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October 18, 1995

Fruits, Vegetables, and Stroke Risk-Reply

Author Affiliations

Boston University School of Medicine Boston, Mass

JAMA. 1995;274(15):1197-1198. doi:10.1001/jama.1995.03530150021019

In Reply.  —We appreciate Dr Folts' letter highlighting another possible mechanism by which the intake of fruits and vegetables may protect against the development of stroke. If the chief protective mechanism of flavonoids involves platelet inhibition, the benefit of these compounds might apply principally to ischemic stroke, since a platelet-inhibiting factor would not be expected to reduce the risk of hemorrhagic stroke. In our data, the intake of fruits and vegetables appeared to reduce the risk of both types of stroke, although the number of hemorrhagic strokes was small. It would be helpful if Hertog et al1,2 or others with information on flavonoid intake could address directly the issue of stroke risk.As the comments of Folts also underscore, we examined the effect of a class of foods on stroke risk without knowing the identity of all beneficial (or harmful) substances these foods contain. However, much of dietary counseling

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