary cholesterol to make sure we get enough. Thee has been nothing else on this front since 2003 when this study came out. I guess the results were too horrific for researchers to delve further into it.
f1jim

[colonyofcells]

I heard the mainstream still tells people to cut down on salt including those who are already eating healthy. Even traditional condiments like miso can be the target of campaigns to lower salt consumption.

[Risto]

This is from the publisher's page on Medical Hypotheses:

Medical Hypotheses will publish papers which describe theories, ideas which have a great deal of observational support and some hypotheses where experimental support is yet fragmentary

The abstract that Birdy linked to is from 2003, so the protective effect of IGF-1 seems to be an idea that was floated twelve years ago. I should think we'd have heard more about it by now if it had panned out.

[dailycarbs]

How many of your relatives who suffered strokes vegans?

[arugula]

McCarty is a vegan himself. He works for a supplement company. He likes to speculate in ways that could sell more supplements.
Even so, the majority of his papers are overtly pro-vegan.

[Birdy]

Jim, I have "been with" the McDougall board almost since it's inception in the early to mid-1990s, not since 2006. I don't appreciate asking for information and receiving responses like yours. You may be a moderator on this board but that doesn't mean you should lob personal remarks against someone asking legitimate questions. We are all equal here and all deserving of respect.

I did, however, appreciate other peoples' responses. Thank you. Argula I've also noticed that McCarty is pro-vegan and find it interesting that he or she is a vegan. As a researcher this scientist is asking questions about vegan diets and trying to make informed observations based on science.

Colonyofcells you're right about the salt intake.

Here are links to several more articles about diet and stroke:
Gillman MW, Cuples LA, Millen BE, et al. Inverse association of dietary fat with development of ischeimic stroke in men. JAMA 1997;278:2145-2150. Iso HM, Stampfer MJ, Manson JE, et al. Prospective study of fat and protein intake and risk of intraparenchymal hemorrhage in women. Circulation 2001;103:856. Sasaki S, Zhang XH, Kestleloot H. Dietary sodium, potassium, saturated fat, alcohol and stroke mortality. Stroke 1995;26(5):783-789

My question is legitimate.

[f1jim]

Sorry you felt personally attacked. My comments were certainly not designed to attack you. However, the point I was making was on point. You can't take one fragment of a piece of research and suddenly have it disturb you. The overwhelming data for the last 50 years shows plant based eating to be a more healthy way of eating. To ignore this data while placing undue concern on this one abstract seems out of place. Together we have seen hundreds of studies on this way of eating get dissected in these pages. I can't remember any that shows a negative risk for stroke or any other heart related illness. Only very positive outcomes.
In those years you have been following this way of eating here have you found a pattern that shows eating a diet without meat to be a risk? I didn't join till 2 years after you and I haven't seen it. Getting people nervous about this bit of data doesn't help. We need to put this data in context to ALL the data regarding this way of eating. That is the context my message was written in.
If there is conflicting data I'd love to see it.
f1jim

[colonyofcells]

Rural asians eating nearly vegan diets (for example, China Study of T Colin Campbell) are probably low in vitamin b12 and epa/dha which might explain why studies tend to have a hard time finding differences in longevity between the nearly vegan and those who eat more animal products (similar to pritikin diet). I heard the lacto vegetarians in India are low in vitamin b12. The McDougall foundation probably needs more donations so it can do more studies on the McDougall diet. Most of the studies are on vegan diets that have some differences with the McDougall diet. Vegan diet gurus also have differences of opinion on amounts of fat so nut wars break out every now and then. Dr William Harris does not believe macronutrient ratios are that important if eating a unrefined vegan diet. My impression is that protein overdose is probably real so I won't overdose on protein. It is hard to overdose on protein on an unrefined vegan diet since beans fill up the stomach and it is hard to overeat beans.

[Birdy]

Jim, I am not "placing undue concern on this one abstract (that) seems out of place." I simply asked a question about it in the context of my family history. You wrote that, "Getting people nervous about this bit of data doesn't help." Asking questions about nutrition should not be construed as as attempt to get people nervous. I've lived with a concern about stroke for twenty-five years since my brother's stroke but I'm not nervous about it. It may help for you to know that it's hemorrhagic stroke that runs in my family, which is the more rare form, and that there are a number of references in the scientific literature that vegan diets may increase risk of this, especially if salt intake is high.

This morning in an effort to answer my own question, I found this article by Dr. Furhman: http://www.drfuhrman.com/library/article5.aspx Parts of this article may represent the "conflicting data" you asked about.


