This isn’t strictly a stroke-prevention post. It’s a dementia-prevention post. But Stroke‑Proof is ultimately about protecting the brain—and looking after your hearing and eyesight may be a more important part of that than most people realise. The 2024 Lancet Commission estimated that addressing 14 modifiable risk factors could potentially prevent or delay around 45% of dementia cases. Two of those factors involve our senses: 👂 Hearing loss in midlife was estimated to account for around 7% of dementia cases at population level. 👁️ Untreated vision loss in later life was estimated to account for around 2%. Why might our senses affect the health of our brain? Think about how much stimulation reaches your brain through your eyes and ears. Every conversation you follow, face you recognise, book you read and environment you navigate activates complex networks of brain cells. When hearing or vision deteriorates, several things may happen: • The brain receives less sensory stimulation. • It has to work harder to interpret incomplete information. • People may withdraw from conversations and social activities. • Reading, exercise, travel and other cognitively stimulating activities can become more difficult. • Reduced input may contribute to changes in the brain regions that process sensory information. It may therefore be partly a case of maintaining the connections that keep our brain circuits active—continuing to stimulate the wiring rather than gradually allowing those pathways to become less active. In the ACHIEVE randomised trial, treating hearing loss did not significantly slow cognitive decline across the entire study population. However, among participants already at higher risk of cognitive decline, a hearing intervention slowed cognitive decline by 48% over three years. For vision, one study of more than 3,000 older adults with cataracts found that cataract surgery was associated with a 29% lower risk of subsequently developing dementia. That cannot prove that the surgery caused the reduction, but it strengthens the case for taking treatable vision loss seriously.

Did you know you can have a healthy weight but still carry too much fat around your waist? Abdominal fat (visceral fat) is stored deep inside your abdomen, surrounding organs such as the liver, pancreas and intestines. Unlike fat just beneath the skin, visceral fat is metabolically active and is linked to inflammation, type 2 diabetes (as discussed in the previous post), high blood pressure, abnormal cholesterol levels, and an increased risk of stroke. You can have a healthy BMI and still carry excess abdominal fat, so checking your waist measurement alongside your weight and BMI can provide valuable information about your health. As a general guide, try to keep your waist measurement below half your height. For example, if you’re 180 cm tall, your waist should ideally be less than 90 cm. What Should You Eat? Certain foods can help reduce visceral fat by improving insulin sensitivity, reducing inflammation, and increasing fibre and satiety. Here are some evidence-based foods that can help reduce abdominal fat, plus ideas for adding them to your diet. 🐟 Oily Fish Salmon, sardines, and mackerel are rich in omega-3 fatty acids (EPA and DHA), which help reduce inflammation, improve insulin sensitivity, and support liver health. Pan-Seared Salmon Lunch Bowl - Season the salmon with olive oil, lemon juice, black pepper and dill. - Pan-sear until thoroughly cooked. - Fry the leeks, peppers and mushrooms in a separate pan with a little olive oil, black pepper and your favourite herbs until softened. - Serve with brown rice, quinoa or barley. 🫒-Virgin Olive Oil Extra-virgin olive oil (EVOO) as part of the Mediterranean diet combined with vegetables, fruit, nuts, and legumes can help reduce abdominal fat. EVOO offers monounsaturated fats and polyphenols that reduce inflammation and improve insulin sensitivity. Mediterranean Quinoa Bowl - Cooked quinoa - Chopped tomatoes - Cucumber - Red pepper - Feta cheese - Olives (optional) Simple Vinaigrette

Why glucose stability may matter in type 2 diabetes. This week for our Stroke Prevention tip Professor Chatterjee has written fantastic post about glucose variability and why it matters for stroke risk. There are some excellent diagrams in the post that I couldn't post into the text window, so instead I've uploaded the whole post as a PDF that you can read by clicking the link below. Enjoy!

Welcome to Week 2 of our series courtesy of Prof Chatterjee on diabetes and insulin resistance. You will find the post attached below. Please comment and let us know your thoughts below. Have a great week and keep doing all the great stuff that you are doing!

Yes, we're back at blood pressure. After dozens of Stroke-Proof tips I think we've reached the point where any new tips we can come up with would be so minor in their importance that we'd be diluting the key messages. So, back to the start and the most important of all.... There are lots of things we can do to reduce our risk of stroke. But one stands above almost everything else: Getting blood pressure under control. It is not glamorous. It will not generate the same excitement as a full-body scan, a biological-age test or a new supplement. But the size of the prize is enormous. The INTERSTROKE study compared 13,447 people who had experienced a first stroke with a similar number who had not, across 32 countries. Having hypertension—or a measured blood pressure of at least 140/90 mmHg—was associated with almost three times the odds of stroke. At a population level, high blood pressure accounted for an estimated 47.9% of stroke risk. Its contribution was even greater for bleeding within the brain. The Global Burden of Disease study reached a remarkably similar conclusion using a very different method. It estimated that high systolic blood pressure contributed to around 55.5% of all healthy years lost to stroke worldwide in 2019—more than any other risk factor. These figures do not mean that lowering blood pressure would instantly prevent exactly half of all strokes. Population-attributable estimates are not the same as the benefit of an individual treatment. But they tell us something hugely important: Blood pressure sits at the centre of the stroke-prevention opportunity. Does lowering it genuinely prevent stroke? Yes. And this is not based only on association. It has been tested in large randomised trials. An individual-participant meta-analysis (combination of trials) combining around 350,000 people from 48 trials found that every 5 mmHg reduction in systolic blood pressure reduced the relative risk of stroke by about 13%. The greater the blood-pressure reduction, the greater the average benefit.