Nutritional Approaches to Reducing the Risk of Stroke
Keywords:
Stroke prevention, Dietary patterns, Macronutrients and micronutrients, Nutrigenomics, ChrononutritionAbstract
Stroke remains a leading cause of mortality and long-term disability worldwide, with diet representing a major modifiable risk factor. Although substantial evidence links nutrition to stroke prevention, effective translation into clinical practice requires integration of dietary patterns, specific nutrients, biological mechanisms, and emerging personalized approaches. This review aimed to synthesize current evidence on nutritional strategies for stroke prevention, encompassing macronutrients, micronutrients, dietary patterns, nutrigenomics, chrononutrition, and gut microbiome–related mechanisms, and to translate these findings into practical clinical implications. A systematic narrative review was conducted in accordance with PRISMA 2020 principles. PubMed/MEDLINE, Scopus, Web of Science, and ScienceDirect were searched for peer-reviewed English-language studies published between January 2000 and April 2024. Eligible studies included randomized controlled trials, observational studies, systematic reviews, and meta-analyses evaluating dietary exposures and stroke-related outcomes. Due to heterogeneity in study design and outcomes, 48 eligible studies were synthesized narratively. Evidence consistently supports the protective role of comprehensive dietary patterns—particularly the Mediterranean, DASH, and MIND diets—in reducing stroke risk. These patterns exert benefits through convergent mechanisms, including blood pressure reduction, lipid profile improvement, attenuation of inflammation and oxidative stress, and preservation of endothelial function. Macronutrient quality, especially fat type and dietary fiber intake, and key micronutrients such as potassium, magnesium, folate, and sodium further modulate stroke risk. Emerging evidence indicates that genetic variation, meal timing, and gut microbiome composition may influence individual responses to dietary interventions. In conclusion, nutrition plays a central role in both primary and secondary stroke prevention. Integrating evidence-based dietary patterns with attention to nutrient quality, chrononutrition, and individual risk profiles may enhance clinical effectiveness. Future randomized trials are needed to strengthen causal inference and support implementation of personalized nutritional strategies in clinical and public health practice.
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