The
above
dietary
guidelines
for
people
who
have
had
a
first
stroke
(secondary
prevention)
do
not
differ
from
those
for
primary
prevention.
It
is
not
surprising
that
multimodal
approaches
offer
the
best
results.
In
a
literature
review
of
relevant
meta-analyses,
it
was
shown
that
the
combination
of
dietary
modification,
exer-
cise,
aspirin,
antihypertensives
and
statins
may
offer
a
relative
risk
reduction
of
80%
for
vascular
events
after
a
stroke
[76].
Unfortunately,
no
specific
dietary
modification
is
detailed
in
that
review.
Patient
adherence
to
dietary
advice
and
modification
is
obvi-
ously
crucial,
as
reflected
in
the
substantial
decrease
in
the
occurrence
of
a
second
stroke
among
those
who
do
adhere
to
a
new
diet.
Gillham
and
Endacott
reported
that
although
all
the
patients
in
their
sample
of
people
who
had
had
a
stroke
declared
the
same
readiness
and
willingness
to
adjust
to
a
healthier
lifestyle,
only
those
receiving
enhanced
secondary
prevention
(motivation
and
surveillance)
were
capable
of
following
a
‘strict’
diet.
As
a
result,
patients
in
the
supervised
group
were
able
to
consume
10
portions
of
fruit
and
vegetables
per
week,
compared
with
1
or
2
portions
a
week
for
the
control
group
(P
=
0.033)
[77].
Similarly,
Kastorini
et
al.
found
differences
between
suffer-
ers
of
a
first
and
a
second
stroke
in
terms
of
adherence
to
a
Theabovedietaryguidelinesforpeoplewhohavehadafirststroke(secondaryprevention)donotdifferfromthoseforprimaryprevention.Itisnotsurprisingthatmultimodalapproachesofferthebestresults.Inaliteraturereviewofrelevantmeta-analyses,itwasshownthatthecombinationofdietarymodification,exer-cise,aspirin,antihypertensivesandstatinsmayofferarelativeriskreductionof80%forvasculareventsafterastroke[76].Unfortunately,nospecificdietarymodificationisdetailedinthatreview.Patientadherencetodietaryadviceandmodificationisobvi-ouslycrucial,asreflectedinthesubstantialdecreaseintheoccurrenceofasecondstrokeamongthosewhodoadheretoanewdiet.GillhamandEndacottreportedthatalthoughallthepatientsintheirsampleofpeoplewhohadhadastrokedeclaredthesamereadinessandwillingnesstoadjusttoahealthierlifestyle,onlythosereceivingenhancedsecondaryprevention(motivationandsurveillance)werecapableoffollowinga‘strict’diet.Asaresult,patientsinthesupervisedgroupwereabletoconsume10portionsoffruitandvegetablesperweek,comparedwith1or2portionsaweekforthecontrolกลุ่ม(P=0.033)[77]ในทำนองเดียวกันKastoriniร้อยเอ็ดอัลพบความแตกต่างระหว่างประสบ-สกู๊ปของมีfirstและมีที่สองโรคหลอดเลือดสมองในเงื่อนไขของต่าง ๆถึงมี
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The above dietary guidelines for people who have had a first stroke (secondary prevention) do not differ from those for primary prevention. It is not surprising that multimodal approaches offer the best results. In a literature review of relevant meta-analyses, it was shown that the combination of dietary modification, exer- cise, aspirin, antihypertensives and statins may offer a relative risk reduction of 80% for vascular events after a stroke [76]. Unfortunately, no specific dietary modification is detailed in that review. Patient adherence to dietary advice and modification is obvi- ously crucial, as reflected in the substantial decrease in the occurrence of a second stroke among those who do adhere to a new diet. Gillham and Endacott reported that although all the patients in their sample of people who had had a stroke declared the same readiness and willingness to adjust to a healthier lifestyle, only those receiving enhanced secondary prevention (motivation and surveillance) were capable of following a 'strict' diet. As a result, patients in the supervised group were able to consume 10 portions of fruit and vegetables per week, compared with 1 or 2 portions a week for the control group (P = 0.033) [77]. Similarly, Kastorini et al. found differences between suffer- ers of a first and a second stroke in terms of adherence to a
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