One in four people reading this may eventually have a stroke. This is a deeply concerning statistic — the average risk has increased a whopping 50% in the last 20 years.
We can point a finger at all sorts of factors, like genetics, or medications, or being ‘unlucky.’
But much of it boils down to lifestyle factors.
Let’s look at the ones that have the biggest impact on risk.
Why strokes are becoming more common worldwide
A stroke occurs when blood stops entering the brain, either due to clotting or a ruptured vessel. This cuts off oxygen to vital cells and leads to significant damage or even death.
The causes of a stroke are typically rooted in high blood pressure, insulin resistance, and inflammation. These are further fueled by poor diet and lifestyle factors, including alcohol, smoking, exercise, and others.
But if you keep peeling the onion, you’re left with a familiar issue: metabolic dysfunction.
I believe that metabolic syndrome — which is present in 93% of Americans — is one of the biggest factors creating the conditions for a stroke.
See for yourself:
- The individual factors of metabolic syndrome (like abdominal fat and high blood sugar) are separately correlated with higher stroke risks.
- Metabolic syndrome is significantly associated with higher odds of stroke.
- And you’re more likely to suffer from a second stroke if you’re currently struggling with metabolic syndrome.
This tells us two things. First, what we eat has a major impact on our long-term health. Second, we have the power to reduce our risks for stroke.
It has only grounded me deeper in my mission: to help people stay off my operating table.
How to lower your risks for a stroke
Based on my work in metabolic health and 20+ years of clinical experience and research, here are seven habits I recommend to lower stroke risk.
1. Adopt a whole, real food diet
Whole, real foods are things that come from the ground or eat food that grows on the ground. They’re the opposite of processed foods: chemical preservatives, added sugar, and excessive salt (which can lead to hypertension for some people).
I encourage my patients to eat a ‘proper human diet,’ which usually follows a keto, carnivore, or low-carb approach. This should include:
- Animal protein. Aim for whole, real options beef, pork, lamb, fish, and poultry, with no prepackaged salt or brines.
- Eggs, which are a nutrient-dense, low-carb staple. Contrary to popular belief, dietary cholesterol isn’t bad for you.
- Non-starchy vegetables such as spinach, kale, or broccoli. Canned vegetables have their place, but for the best health benefits, aim for fresh or frozen.
- Full-fat dairy like butter or cheese in moderation. If you struggle with dairy products, try switching to animal fats such as lard and tallow instead.
This doesn’t necessarily mean never enjoying carbohydrates again, especially whole, real foods like milk or fruit. But the stricter you are at first, the better your insulin sensitivity and inflammation will be (which significantly lowers your stroke risks).
If you’re insulin resistant or have prediabetes, you may want to experiment with intermittent fasting or time-restricted eating. Studies show that building a fasting routine can improve insulin sensitivity and metabolic flexibility in five weeks or fewer.
The short version is: eliminate processed foods, stop consuming added sugars, and replace heavily processed carbohydrates with whole, animal-based foods like red meat, eggs, and fish.
2. Prioritize healthy fats
Not all fats are created equal, especially when it comes to inflammation and stroke risk. Natural fats like butter, lard, and tallow are higher in saturated fat and may increase good HDL cholesterol. Industrial seed oils like canola or vegetable oils, on the other hand, may contribute to metabolic dysfunction.
There’s far too much to cover about industrial oils here, so I suggest getting the details in their respective deep dives. But the short version is, they lack antioxidants and minerals, contain trans fats, and when eaten in place of saturated fat, may contribute to heart disease.
For this reason, it’s best to focus on saturated fats for sustained energy without spiking your blood sugar. You should do your best to read the ingredients label on packaged food — you might be surprised how many products carry unnecessary amounts of seed oil.
If you do decide to include liquid oils like olive, avocado, or coconut, be sure to purchase a quality product. Less-than-trustworthy brands cut their ingredients with seed oils to lower production costs while marketing the product as ‘healthy.’
3. Exercise regularly with resistance training
It’s not necessarily just about going to the gym. It’s about getting consistent movement, whether that’s walking or weightlifting, throughout the day.
I always recommend weight-bearing exercises to reduce insulin resistance and maintain vascular health. However, you don’t have to start with heavy weightlifting right away — you may want to start with pushups, squats, and resistance bands.
Light cardiovascular exercises are also helpful here. Walking around your house, or even taking short strolls during lunch breaks, are easy ways to fit more movement into your day. If you find walking too easy, consider adding a small weight to a backpack and wearing it on your walks.
4. Manage stress
Studies show chronic stress worsens metabolic health and is a negative driver of stroke risk. If you live a high-stress lifestyle, you may want to prioritize mindfulness strategies or at least take up stress-reducing activities like meditation.
Try not to ‘eat’ your way into stress relief, especially if your go-to comfort food looks like calorie-dense cake and ice cream. Instead, consider joining a health community (either online or in-person) for emotional support.
5. Get quality sleep
Poor sleep disrupts metabolism and increases inflammation, so prioritize seven to nine hours of restful sleep nightly.
Keep in mind quality matters just as much as quantity. If you’re not sure how restful your sleep is, consider getting a sleep tracker or a continuous glucose monitor (CGM) with built-in tools for measuring sleep quality.
6. Avoid smoking and limit alcohol
You likely don’t need me to remind you, but bad habits significantly increase your risks of a stroke. For example, smoking damages blood vessels and promotes insulin resistance, while excessive alcohol can spike blood sugar and inflammation.
You should quit smoking, stick to minimal or no alcohol, and focus on eating a clean diet instead.
7. Monitor metabolic markers
To spot metabolic dysfunction in advance, you should keep an eye on the five factors of metabolic health:
- Blood sugar: Fasting glucose should be less than 100 mg/dL
- Blood pressure: Both numbers should be at or under 130/85
- Triglycerides: You want a reading less than 150 mg/dL
- HDL cholesterol: Over 40 mg/dL for men and over 50 mg/dL for women
- Waist circumference: Under 40 inches for men, and under 35 inches for women.
You should also schedule regular blood work to look more closely at specific metabolic markers. This includes insulin levels, hs-CRP, and a few other factors that I discuss here.
Keep challenging the status quo
If you’ve already suffered from a stroke, you might feel powerless to avoid ‘the inevitable.’
I want you to know you don’t have to be a statistic.
Start by eating whole, real foods. Then, carve out time for exercise. Manage your sleep, stress, and unhealthy habits. Finally, keep an eye on your bloodwork.
If you’re still concerned about your risks for stroke, I highly recommend consulting with a healthcare provider who understands metabolic health.
And if you’re open to evidence-based, lifestyle-driven approaches, you’re welcome to read my book on how to Stay off My Operating Table®.
