May is American Stroke Month. Bringing attention and prevention to our nation's fifth leading cause of disease. According to the American Stroke Association, each month 65,000 Americans experience strokes with many of them unaware they were even at risk. The great news is that stroke is preventable, treatable, and beatable. In fact, 80% of strokes can be prevented by making small changes in your lifestyle and health. Here are three important steps to take control of your health, stay well and prevent stroke.

Get Control of Your Blood Pressure 

High blood pressure, or hypertension, is the leading cause of stroke, but before you can reduce your blood pressure you have to know it's high to begin with! It's estimated that approximately 1/3 of people who have high blood pressure don't know they have it. A normal blood pressure is 120/80 and the best way to know if yours is running high is to have regular checkups. If you haven't had a checkup in a while and are experiencing severe headaches, confusion, chest pain, vision problems, or irregular heart rate you may have high blood pressure and should see a doctor immediately. 

Once you know you have high blood pressure there are many small things you can do to make sure you keep it under control. Big picture we know that eating a heart healthy diet (more on that in a bit), moving more and consistently, drinking less alcohol, and managing stress can all help to manage blood pressure even if you are taking medications to control it too. The association between poor sleep quality and quantity and increased blood pressure has been shown in multiple studies too, making getting those zzzz's an important factor in lowering blood pressure and therefore stroke risk. Look for another article from me soon on the numerous ways sleep impacts our health. 

Eat More Plants 

It is a fact, most of us are sadly lacking when it comes to the one dietary change that can make all the difference in not only stroke prevention but overall health. According to a 2018 CDC report only 12.2% of adults eat the recommended 1 ½ – 2 cups of fruit per day and only 9.3% meet the recommended 2-3 cups of vegetables per day. You've heard it before many times, but the importance of making the effort to include more fruits and vegetables in your daily routine can't be discussed enough. One change you could start today that could potentially change your health is to make fruits and veggies a prominent part of your daily routine. 

Plant based eating doesn’t only include eating more fruits and vegetables, it is also about eating more nuts, beans, peas, and whole grains. Recently in working with a client one of her goals was to work on centering her meals less around the meat portion and more around the plant-based portion. This is a great way to change your focus and approach eating in a slightly different way than maybe you were raised. Another common goal among clients is to include at least one fruit or vegetable with each meal. Another client made a goal of simply including more colors on her plate throughout the day. All these goals represent a different focus and approach for planning and shopping for meals. Think about the foods you ate yesterday. How many vegetables did you eat? How many fruits? What about beans? How about whole grains? Many of us are so unaware of our eating habits that it can be very difficult to even remember what we ate yesterday. Awareness and noticing is the first step towards making change. What could you do to add a plant slant to your diet?

Find a Sustainable Approach to Better Health

One recommendation you will see among all stroke prevention organizations is to lose weight. This one bugs me. I can just see someone reading it and thinking, wow, really, I should have thought of that! Often when people hear this recommendation they think they need to go to any means necessary, albeit usually for a short amount of time, to achieve that goal. Everywhere you turn there are people selling THE way to lose weight and keep it off. 

As a society we spend $66 billion (yes billion with a B) annually on cleanses, meal plans, diet plans, magic diet pills, etc. on our quest to lose weight. Sadly, though, most of us may see results on the scale short term only to gain it back plus some because we haven't gotten to the root cause. The root of our issues with weight typically involves not just WHAT we are eating but also why, when, how, and how often. Getting to the root, or deeper reason, of your eating habits is key to making long term changes in your health and the way you eat.  

Getting to and staying at a healthy weight is not only about calories in vs calories out, the old move more, eat less advice. Of course, calories matter and are a piece of the puzzle, but it's not quite that simple. Things like sleep, stress, emotions, hormones, etc. all have a huge impact on what, when, how, and how much we eat and if we ignore these, we miss a huge opportunity to positively impact not only our waist lines, but our stroke risk and overall health too. 

Recently I was talking with a friend who is going low carb…again, and his response was it's gotta be better than doing nothing at all. My response, and what we are learning, is that these weight fluctuations of weight going down and back up over and over have been shown to possibly be even more harmful for our health and actually increase our risk of cardiovascular events including strokes and heart attacks. 

The best approach to eating is the one that is sustainable long term for you, and what we are learning more and more is that is probably different than what worked for your friend, coworker, or that outspoken celebrity. We are all built differently, have different likes and dislikes and varying lifestyles. It doesn't have to be a super strict perfect way of eating, in fact that's a sure-fire way for most people to not stay with a certain eating plan. Instead, think progress, not perfection, and what changes can I make, not white knuckling for as long as I can stand it, but long term sustainable, possibly smaller, gradual change that lasts. Fad diets come and go and so do the results people see from them. 

Big picture, we know that a DASH or Mediterranean type diet that is based on plant based whole foods and includes olive oil, plenty of vegetables and fruits, legumes, fish & seafood, nuts, poultry and some dairy, and includes less red meat, butter, soda or sweet drinks, cakes & sweets, processed foods, and alcohol is one of the healthiest ways to eat and can be very effective in reducing risk for stroke. When we eat an overall diet that includes all these foods, we naturally will be eating a diet higher in fiber, potassium, and magnesium – key nutrients for heart health – and good heart healthy fats, and lower in sodium and saturated and trans fats. Coincidentally, the month of May is International Mediterranean Diet Month too. Go to Oldwayspt.org for resources, recipes, and other information on incorporating the Mediterranean Diet. 

