Heart Disease and Stroke

Anjou BranchHeart disease is the primary cause of death in the United States, and stroke is the third leading cause of death, according to the National Center for Health Statistics at the Centers for Disease Control and Prevention (1). Heart disease is a general term for cardiovascular disease, which refers to the class of diseases that affect the heart or blood vessels, and usually implies the diseases affected by atherosclerosis. Atherosclerosis is the buildup of fatty plaques and eventual hardening of the artery walls due to cholesterol buildup. Fats that we eat naturally travel through the bloodstream, and are deposited in tissues for various vital functions. But when we eat too much unhealthy fat, namely saturated fat, trans fat, or cholesterol, these fats may be deposited in the artery walls. Over time, these deposits, or plaques, grow and may block blood flow to the heart or brain, which may cause death of these tissues. When this blockage happens, it is referred to as a heart attack or stroke.

The American Heart Association affirms that many factors contribute to cardiovascular disease, including diet, activity level, age, and genetic makeup (2). However, including more fruits and vegetables in the diet may help fend off heart attack or stroke (3). Fruits and vegetables carry fiber, potassium, and phytochemicals that fight damage caused by atherosclerosis (4). Likewise, diets that replace energy-dense foods with fruits and vegetables are usually lower in fat and calories, which may help prevent weight gain – another risk factor for cardiovascular disease. Those with a strong family history of heart disease or stroke should seek medical advice and follow a diet high in fruits, vegetables, whole grains, and nuts, and limit sodium, fat, and excess calories. Likewise, following a physical activity regimen approved by your doctor is a key ingredient in a heart healthy lifestyle (5). For more information about diseases affecting the heart and circulation, visit the website of the American Heart Association at

So how do pears fit into your heart-healthy diet? Pears are a good source of the antioxidant vitamin C (ascorbic acid), and contain other antioxidants. They are rich in fiber and contain phytochemicals that may work synergistically to fight cardiovascular disease (4). Likewise, pears are sodium-free, fat-free, and cholesterol-free – important factors in a heart-healthy diet (5). So include pears as part of your fruit and vegetable intake every day for a burst of sweet satisfaction that will please your taste buds, and your doctor!


A prospective 10 year study found that eating more white flesh fruits and vegetables, especially apples and pears, was associated with a decreased incidence of stroke. A total of 20,069 healthy Dutch men and women age 20 to 65 years were monitored for consumption of green, orange/yellow, red/purple, and white fruits and vegetables. The median consumption of white flesh produce was 118 grams per day, but it was found that for every 25 grams more of white fruits and vegetables consumed was associated with a 9% decrease in risk for stroke. The benefit was suggested to be from flavonoids, a class of antioxidants, and fiber in the flesh of the fruit. One medium, 100 gram pear provides flavonoids, 24% of your daily fiber, and may protect against stroke!

Linda M. Oude Griep, W.M. Monique Verschuren, Daan Kromhout, Marga C. Ocké. Colors of Fruit and Vegetables and 10-Year Incidence of Stroke. Stroke 2011;42:00-00.
In an analysis comparing studies of more than 257,551 individuals, increasing daily fruit and vegetable intake was found to decrease risk of stroke! Fruits and vegetables are full of vitamin C, fiber, potassium, and antioxidants. Compared with individuals who eat fewer than 3 servings of fruits and vegetables every day, those who eat three to five servings daily are 11% less likely to have a stroke. Those who eat more than 5 servings of fruits and vegetables every day have a risk reduction of 26%! These findings support eating more fruits and vegetables every day!

He FJ, Nowson CA, MacGregor GA. Fruit and vegetable consumption and stroke: meta-analysis of cohort studies. Lancet 2006; 367: 320-326.

In other research, the diets of 90,513 men and 141,536 women were observed and amounts of fruits and vegetables eaten were directly linked to stroke risk. For each additional serving of fruit, stroke risk was decreased by 11%! Although also protective, additional vegetable servings only decreased stroke risk by 3% each. This dose-response relationship suggests that fruit, and fruit and vegetable consumption, decrease the risk of stroke. So eat more fruit!

