Weight reduction, low-risk diet, regular physical activity, smoking cessation, and low-to-moderate alcohol consumption may reduce
stroke risk up to 50% or more, but level one evidence is still lacking for several interventions. Appropriate
food ingredients can significantly decrease
stroke risk as recently confirmed for
Mediterranean diet. The optimal intensity and amount of physical exercise is still not well established before and after
stroke, although modest levels of activity already show benefits.
Passive smoking represents an important health hazard. The impact of tobacco withdrawal using e-cigarette is currently uncertain. Alcohol and
stroke risk relation is probably J-shaped for
ischaemic stroke and linear for intracranial haemorrhage.
Coffee consumption is J-shaped for overall
stroke. Several interventions have failed to show significant effects, including regular intake of 'healthy' forms of
fatty acids, various
vitamin supplements, and other
antioxidants. Both individualized and public educational programmes are likely needed on a repetitive basis to induce and maintain a healthy lifestyle before or after a
stroke.