136. Stroke Association. Digging beneath the Surface

I have just received a mail shot from the Stroke Association which points out that research into stroke is currently woefully underfunded. In order to maintain its current commitment to stroke research and support further ground-breaking research projects in the future I am asked to donate £100. It continues:

“Tragically, approximately 50,000 people in the UK die from stroke each year. The known risk factors-such as high blood pressure, smoking, high salt intake and lack of regular exercise-increase the chances of having a stroke, but the truth remains that anyone, at any age, is potentially at risk of stroke.”

Furthermore:

“..this is a particularly exciting time for stroke research as the ongoing development of technologies such as advanced Magnetic Resonance Imaging (MRI) scans and new drug treatments have the potential to vastly increase our understanding of how to effectively prevent and treat stroke. Money invested in stroke research is an investment in a healthier, more active and independent future for thousands of people across the UK”.

The letter includes a separate document describing research which is aimed at assessing the effectiveness of clot removing devices. This is being conducted by Professor K Muir who is SINAPSE Chair of Clinical Imaging at the University of Glasgow. It is hoped that this approach may prove to especially valuable for patients who do not respond well to the clot busting treatment with thrombolytic drugs.

The results of this project may ultimately benefit some patients. However the difficulty I have is that unless there is a genuine effort to identify the fundamental causes and take steps to eliminate them, it is highly likely that the person will suffer another stroke. The information provided in the letter states that there are more than one million people living with the after-effects of stroke and that half of all stroke survivors are left with disabilities. It is obvious that the main thrust of the Association’s work is to support research to find a “cure”. However the reality is that this approach can never overcome the disease effectively.

If we are to make genuine progress with strokes then it is essential to place the main emphasis on prevention. It is preferable to help people avoid having strokes in the first place rather than having to try to “cure” them after the event.

I have looked at the Association’s website (1) and it is clear that the prime objective is raise money to fund research to help people affected by stroke. The emphasis on providing advice on how to prevent strokes is somewhat limited. I was particularly interested to find out what information was given about a healthy diet. Here is what we are told about cholesterol:

“Cholesterol is a type of fat produced by your liver. It is also found in foods like meat and dairy products. Your body needs small amounts of it, but too much is unhealthy. Extra cholesterol can travel around the arteries in your body, narrowing them and increasing your risk of stroke. You can lower your cholesterol by making sure your diet is healthy and low in saturated fats[i]. Your doctor may advise you to take medication, too.

If you are over 40, you should have your cholesterol checked regularly. It should be under 5mmol/L. “

It is somewhat bizarre that one of the references cited in the above quotation is the NHS Choices website, which is not exactly a reliable fount of knowledge as I have shown recently (3). Apart from that, it is just re-gurgitating all the old rubbish about cholesterol and saturated fat (SFA), which has been totally discredited as explained in this blog (4). To say that cholesterol travels around the arteries causing them to narrow is a weird statement which has absolutely no basis. Cholesterol is a substance which is essential to life. In fact there is convincing evidence that too little cholesterol rather than excessive amounts may be dangerous to health (5). Similarly lowering cholesterol may cause undesirable side-effects. By contrast, the higher the level of cholesterol levels in the blood the greater the life expectancy especially in women (6).

The case for lowering SFA is based on the belief that it raises blood cholesterol and therefore increases the risks of developing heart disease. As the “cholesterol theory” no longer has any justification the advice to reduce SFA cannot be sustained. Furthermore it is ludicrous to attribute similar characteristics to a family of fatty acids which vary in size from 4 carbon atoms to over 20. It is now widely recognised that many of the individual fatty acids are important nutrients in their own right and if the body lacks an adequate supply it may not be able to function effectively.

In recent years, it has become very clear that it is sugar and refined carbohydrates rather than the SFA which is the primary cause of many of the common chronic diseases, including heart disease, Type 2 diabetes (T2D), cancer and possibly even Alzheimer’s Disease. For example, many individuals with T2D have been able to overcome the condition effectively by reducing the amount of sugar and refined carbohydrates in their habitual diet (7). Therefore it is significant that the chances of developing a stroke are increased the higher the level of triglycerides (fat) in the blood, which in turn is largely determined by the amount of carbohydrates consumed (8).

Confirmation is demonstrated in an article by Laura Schoenfeld which recommends the following advice on healthy eating, which will help to avoid raised blood pressure that is a critical risk factor for stroke (9). These are as follows:

Reduce excessive carbohydrate intake, especially refined carbs and sugars
Increase intake of beneficial minerals like potassium, magnesium, and calcium
Eat grass-fed dairy products like ghee, butter, and cheese
Eat at least one pound of fatty fish per week
Drink tea
Eat more beets.

These are eminently sensible and if followed will help to reduce the risks of wide range of common diseases. The Stroke Association would do well to take note of this information and completely revamp the advice it provides on diet.

CONCLUSION

Despite the impression which people may have about the Stroke Association, the work that it does will certainly not help to reduce the incidence of strokes in the short term. According to its own publicity one its objectives is:

“Life-saving research: working towards a world with fewer strokes”.

While I accept that the results of the research may help those who suffer a stroke to improve their chances of survival, it is difficult to understand how it will lead to fewer strokes. As the Association appreciates, many of those who survive will be seriously incapacitated. The only way to reduce the number is by prevention. There is a considerable body of knowledge on how to achieve this. In particular, by evaluating diet and if necessary making changes. The Association could make a very significant contribution by disseminating what is currently known. As I have already explained the information about healthy eating shown on the Association’s website cannot be supported by reliable research and it is highly likely that those who follow the advice will experience a deterioration in their health. Recommendations to consume sources of carbohydrates such as bread, potatoes, rice and pasta will result in high levels of blood glucose, which will stimulate excessive insulin production and cause damage to many organs by insulin resistance.

In my opinion the work of the Stroke Association while appearing very laudable, will have little impact on the incidence of strokes. The approach adopted in most of the research projects is to try to find a cure. As I have explained this is largely a forlorn hope. The key question is “Who actually benefits?” The answer of course is the research community plus the manufacturers of the drugs and the devices which may possibly alleviate (not cure) the condition. The website lists many pharmaceutical companies among the sponsors! What do the stroke sufferers and the fundraisers gain? The harsh reality is “not a lot”!

So I will not be donating to this particular charity and I would respectfully suggest that anyone else who is considering making a donation asks some penetrating questions before parting with hard-earned cash.

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