Category: 8. Health

The use of hormone therapy in women to prevent cardiovascular events has been a heavily contested topic in preventive cardiology for decades. The second full day of the ASPC 2025 Congress on CVD Prevention sought to settle the debate once and for all. Leslie Cho, MD, and Martha Gulati, MD, MS, MASPC, led a lively debate on the pros and cons of using estrogen in women to lower the risk of atherosclerotic cardiovascular disease.

Pro: Hormone Therapy May Be Useful Within 10 Years of Menopause

Cho, section head of preventive cardiology and cardiac rehabilitation at Cleveland Clinic, opened the debate with her argument for hormone therapy.

“This is my first time at ASPC. When I was first asked to give a talk, I really could not believe I was talking for the Pro for hormone replacement therapy, and debating [Gulati], your immediate chair. What a way to say, ‘Welcome to the meeting,’ I guess,” she joked to laughs from the audience.

In a short poll, 78% of the audience were against the use of hormone therapy, which Cho acknowledged meant that she had her work cut out for her in trying to convince them that hormone therapy was worth looking into. According to Cho, approximately 6000 women enter menopause per day, which leads to an increase in total cholesterol and an increase in the prevalence of metabolic syndrome. Cho noted that in the past, hormone therapy was often promoted as a way to keep women’s husbands happy, which resulted in many women being prescribed hormone replacement therapy in ways contrary to today’s medical guidelines.

In studies conducted in the 1970s and 1990s, hormone replacement therapies were found to increase the prevalence of cardiovascular disease, said Cho. “But I’m going to show you some data about early starting of hormone replacement therapy that’s intriguing, that may help us think about perhaps [for] hormone replacement therapy, we should not close the door completely,” she said.

Studies conducted on women aged 50 to 79 years as part of the Women’s Health Initiative¹ (NCT00000611) showed that those aged 70 to 79 years had increased prevalence of cardiovascular disease when using hormone replacement therapy. However, women aged 50 to 59 years had a different result.² “In the estrogen-alone arm at least, there is a decrease in coronary heart disease and a decrease, perhaps, in all-cause mortality here, which is kind of intriguing,” explained Cho.

Similar studies stopped due to the results of the Women’s Health Initiative study also demonstrated similar results. Although Cho acknowledged there aren’t data to make conclusive statements, there may be a possibility of starting hormone therapy early to produce results.

“I think what we can conclude is that it is extremely intriguing data, and the risk for hormone replacement therapy when started in young women, those less than 10 years [since menopause], I think may provide cardioprotection,” she concluded.

Con: Previous Data Have Shown No Significant Benefit to Hormone Therapy

For her portion of the debate, Gulati, the immediate past president of the American Society for Preventive Cardiology, removed her blazer, declaring, “Well, we’re here to debate!”

Gulati, for her part, also went over the history of hormone therapy in the US, including how women would use hormone replacement therapy and develop uterine cancers prior to the Women’s Health Initiative demonstrating the adverse effects of its use, which led to the decline of hormone therapy.

“But within the last few years, it has really become a growing industry, and there are really influencers out there trying to tell everyone hormone replacement therapy is good for you. And not just that it’s good for you, but it’s cardioprotective,” said Gulati.

She went over the results of the Women’s Health Initiative study, which used a different dose of hormone therapy than may be used now and allowed women at all stages of menopause to enroll. Some women in the placebo arm also started taking hormone therapy. Gulati pushed back on Cho’s assessment that it may have been cardioprotective in younger patients compared with older patients by saying that the study was never powered to look at age stratification, which does not prove the safety of its use.

She also highlighted the results of ELITE (NCT00114517), which showed that women using hormone replacement therapy had a lower mean rate of change in carotid intima-media thickness compared with placebo (0.0044 vs 0.0078) but questioned whether such a result was clinically meaningful.³

“Even though it’s statistically significant, the same author that was the lead author on the ELITE study actually wrote his own paper back in the 90s, and this is his paper saying that it wasn’t meaningful to have carotid intima-media thickness over a year of 0.011. Anything less than that is not clinically important,” she said.