Maybe you see this board as purely a support vehicle for the McDougall Plan and interpret questions about it as threatening. But I agree with you that the science supporting what Dr. McDougall teaches is very strong. It's a good diet and I wouldn't have been trying to eat this way and continue coming to this board if I didn't embrace the message. However, he wrote in his book, The McDougall Plan, that "this is not an all or nothing diet." John McDougall invites all kinds of speakers to his ASW and other venues, many of whom give presentations that present viewpoints different than or even challenging to his; Stephan Guyenet is a great example. I don't think Dr. McD's intent is to make people nervous.

[f1jim]

You are absolutely correct that discussing these studies is a big part of the makeup of the discussions. I myself love the dissecting of these studies but his is an older study with only an abstract that is incomplete. You didn't preface your original post with any of the information you just gave us to set the context. Only that a vegan diet and stroke may be linked with the evidence being this abstract of the old study. For anyone new this would be a troublesome note with which to begin this diet. Again, that may seem like a personal attack but it is not.
Perhaps low salt intake is a risk of increased stroke, but a diet devoid of meat is not. The evidence for that is overwhelming. If there is a subset of the population(perhaps like yourself) that the combination of a poor vegan diet and low sodium may be a risk for that would be fodder for discussion. Your OP didn't reveal that and we only have what you posted to go on.
The diet promoted in this website is not a risk for stroke. Nor is it deficient in sodium. Except in unusual circumstances, this isn't an issue for us. Your post made it appear like it might be.
I too have a strong family history of stroke. I like to joke that stroke is my family's middle name. I share some disturbing family experiences regarding stroke with many here. I am glad to hear you are trying to eat this way. I hope the years you have been around these forums are a help to your efforts to try to eat this way. I strongly believe eating this way would be the biggest contribution to reducing your chance of stroke you could take.
Good luck.
f1jim

[colonyofcells]

I also enjoy looking at the competition like paleo diet videos on youtube (ahs13 and ahs14, but ahs15 has been cancelled due to scheduling problems). I've not heard of higher stroke risk for vegans from the anti-vegans. There are not that many long term studies of low fat vegans or low fat unrefined vegans. Most studies are about typical vegans who include some refined foods like oil and probably more fat than the McDougall diet. The last Mcdougall diet study for multiple sclerosis was only for 1 year and on few participants due to lack of funds. I prefer to be a skeptic and I do my best to choose words carefully in making claims about the benefits of the McDougall diet and the long term results. As an anecdote, Dr William Harris is eliminating his salt bec. once he reached old age, salt has become a problem which was not a problem when he was younger. He also had problems with too much epa/dha.

[arugula]

Birdy,

I've read that paper that motivated McCarty:

http://ije.oxfordjournals.org/content/32/4/536.full.pdf

They didn't look at vegans per se.

The examined diets for content of beef + pork, eggs, milk, chicken, and fish. They sorted by each category of animal product, but there was no category or comparison for "none of the above." See table 4.

There was one study (Heidelberg) that did not find an increased risk of cerebrovascular disease for vegans, but when Fraser et al did their meta-analysis "magic" (obtained by combining the results of all studies with use of a random-effects model) this somehow turned into an increased risk. I think somebody might have made a typo or something.

raw data for heidelberg, table 2 here
http://cebp.aacrjournals.org/content/14 ... l.pdf+html

meta-analysis, table 3 here
http://www.direct-ms.org/sites/default/ ... tality.pdf

In other analyses, the data for cerebrovascular disease comparing vegans to non-vegans rarely achieve statistical significance (P<0.05 generally for that, an arbitrary cutoff but somewhat useful).

See table 3. Most of the stroke column has very high P-values
http://ajcn.nutrition.org/content/89/5/ ... nsion.html

I question the Key/Fraser manipulations on the Heidelberg study for cerebrovascular disease is all. I don't know what their machinations were. They didn't spell it out and it's possible that they messed it up.

In short, I would not worry about it.

[colonyofcells]

Hard to answer questions about diet, lifestyle and diseases and there are always lots of debates bec. there are very few studies and there is no profit in them so corporations don't fund diet studies. I just follow the traditional diet of my ancestors and hope for the best.

[f1jim]

Also, going back to the original post, this is an abstract, not of any study, but it's an abstract of a "medical hypothesis." I guess it's good to have people making hypotheses about topics but since it doesn't conform to the demographic data what's the point? I guess it could be an interesting medical exercise. If vegans start falling over in large numbers maybe we can revisit this subject. Till then we should be vigorously reinforcing the removal of animal products from the diet.
f1jim