Eating well doesn't have to be 100% or none at all. Food and eating should not be approached as an all-or-nothing thing. If you currently eat this way 0% or 5-10% of the time, then maybe your goal is to up it to 50% of the time. An end goal would be following the 80/20 rule of thumb – 80% of the time your choices are healthy and based on better quality nutrition and 20% of the time you eat a little less healthy and indulge yourself.

When it comes to all our health goals, whether it is weight loss or reducing our risk of stroke or any other chronic disease there is no silver bullet. No one food or supplement is going to create health and longevity. Instead it is the overall pattern of our choices that can keep us healthy and protect us and the people we love from disease. We have multiple opportunities each and every day to feed our bodies in a way that creates wellness. Food and our choices around it truly can be medicine. 

Lemony Mediterranean Farro Salad with Fresh Herbs

Total Time: 15 minutes

8 servings

Ingredients

1 ½ cups farro (I used 8.8-ounce bag Trader Joe's 10 Minute Farro or 1 ½ cups any brand)

3 cups vegetable broth

3 small English cucumbers, rinsed and chopped

1 cup cherry tomatoes, rinsed and quartered

4 green onions (whites and greens), rinsed and chopped

½ cup fresh mint, rinsed and chopped

½ cup Italian flat-leaf parsley, rinsed and chopped

3 Tablespoons fresh dill, rinsed and chopped

¼ cup feta cheese, crumbled

¼ cup kalamata olives, chopped (optional)

1/3 cup olive oil

2 lemons, juiced

Pinch of salt and some fresh ground pepper

Directions

1. Place farro and vegetable broth into a pot and bring to a boil. Cover and reduce to a simmer for 10 minutes. Remove from heat, drain, and rinse. Set aside to cool slightly.
2. In a large bowl, add slightly cooled farro, cucumber, tomatoes, green onions, mint, parsley, dill, feta cheese, and olives, if using them.
3. Pour olive oil and lemon juice into Tupperware, seal with lid, and shake to combine. Season with salt and pepper. Refrigerate for 2-3 hours before serving.

Nutrition Information

Calories:  219    Fat: 10 g    Saturated Fat: 2 g    Cholesterol: 4 mg   

Sodium: 448 mg    Total Carbohydrate: 26 g    Fiber: 4 g    Protein: 6 g

Open-Face Roasted Vegetable Sandwiches

8 servings

Ingredients

1 medium onion, thinly sliced

2 bell peppers any color, seeded and sliced

8 large mushrooms, sliced

1 medium zucchini, sliced

8 asparagus spears, chopped into 3 inch pieces

2 Tablespoons extra-virgin olive oil

Whole grain bread (I love Dave's Killer thin-sliced bread)

Hummus (my recipe rocks, but feel free to use premade hummus)

Balsamic vinegar glaze

Feta cheese

Salt and pepper

Directions

1. Preheat oven to 450°F. Line a baking sheet with aluminum foil and spray lightly to grease. Arrange the vegetables in a single layer and lightly drizzle with olive oil and season with salt and pepper. Bake for 10-15 minutes, until the vegetables are just starting to darken around the edges.
2. Spread each piece of bread with 1-2 Tablespoons hummus. Add about ½ cup vegetables. Drizzle with balsamic glaze and sprinkle with 1-2 teaspoons feta cheese. Place under broiler at 450° for 2-3 minutes. Serve and enjoy.
3. Refrigerate any leftover, cooled vegetables in a container with tight-fitting lid.

1 serving = 2 slices bread, each with 1 tablespoon hummus topped with vegetables

Nutrition Information

Calories:  238 calories    Fat: 10.7 g    Saturated Fat: 2.2 g    Cholesterol: 4 mg    Sodium: 420 mg    Total Carbohydrate: 29 g    Fiber: 8.8 g    Protein: 10.6 g

Two-Bean Hummus

Ingredients:  

Fresh juice of 1 lemon juice, or 2-3 Tablespoons

1/3 cup tahini

1/2 an onion, roughly chopped

2-3 cloves garlic, or 1-2 Tablespoons

1 teaspoon black pepper

1 teaspoon salt

1/8-1/4 teaspoon cayenne pepper

2 teaspoons cumin

1/2 cup parsley

15 ounce can black beans, drained and rinsed

7.75 ounce can garbanzo beans, drained and rinsed

Directions:  
1. In food processor add lemon juice and tahini, and blend for about 1 minute.  Scrape down sides and bottom of bowl and process for another minute or so.

2. Add in onion, garlic, pepper, salt, cayenne pepper and cumin. Blend for 1-2 minutes, scraping down sides about halfway through. Add in parsley, black beans, and garbanzo beans.  Blend until desired consistency. You can add in a teaspoon or two of water if the mixture is too thick.

Makes 10 (1/4 cup) servings

Nutrition Information (per serving):  
Calories:  111   Total Fat:  5 g   Saturated Fat:  1 g   Cholesterol:  0 mg   Sodium:  270 mg   Carbohydrates:  13 g    Fiber:  4 g   Protein:  5 g