In a move to close the case for good, Gurati used the guidelines published by Cho herself that stated that all professional societies agreed that it had no cardioprotective value,⁴ to laughs from the audience. Gurati concluded that hormone therapy “should not be used for the primary prevention of cardiovascular disease. It should not be used to replace statins or other lipid-lowering therapies.”

Rebuttal: More Research Can Help to Settle the Debate Once and for All

As Cho prepared for her rebuttal, and Gurati put her blazer back on, the audience laughed as Cho said, “Well, that was nice to have your words quoted back. You have to be careful what you put out there!”

She acknowledged that the cardiology community has come down hard on hormone replacement therapy, including denying its use in women who are symptomatic. However, she acknowledged that there may be a little room for randomized control studies to be done on younger women, and that studies on statins in women only show a trend toward effectiveness, but cardiologists have agreed upon their usefulness in treating patients, opening up the possibility of perhaps finding hormone therapy useful in the future.

“I will say, I took the easy side because I got to choose which side and I knew [Cho]’s paper would guide me,” Gulati joked as she began her own rebuttal.

For her own part, Gulati concluded that cardiologists have not fully solved the issue of hormone therapy in preventive cardiology. Although the Women’s Health Initiative had flaws, she said that studies like this have to be done.

“Now in a new contemporary era where we’re using different doses and we’re using transdermal and transvaginal, depending on the symptoms, we need those trials done. We should be insisting on them,” she said. “These should be priorities if we have a National Institutes of Health anymore, and if we have studies that are going to be done…because this does affect at least 51% of the population in their lifetime.”

References

1. Women’s Health Initiative (WHI). National Heart, Lung, and Blood Institute. Accessed August 2, 2025. https://www.nhlbi.nih.gov/science/womens-health-initiative-whi

2. Manson JE, Chlebowski RT, Stefanick ML, et al. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women’s Health Initiative randomized trials. JAMA. 2013;310(13):1353-1368. doi:10.1001/jama.2013.278040

3. Hodis HN, Mack WJ, Henderson VW, et al. Vascular effects of early versus late postmenopausal treatment with estradiol. N Engl J Med. 2016;374(13):1221-1231. doi:10.1056/NEJMoa1505241

4. Cho L, Kaunitz AM, Faubion SS, et al. Rethinking menopausal hormone therapy: for whom, what, when, and how long? Circulation. 2023;147(7):597-610. doi:10.1161/CIRCULATIONAHA.122.061559

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Artificial intelligence (AI) can use glucose spikes to predict if people are at risk of developing type 2 diabetes, latest research has claimed.

Scientists from Scripps Research have found that AI models are more effective at predicting type 2 diabetes compared to HbA1c – the test currently used to spot the condition.

By using continuous glucose monitor (CGM) data alongside an individual’s gut microbiome, physical activity, genetic information and diet, a new AI model can detect early signs of type 2 diabetes that are often missed by standard HbA1c tests.

Senior author Professor Giorgio Quer said: “We showed that two people with the same HbA1c score can have very different underlying risk profiles.

“By bringing in more data – how long glucose spikes take to resolve, what happens to glucose overnight, what the food intake is, and even what’s happening in the gut – we can start to tell who’s on a fast track to diabetes and who isn’t.”

Corresponding author Ed Ramos said: “Ultimately, the goal of this work is to get a better understanding of what is driving diabetes progression and how we can intervene earlier in the clinic.”

Exaggerated glucose spikes can be an early sign that the body is unable to manage sugar effectively.

More than 1,000 adults took part in this clinical trial by wearing a Dexcom G6 CGM for 10 days and tracking their food intake and exercise. In addition, each participant sent in samples of their blood, saliva and stool for testing.

