Could Diet and Exercise Help Both Depression and Stroke Risk?
This month, a new study found that postmenopausal women with a current or past history of depression were at a 29% increased risk of stroke. Thankfully, some simple lifestyle habits – namely diet and exercise – have been found to be beneficial both for the cardiovascular system and in the reduction of depression symptoms.
The study, conducted by Dr. Kathryn M. Rexrode MD of Harvard Medical School, surveyed more than 80,000 women between the ages of 54 and 79 for six years beginning in 2000. At the start of the study, 22.3% of the women self-reported that they were depressed. During the study period, just over 1,000 strokes occurred in the study participants.
Women with a current diagnosis of depression had a 41% greater risk of stroke, while those who reported having a history of depression had a 23% greater risk over women who had never been depressed or had never taken an antidepressant medication.
Depression on its own can influence stroke rate in a variety of ways including neuroendocrine and inflammatory pathways. However, the antidepressant medication also carries risks, including a risk of sudden death and fatal coronary heart disease. The most commonly-taken form of antidepressant (SSRI’s including Prozac and Zoloft) was linked to a 40% increased risk of stroke during the study period.
While the researchers attempted to control for various factors such as age, history of heart attack or other cardiovascular risk factors (such as hypertension), physical activity level, body mass index, alcohol consumption, smoking status, and diet score, many of these factors are significant in the risk of having a stroke. Notably, the majority of the strokes that occurred during the study period were ischemic strokes, the type caused by an obstruction within a blood vessel to the brain (atherosclerosis).
The risk of ischemic stroke is increased in those with high blood pressure, cigarette smoking, diabetes, high cholesterol, poor diet and physical inactivity. Dr. Rexrode’s study did find that the women most likely to have depression as a comorbid factor to their stroke were smokers and had higher body mass index.
Adopting a healthful diet should be one of the first steps a patient should take in alleviating depression symptoms and reducing stroke risk. A recent study conducted at the University of Las Palmas de Gran Canaria found, for example, that a diet high in trans-fats and saturated fats increased depression risk while switching to polyunsaturated fats found in fish and olive oil reduced the risk by 48%. Other foods to avoid include sugars, refined flours, and alcohol.
Exercise is another important way to ease depression and anxiety symptoms while improving cardiovascular health. Two studies released last year find that sessions of at least 30 minutes per day of moderate intensity exercise had lasting positive effects on mood and stress levels. To encourage the exercise habit, choose one that is fun and fits well into your current lifestyle.
Lastly, smoking cessation is essential for both physical and mental health. A study from Brown University this past December finds that quitting smoking makes people happier and elevates mood, despite the stereotype that smoking eases anxiety.
Pan A, et al "Depression and incident stroke in women" Stroke 2011; DOI: 10.1161/strokeaha.111.617043.