We've spoken many times about the health benefits of extra-virgin olive oil (EVOO). But how do you choose a genuinely good one and keep it fresh? Why does this matter? Extra-virgin olive oil is an important part of the Mediterranean diet, which has been linked to a lower risk of heart disease and stroke. Choosing a good-quality olive oil and storing it properly can help preserve its flavour and the natural compounds that may provide health benefits. When buying olive oil, look for: • 🏷️ Extra virgin" on the label. Extra-virgin olive oil is made by pressing olives without using chemicals. This helps keep its natural flavour and nutrients. • 📅 A recent harvest date. Unlike wine, olive oil does not improve with age. Its flavour fades and its beneficial polyphenols (antioxidants) gradually break down. Look for "harvest date", "harvested" or "crop year", rather than relying only on the best-before date. • 🫙Dark glass or a tin. Light can gradually damage the oil and reduce some of its beneficial compounds. Dark glass and tins help protect the oil. • 🌍Clear information about its origin. Check where the olives were grown and where the oil was produced, not just where it was bottled. Some producers include a QR code that provides information about the oil's harvest date, origin, producer and, occasionally, laboratory results. This can improve traceability, although a QR code alone does not guarantee quality. • 📦 A practical container size. Choose an amount you can finish within a few months. A large container is not economical if the oil remains open and exposed to oxygen for too long. • 💧Filtered oil for longer storage. Unfiltered olive oil can be delicious when it is very fresh, but excess moisture and sediment may cause it to deteriorate more quickly. If you choose an unfiltered oil, use it promptly. Price and attractive packaging do not always guarantee quality. Words such as "pure" and "light" do not mean that the oil is fresher or healthier. "Light" refers to a milder flavour and colour, not fewer calories.

“I vape, but I don’t smoke.” I hear this quite often. Vaping and smoking are not the same. Vaping is less harmful than smoking, but that does not mean it is harmless. When you smoke a cigarette, tobacco burns and releases 7000 of chemicals. Many of these chemicals damage blood vessels, make the blood more likely to clot and contribute to the build-up of fatty plaques in the arteries a process called atherosclerosis. These effects increase the risk of stroke. Vapes do not burn tobacco. As a result, people who vape are generally exposed to fewer harmful chemicals, and at lower levels, than people who smoke. For someone who smokes, switching completely to vaping can therefore reduce harm (1). But vaping is not risk-free. Vapes contain a base liquid (propylene glycol, vegetable glycerine), flavourings, and usually nicotine, but not the tar and carbon monoxide produced by burning tobacco. Nicotine is addictive and can temporarily increase heart rate and blood pressure. Vaping can affect the lining of blood vessels, increase inflammation, activate platelets and temporarily make arteries stiffer. These changes could contribute to cardiovascular disease, but we do not yet fully understand the long-term effects of vaping on the heart and blood vessels (2). Why does this matter for stroke prevention? High blood pressure, damaged arteries and blood clots can all play a part in causing a stroke. However, the evidence available today does not establish that vaping directly causes stroke. Research into the relationship between vaping and stroke is still developing, and its findings have not always been consistent. A 2025 systematic review and met-analysis found a clearer association between vaping and heart attack than between vaping and stroke. The study found a small increase in reported strokes among e-cigarette users, but the evidence was not strong enough to confirm a real difference. Some groups, including former smokers who currently vaped, reported more strokes. However, their previous smoking may partly explain this finding. Most of the research was observational, meaning it could identify connections but could not prove that vaping caused the events. Longer-term studies are still needed (3).

After a stroke, you may suddenly find yourself taking several tablets every day. But often we aren't clear about what each tablet does and why. Many of the medicines prescribed after a stroke have one very important job — reducing your risk of another stroke. Here are some of the common ones: 🩸 CLOPIDOGREL / ASPIRIN — stopping platelets sticking together If you’ve had an ischaemic stroke — a stroke caused by a blood clot blocking an artery — you will often be prescribed an antiplatelet medicine. The most common long-term medication is clopidogrel. Aspirin is another antiplatelet and is commonly used immediately after an ischaemic stroke or TIA. Some people take aspirin instead of clopidogrel, and in certain situations aspirin and clopidogrel may be used together for a short period. These medicines make platelets less likely to stick together and form another clot. ❤️ APIXABAN, RIVAROXABAN, DABIGATRAN or EDOXABAN — preventing clots from the heart These belong to a group called DOACs — Direct Oral Anticoagulants. They are particularly important if your stroke was associated with atrial fibrillation (AF). AF causes the heart to beat irregularly. Blood can pool inside the heart, allowing a clot to form. That clot can then travel to the brain and cause a stroke. DOACs reduce the ability of the blood to form these dangerous clots. They include: • Apixaban • Rivaroxaban • Dabigatran • Edoxaban Some people need warfarin instead — for example, in certain types of heart-valve disease or with a mechanical heart valve. Importantly, anticoagulants and antiplatelets are not the same thing, and most people do not need both long-term unless there is another reason. 🫀 ATORVASTATIN and other statins — reducing cholesterol and stabilising arteries Statins are not simply “cholesterol tablets”. After an ischaemic stroke or TIA, a high-intensity statin such as atorvastatin is commonly prescribed to reduce the risk of another event. Lowering LDL cholesterol reduces the chance of cholesterol-rich plaques (artery deposits) growing or causing further problems in your arteries.

This week instead of a tip we have added Professor Chatterjee's guide to understanding blood glucose in detail to the Classroom section of the community. Diabetes is a clear risk factor for Stroke, but even pre-diabetes and insulin resistance carry risks making this book an absolutely excellent read. Alongside this we will be workign on an audio version too which will be available soon. Please add your feedback or reflections on what you've learned below in the comments so we can support eachother in our learning.

I attended a Lifestyle Medicine Conference last week and came away with four important messages that I believe are highly relevant for our stroke prevention community. For those who may not be familiar with Lifestyle Medicine, it is an evidence-based approach that supports people to improve their health through sustainable changes in nutrition, physical activity, sleep, stress management, social connection, and the avoidance of harmful substances. It works alongside, not instead of, conventional medicine. 1. Small Changes Can Make a Meaningful Difference One of the clearest messages from the conference was that you do not need to transform your life overnight to improve your health. Research consistently shows that realistic changes to how we eat, move, sleep, manage stress, and avoid harmful substances can improve blood pressure, cholesterol, and blood glucose control. These changes can also improve how we feel day to day, helping us with energy levels, mood, and overall wellbeing. 2. Our Reason for Changing Matters Knowing that we need to lower our blood pressure or lose weight is not always enough to sustain long-term change. We are far more likely to maintain healthy habits when they are connected to something personally meaningful: remaining independent, spending quality time with family, watching our children or grandchildren grow up, travelling, gardening, or continuing to enjoy the activities we love. The number may be the clinical goal, but our "why" is often what helps us take the next step and keep going when motivation fades. 3. Sleep Is Powerful and Often Underestimated Sleep is not simply a period of rest. It influences what we eat, how active we feel, how we manage stress, how we connect with others, and even our relationship with smoking and alcohol. Poor sleep can make healthy choices feel harder and unhealthy choices feel more tempting. Rather than thinking of sleep as separate from the other pillars of health, it may be more helpful to see it as the foundation that supports them all.