Ed Ramos said: “This was a really pioneering effort in the remote clinical trial space. We had to design a study that participants could complete entirely on their own – from applying sensor to collecting and shipping biological samples – without ever visiting a clinic.

“That level of self-guided participation required a completely different kind of infrastructure than usual.”

For people with type 2 diabetes, it would take 100 minutes or more for blood sugar to decrease after a spike, much longer than it would do in healthier individuals, the study has reported.

Professor Quer has concluded: “Ultimately, this is about giving people more insight and control. Type 2 diabetes doesn’t just appear one day, it builds slowly, and we now have the tools to detect it earlier and intervene smarter.”

To read the study, click here.

You need fibre. That much is true. But in the world of online health trends, what started out as sound dietary advice has spiralled into “fibremaxxing” – a push to consume eye-watering amounts in the name of wellness.

In the UK, NHS guidelines suggest that an adult should consume at least 30g of fibre a day. Children and teens typically need much less.

Yet despite clear guidelines, most Britons fall short of their daily fibre target.

One major culprit? The rise of ultra-processed foods, or UPFs. UK adults now get over 54% of their daily calories from ultra-processed foods. For teenagers, it’s nearer 66%.

Related: Eating Fiber Could Protect You From Infections. Here’s Why.

This matters because UPFs are typically low in fibre and micronutrients, while being high in sugar, salt and unhealthy fats. When these foods dominate our plate, naturally fibre-rich whole foods get pushed out.

Studies show that as ultra-processed food intake increases, fibre consumption decreases, along with other essential nutrients. The result is a population falling well short of its daily fibre target.

Dietary fibre is essential for good health as part of a balanced diet. And it is best found in natural plant-based foods.

Adding high fibre foods to your meals and snacks throughout a typical day, such as switching to wholegrain bread for breakfast, keeping the skin on fruits like an apple, adding lentils and onions to a chilli evening meal and eating a handful of pumpkin seeds or Brazil nuts between meals, would help an average person hit their 30g-a-day dietary requirements.

Displacement

With fibremaxxing, what might make this trend somewhat dangerous is the removal of other food groups such as proteins, carbohydrates and fats and replacing them with fibre-dense foods, supplements or powder.

This is where the potential risk could mitigate the benefits of increasing fibre, as no robust studies in humans – as far as I’m aware – have been conducted on long-term fibre intakes over 40g a day. (Some advocates of fibremaxxing suggest consuming between 50 and 100g a day.)

Eating too much fibre too quickly – especially without enough water – can lead to bloating, cramping and constipation. It can also cause a buildup of gas that can escape at the most inconvenient moments, like during a daily commute.

Rapidly increasing fibre intake or consuming too much can interfere with the absorption of essential micronutrients like iron, which supports normal body function, as well as macronutrients, which provide the energy needed for movement, repair and adaptation.

However, it’s important to remember that increasing fibre in your diet offers a wide range of health benefits. It supports a healthy digestive system by promoting regular bowel movements and reducing the occurrence of inflammatory bowel disease.

Soluble fibre helps to regulate blood sugar levels by slowing the absorption of glucose, making it especially helpful for people at risk of type 2 diabetes. It also lowers LDL (bad) cholesterol, reducing the risk of heart disease. Fibre keeps you feeling full for longer, which supports healthy weight management and appetite regulation. These findings are all well documented.

Additionally, a high-fibre diet has been linked to a lower risk of certain cancers, particularly colon cancer, by helping to remove toxins efficiently from the body. Gradually increasing fibre intake to recommended levels – through a balanced, varied diet – can offer real health benefits.

Given the evidence, it’s clear that many of us could benefit from eating more fibre – but within reason.

Until we know more, it’s safest to stick to fibre intake within current guidelines, and get it from natural sources rather than powders or supplements. Fibre is vital, but more isn’t always better. Skip the social media fads and aim for balance: whole grains, veg, nuts and seeds. Your gut – and your fellow commuters – will thank you.

