This month, The Lancet Neurology published an article stating that 90.2% of the burden of stroke is attributable to modifiable risk factors, and that China has one of the highest proportions of stroke risk factors in the world. As the title suggests, the article analyzed disease information from the GBD2013, a large database targeting stroke. Stroke was chosen for this study because the researchers believe that the burden of stroke and the wide range of factors that influence it can best reflect and predict the health of society as a whole in both the short and long term. The measure of stroke burden used in this study was stroke disability-adjusted life years (DALY), which refers to the total number of healthy life years lost from onset to death. What are the controllable risk factors? The study identified 17 controllable risk factors for stroke, including: 1. Air pollution and environmental factors: ambient PM2.5 pollution, household solid fuel combustion pollution, lead exposure; 2. Dietary risks: high natriuretic diet, high intake of sugar-sweetened beverages, low intake of fruits, low intake of vegetables, low intake of whole grains, and alcohol consumption; 3. Physical activity factors: low levels of physical activity; and 4, Tobacco factors: smoking, secondhand smoke; 5. Physiological factors: high BMI, high fasting blood glucose, high systolic blood pressure (SBP), high cholesterol, low glomerular filtration rate (GFR). In particular, air pollution contributes up to 33.7% to the burden of stroke for low- and middle-income countries, and 29.2% worldwide. This is the first time in history that air pollution has had such a large impact on the burden of stroke that it has reached the top three risk factors for stroke DALYs. First and second are behavioral and metabolic risk factors, respectively. How many risk factors does China actually account for? China again largely leads the way in the above controllable factors contributing to the burden of stroke, with a large number of hits: (The graph above represents the proportion of risk factors contributing to the burden of stroke, with the cooler colors indicating lower proportions and the warmer colors marking higher.) China is clearly well over 90%, at around 94%. In other words, 94% of the burden of stroke in China is due to controllable factors that can be avoided. Against the risk factors listed above, this is not too surprising, given that China is in the midst of a diabetes explosion, with obesity on the rise, a complete failure of tobacco control, grossly inadequate levels of physical activity (as much as 80% of the population does not meet the minimum activity standards), habitual hypernatremic diets, and a while ago statistics showed that Chinese diets were below the average for fruit consumption, and not necessarily for alcohol consumption. Alcohol consumption is not necessarily low, and of course, we all know about air pollution. Among the major controllable factors, the researchers again made separate graphs: 1, high systolic blood pressure. Leading to the burden of stroke, China is in a high level segment in the world. 2, Low fruit intake. This is also more problematic in China. 3, high BMI. from the overall data, the Chinese BMI looks relatively reassuring, but in fact China has the world’s largest number of BMI in 30 or more fat, at the same time, the same BMI, due to the higher body fat content, the Chinese are more prone to cardiovascular and endocrine diseases than Caucasians is already a foregone conclusion. Therefore, using the same BMI standard for disease-related statistics is not very appropriate. In other words, even if our country presents a pleasing blue color on this chart, we have not reached a point where we can let our guard down in practice. 4. Gona Diet. Many parts of Asia (including China) consume diets that are too high in Na, and some studies have suggested that this dietary structure tends to lead to the development of high blood pressure. 5, smoking. China’s smoking situation is far from good, in fact, the overall failure of tobacco control, smokers more and more, has reached the point of 1 million deaths per year due to smoking, deaths due to second-hand smoke 100,000 people. An article in The Lancet predicted that the number of smoking deaths in China would reach 3 million per year by 2030. The graph shows that the smoking situation in China is far worse than in developed countries such as Europe, the US and Australia, and even worse than in Russia. Trends in Risk Factors: Globally, from 2009 to 2013, the following risk factors have been on the rise: ① high BMI, up 46% or more; ② low physical activity, up 39% or more; ③ high fasting glucose, up 44% or more; ④ high SBP, up 39% or more; ⑤ high intake of sugar sweetened beverages, up 63% or more; ⑥ high cholesterol, up 24% or more; ⑦ ambient PM2.5 or higher; ⑦ high cholesterol, up 24% or more; ⑦ high cholesterol, up 24% or more; and ⑦ high environmental PM2.5 or higher. ⑪ High cholesterol, up by 24%; ⑦ Environmental PM2.5 pollution, up by 33% or more; ⑧ Alcohol consumption, up by 32% or more; ⑨ Low GFR, up by 25% or more; ⑩ High-energy diet, up by 34% or more; ⑪ Low vegetable intake, up by 23% or more; ⑫ Smoking, up by 10% or more. Overall, the global picture for controlling controllable risk factors that contribute to the burden of stroke is not good. The situation in China is likely to be even worse because, in addition to the fact that none of the above risk factors are increasing in China, secondhand smoke, a risk factor that has been on the decline globally, is also on the rise in China. Of course, it is not to say that a piece of the big bad dead pigs are not afraid of boiling water to ignore. After all, with the exception of air pollution, which is difficult to change on an individual basis, all of the above risk factors can be controlled through health education of patients and high-risk groups by health departments and doctors, and since 94% of the risk factors can be avoided, why not give it a try? Let’s take a look at the preventive measures for stroke. 1, reasonable diet: young people to eat a balanced diet to “good color”, red, yellow, green, white and black through the best. Red refers to red wine, drink 50mg-100mg per day, yellow refers to carrots, sweet potatoes and other yellow vegetables, green refers to green leafy vegetables, white refers to oatmeal, black refers to black fungus, mushrooms, etc., these foods help to soften blood vessels, reduce blood fat and blood viscosity. Do not overeat. 2, appropriate exercise: young people, especially white-collar workers, busy work, fast-paced life, alcohol, late at night, do not pay attention to exercise. Young people must set aside a little time to exercise, aerobic exercise is good: such as jogging, cycling, swimming, hiking, etc., are excellent sports programs, but also in the office busy, do gymnastics, jumping rope. Exercise should be moderate, gradual and persistent. 3, early detection and treatment of hypertension: hypertension is the first killer of stroke, easy on the brain and kidney harm. Young people should pay attention to regular monitoring of blood pressure, found that high blood pressure should be adjusted through life, low-salt and low-fat diet, and medication to control blood pressure at the ideal level. 4, heart disease should be treated early: many cardiac diseases, such as: congenital heart disease, rheumatic heart disease, atrial fibrillation is a major cause of ischemic stroke in young people. Once found with the above diseases, must be early treatment to prevent the scourge of the brain. 5, not to be underestimated snoring: snoring is not a sleepy performance, is the performance of breathing airflow obstruction, obese people. It can cause lack of oxygen in the body, from the face of the blood viscosity increases, the serious cause sleep apnea, induced the occurrence of stroke. Young people can reduce weight, quit smoking and alcohol, side-lying position, avoid overwork to prevent serious cases to go to the hospital for corrective treatment. 6, supplement folic acid and B vitamins: research shows that hyperhomocysteinemia is an independent risk factor for stroke in young people. Hyperhomocysteinemia can accelerate the process of atherosclerosis and increase the risk of stroke. Supplementary folic acid and vitamin B12 and B6 can effectively reduce the level of cystine, thus preventing the formation of blood acid, cereals and fresh fruits and vegetables rich in folic acid and vitamin B12 can be eaten more. 7, quit smoking and alcohol, tea instead of alcohol: smoking causes damage to the blood vessel wall, arteriosclerosis, and ultimately cause stroke. A small amount of alcohol is good for blood circulation, and a large amount of alcohol is easy to cause blood damage. Because some young people should quit smoking and drinking, tea instead of alcohol, green tea is the best, so that both the body can supplement the water needed to prevent hyperviscosity, but also to play the role of green tea antioxidant free role in preventing atherosclerosis. 8, cessation of anxiety, proper relaxation: emotional excitement can lead to increased blood pressure, heartbeat, thus triggering vascular damage, blood viscosity increased, is the cause of cardiovascular. Young people are just blood, pay more attention to emotional stability, calmness and tranquility, work tension, pay attention to tension and relaxation, appropriate relaxation. Life we should eat more vegetables, most vegetables and fruits are rich in vitamins, especially vitamin C content. Vitamin C is an antioxidant, absorbed by the body can play a role in maintaining the elasticity of blood vessels, inhibit the role of platelet aggregation, but also to remove free radicals in the body, you can maintain blood circulation in the body. Smooth blood flow will reduce the incidence of myocardial infarction, cerebral infarction, and thus reduce the risk of stroke.