Dauchet L, Amoyel P, Dallongeville J. Fruit and vegetable consumption and risk of stroke: a meta-analysis of cohort studies. Neurology 2005;65(8):1193-1197.
Those who follow a prudent diet have a higher intake of fruits, vegetables, legumes, fish, and whole grains. This diet is thought to be a healthier pattern than the typical Western diet, which consists of a higher intake of red and processed meats, refined grains, french fries, sweets, and desserts. Previous studies have found strong associations between the Western diet and coronary heart disease and colon cancer:

In a study of 72,113 women free of illness, over 18 years 1154 died of cardiovascular death and 3139 died from cancer. The prudent diet was associated with a 28% lower risk of cardiovascular mortality, and 17% lower risk of all-cause mortality. Generally, the Western diet was associated with 22% higher risk of death from cardiovascular disease, 16% from cancer, and 21% of all causes of death. Thus, eating a healthful diet high in plant foods and lean meats may reduce risk of cardiovascular disease and overall mortality.

Heidemann C, Schulze MB, Franco OH, van Dam RM, Mantzoros CS, Hu FB. Dietary patterns and risk of mortality from cardiovascular disease, cancer, and all causes in a prospective cohort of women. Circulation 2008;118(3):230-237.

In a similar population, 69,017 women aged 38 to 63 years followed either a prudent or Western diet. Those following the Western eating plan on average ate up to 1.5 servings of fruit and up to 3.2 servings of vegetables per day. On the other hand, those following a more prudent plan ate up to 2.4 and 5.3 servings respectively. Overall, those following the Western plan were 1.64 times more likely to develop coronary heart disease (CHD). On the other hand, those following a more prudent eating plan had an inverse relationship with CHD; meaning, the more healthful foods eaten, the lower the risk for CHD! In a follow-up study of 71,768 women and risk for stroke, those who followed the Western diet most closely, had 1.58 times the risk of having a stroke compared to those who ate a more varied Western diet. Likewise, those who ate the most fruits and vegetables had a negative association with stroke. These findings suggest that including more fruits and vegetables in the diet as part of an overall healthy diet is protective against coronary heart disease and stroke.

Fung TT, Willett WC, Stampfer JM, Manson JE, Hu FB. Dietary patterns and the risk of coronary heart disease in women. Archives of Internal Medicine 2001;161:1857-1862.
Measuring vitamin C (ascorbic acid), the antioxidant vitamin, carried in the bloodstream is one way to assess fruit and vegetable intake. High levels in the bloodstream are associated with reduced risk for coronary artery disease, since it protects against oxidative damage that causes vascular injury. However, past studies have found that long-term supplementation with antioxidant pills did not offer any protective benefits. In a study of 979 individuals with no history of heart attack or stroke, those with the highest intake of ascorbic acid from fruits and vegetables had lower BMI, lower blood pressure, lower C-Reactive Protein (a marker of inflammation), and a higher HDL-cholesterol (the “good” cholesterol that protects against heart disease). Those with the highest levels of ascorbic acid had a 33% lower risk of developing coronary artery disease! This suggests that nutrients found in whole fruits work together synergistically, and offer more protection than supplements!

Boekholdt SM, Meuwese MC, Day NE, Luben R, Welch A, Wareham NJ, Khaw KT. Plasma concentrations of ascorbic acid and C-reactive protein, and risk of future coronary artery disease, an apparently health men and women: the EPIC-Norfolk prospective population study. British Journal of Nutrition 2006;96:516-522.
Fiber from fruits, vegetables, grains, and cereals may reduce the risk for cardiovascular disease by lowering blood pressure and reducing cholesterol. In a Harvard study of 91,058 men and 245,186 women, for every 10 grams of fiber eaten, a 14% decrease in risk for heart attacks and a 27% decrease in overall risk of dying from coronary heart disease were observed. This research also suggests that associations were strongest for fiber from fruit (30% decrease), followed second by cereal fiber (25% decrease). So eat an excellent source of fiber today!

Pereira MA, et al. Dietary fiber and risk of coronary heart disease. Archives of Internal Medicine 2004;164:370-376.

1. Centers for Disease Control and Prevention: National Center for Health Statics, Fastats. Available online here.
2. American Heart Association, Risk Factors and Coronary Heart Disease. Available online here.
3. American Heart Association, Risk Factors you can Change. Available online here.
4. Lichtenstein AH, Appel LJ, Brands M, et al. Diet and Lifestyle Recommendations Revision 2006: A Scientific Statement From the American Heart Association Nutrition Committee. Circulation. 2006;114:82-96.  Available online here.
5. American Heart Association, Diet and Lifestyle Recommendations. Available online here.

This site is for informational purposes only, and is not intended to treat any illness or condition. If you have questions or concerns about your health, seek advice from your physician.