Lewis Mattin, Senior Lecturer, Life Sciences, University of Westminster

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Turns out, you’re not exactly ‘child’ at heart!A new nationwide study has shed light on a concerning trend: most American adults have hearts that are older than their real age, sometimes even by over a decade. Using the PREVENT Heart Age Calculator developed by researchers at Northwestern Medicine, scientists found that the average heart age is 4 to 7 years older than a person’s actual calendar age.What does that mean? This means that even in your 40s or 50s, your heart could be aging like it’s in its 60s or 70s.The silver lining amidst this troubling news? Cardiologists say your heart age is not fixed. By adopting a few evidence-based lifestyle habits, you can turn back the clock naturally and powerfully.

Why most American hearts are aging too fast

According to a large-scale study analyzing over 14,000 US adults aged 30 to 79, the average heart age for men was 56.7, despite their average chronological age being just 49.7. For women, the average heart age clocked in at 55.4, with an actual average age of 51.3. That’s a 7-year and 4-year gap, respectively.In some cases, especially among men from Black and Hispanic communities, the heart was found to be 8 to 9 years older than the person.What’s driving this premature heart aging?The contributing factors are familiar: high blood pressure, poor diet, inactivity, obesity, smoking, diabetes, and chronic stress. But while these factors are widespread, they are also largely manageable, with some simple yet effective changes in habits.

7 simple habits to keep your heart young

You don’t need a gym membership, a strict diet, or expensive supplements to start rejuvenating your heart. Here are 7 expert-approved, research-backed habits that can help:

Eat mindfully

Your eating pattern is one of the most defining and deciding factors when it comes to health, especially your heart health. What goes in the stomach often leaves a lasting effect on the heart. Make sure the effect is a good one. Embrace the Mediterranean diet, rich in vegetables, whole grains, nuts, lean protein, and healthy fats like olive oil. Limit ultra-processed foods, sugar, and sodium. And yes, swear off those nasty bits of junk food!

Pro tip: Swap red meat for salmon or beans twice a week for better heart health.

Move your body (every step counts)

The more mobile you are, the better your heart health is. No matter what age you’re at, keep yourself active. Aim for at least 150 minutes of moderate exercise weekly. If you calculate, that’s just 30 minutes, 5 days a week. Walking, swimming, cycling, or dancing can lower blood pressure, improve cholesterol, and boost circulation.

Pro tip: Take walking meetings, use stairs, or stretch during screen breaks. Every step counts.

Prioritize sleep quality

No, you’re not being lazy or making excuses to hit the bed. Rest isn’t reward, it’s a necessity. Poor sleep is linked to higher risks of hypertension, obesity, and heart failure. Adults should get 7-9 hours of quality sleep per night.

Pro tip: Power down screens an hour before bed and aim for a consistent bedtime, even on weekends.

Manage stress (before it manages you)

Chronic stress elevates cortisol and blood pressure, damaging arteries over time. Stress can also lead to poor sleep habits, which eventually catalyze the risk of heart disease. Try meditation, deep breathing, journaling, or even a walk outdoors.

Pro tip: Just 10 minutes of daily mindfulness can lower your heart rate and reduce anxiety.

Quit smoking

Smoking is one of the most significant accelerators of heart aging. It’s not cool; in fact, the long-term effects of smoking can be extremely cruel. Even secondhand smoke increases risk. The benefits of quitting begin within 24 hours.

Pro tip: Use a combination of support groups, nicotine replacement, or prescription medication if needed.

Keep track of the “Big 4”

This one might sound a bit daunting; however, the regular checks pay off in the long run. Monitor your blood pressure, cholesterol, blood sugar, and BMI regularly. Keeping these in the healthy range can reduce your heart age by several years.

Pro tip: Use free apps or smart devices to track your numbers at home and share them with your doctor.

