Everyone knows they are the cornerstone of a healthy diet, but new research from the American Heart Association and published in their journal Stroke makes the case that eating more fruits and vegetables could reduce the risk of stroke worldwide.

In high-income countries, stroke incidence has decreased by 42% over the past 4 decades, but in low- and middle-income countries, stroke incidence has more than doubled. Mortality rates from stroke are highest in low-income countries and, in 2010, stroke was the leading cause of death in China.

Health professionals know that improving diet and lifestyle is essential to reducing the risk of cardiovascular disease in the general population. A big part of this dietary improvement is in encouraging people to eat more vegetables and fruits. But the prevalence of fruit and vegetable consumption is low worldwide – especially in low- and middle-income countries.

The World Health Organization (WHO) have estimated that increasing consumption of fruits and vegetables by up to 600 g each day could reduce the worldwide stroke burden by 19% worldwide, and 10-15% among countries in the European Union.

The American Heart Association (AHA) researchers performed a meta-analysis of 20 studies published over the last 19 years to assess the global effect fruit and vegetable consumption has on stroke. In total, the meta-analysis covered 760,629 participants and 16,981 cases of stroke.

The meta-analysis found a decrease of 32% in stroke risk for every 200 g of fruits consumed each day, and a decrease in stroke risk of 11% for every 200 g of vegetables consumed each day.

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Eating fruit and vegetables can lower blood pressure, improve microvascular function and have beneficial effects on body mass index and cholesterol, among other things.

Senior study author Dr. Yan Qu, director of the intensive care unit at Qingdao Municipal Hospital and professor at the Medical College of Qingdao University in Qingdao, China, says:

“Improving diet and lifestyle is critical for heart and stroke risk reduction in the general population. In particular, a diet rich in fruits and vegetables is highly recommended because it meets micronutrient and macronutrient and fiber requirements without adding substantially to overall energy requirements.”

Eating fruits and vegetables, the study says, can lower blood pressure, improve microvascular function and have beneficial effects on body mass index (BMI), waist circumference, cholesterol, inflammation and oxidative stress.

The study found that these beneficial effects are consistent across men and women, regardless of age.

The AHA recommends that the average adult should eat 4-5 servings of fruits and vegetables a day. Eating a variety of colors and types of vegetables and fruits, the organization says, is the best way of getting important vitamins, minerals and dietary fiber.

Recently, a study from the UK suggested that people should eat at least seven portions of fruits and vegetables a day. Publishing their findings in the Journal of Epidemiology and Community Health, the researchers reported that people who ate at least seven portions a day had a 42% lower risk of death from all causes.

In that study, vegetables offered more protective benefits than fruit. Eating 2-3 portions of vegetables a day was linked with 19% lower risk of death, while eating 2-3 portions of fruits provided a 10% lower risk of death.