I was reading a new study that has been published on line for free in Neurology. At first I would say that there were no surprises; but on second look, I feel that the size of the stroke risk reduction is pretty amazing – 54%. The researchers at the Karolinska Institute in Stockholm, Sweden found that women who ate a healthy diet, drank alcohol moderately, never smoked, remained physically active and had a healthy body weight were 54% less likely to have a stroke than women with none of the five factors.

Like so much in modern research and medicine, the field is beginning to look at multiple causes and multiple treatments. In the past researchers have looked at stroke with single risk factors, but this study is looking at the effects of a healthy lifestyle on stroke risk.

If you, desire to reduce your risk of stroke, but presently don’t have all the healthy lifestyle habits, don’t give up. The research found that the risk of stroke decreased steadily with an increasing number of healthy lifestyle habits. You can gain all but one of the healthy lifestyle habits by tweaking your lifestyle habits. The one you can’t tweak is if you’ve already been a smoker, you can’t go back and change the past. But there’re plenty of other studies that say it’s never too late to stop smoking; so I’ll stick with that as a good goal.

Some of the facts of the study that I like are: (1) the researchers followed 32,000 Swedish women, average age 60. I really like the big studies; they help me feel more secure in validity issues. (2) The other fact that I like is that they followed the women for an average of 10.4 years; that’s a time interval that gives ample opportunities for strokes to occur. Indeed, 1554 cases did occur during that time, which is enough to evaluate the relationship with healthy and unhealthy lifestyles.

Something that I don’t feel as comfortable with is way they dealt with the alcohol risk factor. Their conclusions place moderate alcohol drinking as a factor, which reduces risk above, little or no alcohol, but their methods and data do not justify that conclusion. In their Table 2 they show that very low drinking is lumped in with higher than moderate drinking; then compared with moderate drinking. Guess what? Moderate drinking is less risky than this combination of low and high drinking. The known bad effects of excessive drinking then balance out any possible positive effects of low drinking. Even then the relationship of moderate alcohol consumption to risk reduction was non-significant statistically. A better explanation of why alcohol is correlated at all can be seen in their table 1.  There is a perfect rank-order relationship between their five categories (0-5) of healthy living and the percentages of people with education beyond high school, smoking (negative relationship), total physical activity, body mass index, and diabetes (negative). One could say from this, that more education is strongly correlated with healthier behaviors and outcomes, but also with a non-significant amount of increased drinking. It is a jump too far to imply that moderate drinking is better for stroke reduction than little or no drinking. They do the field a disservice by drawing this conclusion that might lead people to lump moderate drinking into the behaviors they need to improve.

Last month I posted Big surprise – The Safe Amount of Alcohol – None.  Based upon that recent research, I definitely would not take up drinking to lower my risk for stroke, especially since we know that there is a link with stroke and alcohol, particularly too much alcohol.

Gregg Fonarow M.D., professor of cardiology at UCLA said that although cardiovascular disease is the leading cause of death and stroke is the forth-leading cause of death in the United States, “the vast majority of heart attacks and strokes are preventable.” It seems to follow that beginning to tweak our lifestyle is positively worth the effort.