Know your heart age

Awareness is the very first and the most crucial step of prevention. Take five minutes to use the free PREVENT Heart Age Calculator online. Discuss the results with your healthcare provider to build a personalized prevention plan.

Pro tip: Knowing your heart age can make you more likely to take action, especially if it’s older than expected.

‘Heart Age’: Why it matters and how you can turn the clock

Heart age is a more intuitive and motivating way to convey cardiovascular risk than traditional numbers or percentages. As Dr. Sadiya Khan, a cardiologist and lead researcher of the study, explained, “Telling someone they have a 7% risk of a heart attack in 10 years doesn’t land the same way as saying their heart is aging 10 years faster than they are.”This approach may encourage earlier intervention, particularly in people under 50 who often think heart disease is a concern for “older” adults. But the truth is, heart disease remains the leading cause of death in the US, and it begins silently, long before symptoms appear.

However, despite the grim reality, the encouraging truth is that heart aging isn’t inevitable.With consistent, small lifestyle changes, you can lower your heart age, reduce your risk of heart attack and stroke, and improve the quality of your life.It’s never too early or too late to start. Whether you’re 30 or 70, your heart responds to positive changes, often within weeks.So if your heart feels older than you are, take that as a wake-up call, not a life sentence. Incorporate these simple habits into your daily routine, and your heart may thank you with many more vibrant, active years to come.

The ongoing DETECT AS trial (NCT05230225) is a randomized investigation evaluating how electronic provider notification might impact the care of patients with severe aortic stenosis and their providers’ utilization of aortic valve replacement (AVR). Varsha Tanguturi, MD, MPH, cardiologist at Mass General Hospital and DETECT AS investigator, presented new data from the study at the ASPC 2025 Congress on CVD Prevention, in the poster, “The Impact of Electronic Provider Notification on Treatment of Severe Aortic Stenosis Amongst Different Provider Specialties: Findings from the DETECT AS Trial.”

In this conversation, she highlights how the findings she and her colleagues saw indicate almost universal increases in rates of AVR, across both provider and patient groups, with one of the most notable findings being the impact on women with aortic stenosis.

“We were hopeful that our intervention would make a difference,” she says. “That’s what we all want to do is make care better, but the size of the impact on women was actually quite impressive.”

This transcript has been lightly edited for clarity; captions were auto-generated.

Transcript

Why is aortic stenosis an important area of investigation in preventive cardiology?

I’ll back up a little bit. Early on in my fellowship in cardiology, I met a patient who was so sick from his aortic stenosis that he was having all sorts of near death experiences and arrhythmias, but then also kept getting turned down for procedures and to have his valve fixed. It got me thinking: what makes somebody so sick or what makes somebody really fall through the cracks like that for this disease? We really wanted to work upstream to figure out how to make this better, so that all the patients can get better care for their valvular disease. What we wondered about is, if we could tell providers about their patients’ aortic stenosis on echocardiography, if that would help them treat it more often. What we did was randomize providers to either receive a notification or just sort of standard of care and then look to see what the impact was on their treatment rates for aortic stenosis.

How was the notification system integrated into the clinical workflows?

We identified patients with severe aortic stenosis on their echocardiograms and then used this to identify the patients as well as the providers they were associated with. What we did was send an email, as well as an in-basket message, that detailed the fact that their patient had severe aortic stenosis, but then also some guideline-based suggestions for what they could do next that might have included further diagnostics, as well as recommendations for either evaluation or treatment by advanced or interventional providers to help treat the disease.

What are key findings you would like to highlight from the DETECT AS trial?

The thing we were most impressed with was that the notification seemed to make rates of aortic valve replacement higher, really, across the board, so across provider groups—meaning specialty types—as well as across patients. It was pretty impressive to see that the most notable impact was actually on women. There was a pretty impressive disparity in the usual care arm between men and women in their treatment rates, and then with notification, that disparity nearly melted away. When we look at providers, about 50% of the group was cardiologists, but about 50% of the group was also either primary care doctors or other specialists, non–cardiology-based physicians, and in both of those groups, there was a notable improvement in AVR rates.

