Lifestyle 'doubles stroke risk'
Drinking and smoking both increase the risk of stroke
Unhealthy lifestyles are associated with more than double the risk of a stroke, a UK study has reported.
Smoking, drinking too much alcohol, not taking enough exercise and eating few vegetables and little fruit contribute to the chances of a stroke, it found.
Just a small proportion of the 20,000 adults studied had healthy enough lifestyles to protect against the condition, researchers said.
Strokes cost the UK £7bn a year, the British Medical Journal article added.
Previous studies have shown that lifestyle behaviour, such as smoking and diet, are associated with the risk of heart attacks and stroke, but the impact of a combination of risk factors in apparently healthy people has been less clear.
Even small changes to our lifestyle, such as an improved diet, drinking alcohol in moderation, not smoking and being active, can reduce your risk of stroke
The Stroke Association
In the latest study, led by the University of East Anglia, researchers gave one point for each "healthy behaviour" reported by the participants, aged between 40 and 79.
One point was given to those who did not smoke, one point awarded for drinking just one to 14 units of alcohol a week, one point for consuming five portions of fruit and vegetables a day and one point for being physically active.
A significantly higher percentage of women than men scored a maximum of four.
The study found those who scored zero points were 2.3 times more likely to have a stroke in the 11-year follow-up than those with four points.
For every point decrease in the scores, there was an increase in likelihood of stroke, the researchers said.
Some 259 people did not score any points, of whom 15 had a stroke - at a rate of 5.8%.
But the most common score was three - achieved by 7,822 individuals, of whom 186, or 2.4%, had a stroke.
Around 5,000 achieved the healthiest score of four, which was associated with an absolute stroke risk of 1.7%.
The researchers said the results could provide further support to the idea that small differences in lifestyle affect stroke risk.
Study leader Dr Phyo Myint said: "Over the study period we observed six people for every 100 participants who had no health behaviours suffered a stroke compared to about one to two people for every 100 participants who had four positive health behaviours.
"Together with the substantial existing body of evidence about modifiable behaviours and stroke risk, this may provide further encouragement to make entirely feasible changes which have the potential to have a major impact on stroke."
In an accompanying editorial, Dr Matthew Giles, from the Stroke Prevention Research Unit at John Radcliffe Hospital in Oxford, pointed out that the small proportion of participants with a lifestyle that protected against stroke meant a huge shift in behaviour would be needed to achieve any benefit.
Joanne Murphy, a spokeswoman for The Stroke Association, said that with obesity levels on the rise, the findings were worrying.
"A stroke is a brain attack, it happens when the blood supply is cut to the brain, it causes brain cells to die and results in brain damage," she said.
"It's the third biggest killer and if it doesn't kill it can leave you severely disabled.
"However, even small changes to our lifestyle factors, such as an improved diet, drinking alcohol in moderation, not smoking and being active, can reduce your risk of stroke."