To the Editor.
—The interesting article by Dr Gillman and colleagues1 showed a protective effect from increased consumption of fruits and vegetables on transient ischemic attacks and stroke in men. After adjusting for a variety of potential confounders, the authors suggested potassium intake or antioxidant vitamins as possible mechanisms.I would offer another possible mechanism for the protection of fruits and vegetables against transient ischemic attacks and ischemic strokes. Fruits and vegetables, but not animal products, are known to contain biologically active polyphenolic compounds called flavonoids.2 These compounds are known to be potent antioxidants but also are very effective platelet inhibitors.2 Transient ischemic attacks and ischemic strokes, which instituted the majority of strokes in their study, are now thought to be mediated by platelets.3 Platelets are known to exacerbate the rate of atherosclerosis and coronary and cerebrovascular disease, as well as being the primary mediator of
Folts JD. Fruits, Vegetables, and Stroke Risk. JAMA. 1995;274(15):1197. doi:10.1001/jama.1995.03530150021018