Were there any surprising results?

I think that gender disparity actually really surprised us. We were hopeful that our intervention would make a difference. That’s what we all want to do is make care better, but the size of the impact on women was actually quite impressive.

It’s not entirely clear why. There’s many hypotheses. There’s some things about women’s hearts that might make them more prone to certain types of aortic stenosis that are, frankly, just a little more complicated and harder to pick up, like that, and so that might make it harder to identify on an echocardiogram by someone who’s looking quickly. It might be that the symptoms are vague or maybe minimized by patients in different ways, for different reasons, but really we don’t know for sure.

Constipation isn’t anyone’s ideal state of digestive affairs. The bloating, distension and overall discomfort of a gastrointestinal slowdown are a combo you’d probably prefer to skip. But for most of us, being backed up is an occasional fact of life (sometimes even a chronic one). Constipation is so common, in fact, that about 16% of U.S. adults say it’s a problem.

Fortunately, certain dietary supplements can help get things moving again. Though they may not work immediately, with a little patience, the right choices may make you feel lighter and brighter sooner than later. We tapped Sandhya Shukla, M.D., a board-certified gastroenterologist with Atlantic Coast Gastroenterology, a division of Allied Digestive Health, for her top supplement recommendations for constipation. She says the following five are worth a try.

1. Psyllium Husk

With its surging popularity on social media, psyllium husk may seem like a buzzy modern supplement. But it’s been used in Ayurvedic medicine as a natural remedy for constipation for thousands of years. What makes it so effective? Psyllium husk is rich in soluble fiber, which creates a slick, gel-like substance in the digestive tract that retains water. This, in turn, makes your poops easier to pass, Shukla says.

Besides psyllium’s ability to hold water, research reveals that it may also get things going by positively impacting gut microbiota. Those are the trillions of bacteria that regulate a healthy digestive tract. For instance, one small study found that supplementing with psyllium husk for four weeks led to beneficial changes in the gut microbiota of people with constipation. And another older study reported similar improvements in as little as one week.

Just note that psyllium husk can cause side effects in some people. (Shukla says a feeling of bloating is especially common.) You may want to start with a small dose to test your tolerance gradually. Also good to know: while supplements containing insoluble fiber may claim to ease constipation, they can actually make things worse. So, stick with soluble fiber-containing psyllium instead.

2. Probiotics

By now, you’ve probably heard of probiotics. These beneficial, live bacteria may be an inexpensive, over-the-counter means of maintaining a happy gut. Here’s a tip, though: don’t just choose any old strain you see. Current research shows that certain probiotic strains may be more helpful than others for specific health issues, including constipation.

One that has a solid track record is Lactobacillus reuteri. It works by getting your gut moving, helping you go more often., So, look for this strain specifically, or ask your doctor if another strain might be right for you.

3. Magnesium Oxide

Magnesium is often touted as a constipation preventer. However, with so many forms of this mineral on supplement shelves, it can be hard to distinguish which one is best. Shukla recommends magnesium oxide. Like psyllium husk, she says magnesium oxide draws more water into the stool, keeping things nice and soft to help with easier evacuation.

This form of magnesium may be particularly useful for treating chronic constipation that doesn’t have a known cause (also known as idiopathic constipation). In fact, the American Gastroenterological Association and American College of Gastroenterology recently released new guidelines recommending magnesium oxide as a pharmacological treatment for idiopathic constipation. But don’t be put off by the “pharmacological” terminology—magnesium oxide is available over the counter.  

Shukla says you can find magnesium oxide in different strengths. “I usually recommend starting at 200 or 250 milligrams [per day] and increasing to a maximum of 1,000 milligrams per day.” She also notes that people with decreased kidney function should avoid taking magnesium, as it can build to dangerous levels if the kidneys are unable to filter it properly.

