I’m not trying to become a salesman in the food industry, but if you can spend the money on drugs to buy some good food, why not! A prospective study published in the November 01, 2011 issue of Stroke showed that women without a history of cardiovascular disease who ate large amounts of antioxidant-rich foods, including fruits, vegetables, tea, whole grains, and chocolate, had a 17% lower risk of stroke compared to women who ate small amounts of antioxidant-rich foods. For women with a history of cardiovascular disease, the risk of hemorrhagic stroke was reduced by 45% with a high intake of antioxidant-rich foods. The study showed that a high intake of antioxidant-rich foods, especially vegetables and fruits, may prevent strokes. The study included 36,715 women born between 1914 and 1948 in Sweden, followed up from 1997 to 2009, using the questionnaire used at the time of study inclusion in 1997 as the baseline analysis, including diet, education, weight, height, and stroke risk factors. The investigators applied a database of common foods to calculate the total antioxidant content of foods. The calculation of antioxidant content was not to identify specific antioxidants, but mainly to determine all antioxidants, also taking into account the synergistic effects between various compounds. The researchers analyzed and compared 31035 women without a history of cardiovascular disease at the time of inclusion in the study with 5680 women with a history of cardiovascular disease. Based on the total antioxidant content of the diet, the researchers divided the women in the group without a history of cardiovascular disease into five groups (five classes) and the women with a history of cardiovascular disease into four groups (four classes). The investigators identified 1322 women with stroke without a history of cardiovascular disease and 1007 women with stroke with a history of cardiovascular disease from the Swedish Hospital Discharge Register. The risk was corrected for the following factors: age, education, smoking, body mass index, physical activity, hypertension, hypercholesterolemia, diabetes, family history of myocardial infarction, aspirin use, other diet, total energy intake, alcohol intake, and coffee intake. The researchers found that among women without a history of cardiovascular disease, those in the top quintile who consumed the highest levels of total antioxidants had a 17% lower risk of stroke compared with those in the lowest quintile. Total dietary antioxidant content was negatively associated with ischemic stroke and hemorrhagic stroke. Fruits and vegetables accounted for approximately 50% of the total antioxidant content, while other foods included: cereals (18%), tea (16%), and chocolate (5%). In the subgroup with cardiovascular history, women in the top quartile with the highest intake of total antioxidants had a 45% lower risk of hemorrhagic stroke compared with women in the bottom quartile. However, there was no correlation with total hemorrhagic and ischemic strokes. In this subgroup, women in the bottom quartile who consumed the lowest levels of total antioxidants were more likely to have a combined history of stroke and were more likely to have a hemorrhagic stroke. However, after correcting for stroke history, antioxidant consumption was still negatively associated with hemorrhagic stroke. It has also been hypothesized that women with a history of cardiovascular disease may be better able to control their blood pressure and change their lifestyle because of their knowledge of the disease, possibly producing a pseudo-negative association between antioxidant-rich food consumption and hemorrhagic stroke. The results of this study are contradictory to previous studies, which concluded that antioxidant supplementation was not beneficial in reducing stroke risk. A possible explanation for this contradiction is that the previous studies focused on a single type of high-dose antioxidant, whereas the current study considered all types of antioxidants contained in the diet, including thousands of compounds contained in the general diet. Oxidative stress may be the underlying cause of some strokes, where the body is unable to neutralize free radicals produced by cellular damage, and these free radicals lead to inflammatory responses and vascular damage. How do foods rich in antioxidants reduce stroke risk? It may be that vitamin C, vitamin E, carotenoids, bioflavonoids and other similar compounds scavenge free radicals and inhibit oxidative stress. Antioxidants, especially bioflavonols, may also improve vascular endothelial function, lower blood viscosity, lower blood pressure, and inhibit inflammatory responses. The next step for this research group is to clarify whether total antioxidant intake, in addition to stroke, is associated with cardiovascular disease. It has been argued that the study is persuasive because of the large sample size and the long follow-up period. In fact, the study is also the largest and most well-established pilot study available. The results of this study confirm what has long been suspected: retrospective and correlational studies analyzed that antioxidants in vegetables and fruits reduce the risk of stroke. The study confirms these views with a prospective experimental design. The researchers noted that a healthy diet rich in antioxidant foods is often associated with other health behaviors. Overall, people who eat a healthy diet are more likely to have a healthy lifestyle. However, the study of a large sample found that diet was not yet an independent beneficial factor in the incidence of stroke.