4. Polyethylene Glycol

Never heard of polyethylene glycol? You may have seen it in dietary supplements without realizing it’s there. This compound is the active ingredient in powdered supplements like MiraLax and its generic equivalents.

Shukla recommends polyethylene glycol for its ease of use and effectiveness in alleviating constipation. “It is tasteless and odorless and therefore well tolerated,” she says. “Its absorption from the gut is negligible, making it a safe and effective option for treating constipation.” And unlike over-the-counter laxatives that should only be used occasionally, it’s safe for longer-term use. For instance, one study found that polyethylene glycol was safe and effective in reducing the frequency of hard or lumpy stools in people with chronic idiopathic constipation over the course of 24 weeks.

5. Prunes & Prune Juice

Turns out, Grandma was onto something. While not a supplement per se, the old prune juice remedy really is a smart move for getting regular again. And there’s research to prove it. For instance, one study found that people with chronic constipation who drank slightly less than 2 ounces of prune juice daily for eight weeks experienced significantly fewer hard or lumpy stools. That makes it food as medicine for the win!

“Prunes have high dietary fiber and sorbitol, both helpful for treating constipation,” explains Shukla. “This contributes to increased stool bulk and improved bowel movements.” Just ¼ cup of prunes (about 5 prunes) provides 3 grams of fiber.  Sorbitol, on the other hand, is a naturally occurring sugar alcohol that offers some surprising benefits for digestive health. “Sorbitol has osmotic properties that draw water into the intestines, keeping stool soft and easy to expel,” says Shukla. In fact, some people with quick intestinal transit actually avoid sorbitol for this reason. So, if you want to give prunes or prune juice a try, start slowly.

Our Expert Take

When your digestive tract gets a bit sluggish, a healthy diet, proper hydration and exercise should be your first lines of defense. When they aren’t enough, the supplement aisle has safe, effective options for constipation relief. Psyllium husk, probiotics, magnesium oxide and polyethylene glycol are all gastroenterologist-approved supplements for constipation relief. And if you’d prefer a more natural remedy, give prunes or prune juice a try. They may not be trendy, but they work!

Stroke is the fifth leading cause of death in the United States—and up to 80% of cases may be preventable through lifestyle changes. One of the most impactful steps you can take to reduce your risk is limiting sodium intake, since a high-sodium diet is strongly linked to high blood pressure, the leading cause of stroke., “The key point is stroke prevention is largely within our control through dietary and lifestyle choices, with sodium reduction being one of the most impactful single changes we can make,” says Aaron Feingold, MD, a cardiologist

Most people consume far more salt than is recommended—often without even realizing it. It’s not just about using the salt shaker too generously. Instead, the majority of sodium in the diet comes from highly processed foods, which are often loaded with it. By cutting back on salt, you may be able to lower your stroke risk. So, we asked doctors and dietitians what you can do to lower your sodium intake and why it’s so important.

Why a High-Sodium Diet is the #1 Thing to Avoid to Reduce Stroke Risk

“High sodium diets can exacerbate high blood pressure and aggravate preexisting risk factors, which increase the likelihood of developing a stroke over time,” says Leonard Pianko, MD, a cardiologist. “By reducing your sodium intake, you can lower your blood pressure and decrease your risk of a stroke.”

When you consume too much sodium, your body retains water, which increases blood volume. That extra fluid puts more pressure on your blood vessels, causing damage over time. It also forces your heart to work harder. “When the demand on our heart and blood vessels continues over a long period of time, we develop a high risk of experiencing a hemorrhagic or ischemic stroke,” says Feingold. “In a hemorrhagic stroke, our arterial walls rupture. In an ischemic stroke, we suffer a blockage.” 

Considering most individuals consume well over the recommended sodium limit of 2,300 mg per day, it’s wise to pay attention to how much you’re eating. To reduce your sodium intake, the experts we spoke with recommend some simple tips and swaps, including:

• Read Food Labels. Choose products with less than 5% of the Daily Value of sodium per serving.
• Cook at Home. Preparing your own meals keeps you in control of your sodium intake, unlike sodium-rich meals served at restaurants.
• Use Sodium-Free Flavor Enhancers. Experiment with different herbs and spices to flavor your meals without any extra salt. Be careful with sauces and condiments, which can also be high in salt.
• Buy Fresh or Frozen Vegetables. Canned varieties tend to contain the most sodium. Opting for fresh or frozen vegetables can keep sodium intake at bay.
• Limit Ultra-Processed Foods. Pre-packaged foods contain more sodium to enhance flavor and to preserve it. Examples of high sodium foods include processed meats, frozen pizzas, canned soups, breads and chips.

What To Do Instead to Reduce Stroke Risk

Limiting sodium in your diet is an important step in lowering your risk of stroke, but there are plenty of other things you can do as well. Here are some lifestyle changes that experts recommend. 

Try The DASH Diet Or The Mediterranean Diet

The DASH diet (Dietary Approaches to Stop Hypertension) has been shown to improve blood pressure and may lower risk of stroke. This diet consists of foods like fruits, vegetables, whole grains, legumes, low-fat dairy, nuts and healthy fats, while limiting highly processed foods that contain excessive sodium, sugar and saturated fat. 

Meanwhile, the Mediterranean diet, which emphasizes similar foods like fruits, vegetables, whole grains, legumes and fish, has been found to reduce the risk of stroke and other forms of heart disease. “A big part of that benefit comes from nutrients like potassium, fiber, and unsaturated fats, all of which help support healthy blood pressure,” says Deena Goldman, RDN.

Prioritize Healthy Fats

“Diets higher in unsaturated fats, specifically monounsaturated fats from olive oil and polyunsaturated fats from fatty fish, nuts and seeds, have been linked to lower risk of stroke,” Goldman says. “These fats help improve blood vessel function and reduce inflammation, both of which are key for keeping your heart healthy.”

Although research on saturated fat and stroke risk is mixed, incorporating more unsaturated fats into your diet is a heart-healthy choice that may help lower your risk.

Limit Your Alcohol Intake

Excess alcohol consumption can contribute to high blood pressure, Pianko points out. In one study, both moderate and high alcohol intake—defined as more than seven drinks per week—were associated with a significantly higher risk of stroke. The Dietary Guidelines for Americans recommends drinking no more than two alcoholic drinks per day for men and one for women.

Move Your Body

Regular physical activity is one of the best things you can do to lower your stroke risk. It helps to reduce blood pressure, eases strain on the heart and supports a healthy body weight—all key factors in stroke prevention. Along with this, limiting sedentary time is just as important. 

The American Heart Association recommends getting at least 150 minutes per week of moderate-intensity exercise or 75 minutes of vigorous exercise. If you’re new to exercise, just start moving—even a short walk is better than nothing. 

Maintain a Healthy Weight

Research suggests that a higher body mass index—particularly among those with overweight or obesity—may increase the risk of stroke. However, there is ongoing debate about how weight itself contributes to that risk. One study found that individuals with metabolically healthy obesity did not have an increased risk of stroke. Rather, it appears that metabolic effects commonly associated with obesity—such as high blood pressure and type 2 diabetes—increases risk. Therefore, prioritizing healthy behaviors that support metabolic health, independent of weight loss, may be the most important factor for reducing stroke risk.

Our Expert Take

To lower your risk of stroke, it’s important to avoid a high-sodium diet since it can raise your blood pressure, a major risk factor of stroke. To cut back, carefully read food labels, cook more meals at home, limit ultra-processed foods and experiment with fresh herbs and spices to boost flavor instead of relying on salt. Experts also encourage other lifestyle changes—such as following the DASH diet, limiting alcohol, and staying active—to further support heart and brain health.