COR LOE Recommendations In patients with stroke and TIA, it is reason- able to counsel individuals to follow a Mediterranean-type diet, typically with empha- sis on monounsaturated fat, plant-based foods, and fish consumption, with either high extra virgin olive oil or nut supplementation, in preference to a low-fat diet, to reduce risk of In patients with stroke or TIA and hypertension who are not currently restricting their dietary sodium intake, it is reasonable to recommend that individuals reduce their sodium intake by at least 1g/d sodium (2.5 g/d salt) to reduce the risk of cardiovascular disease (CVD) events (including stroke).97,98 Synopsis Limited evidence supports dietary interventions to reduce recurrent stroke,96 with recommendations CLINICAL STATEMENTS AND GUIDELINES Kleindorfer drawn from high-risk CVD and coronary heart disease populations, or dietary effects on stroke risk factors, for example, BP and cholesterol.98 Epidemiological diet and nutrition studies identify protective effects for stroke from regular consumption of fish,99 high consumption of fruit and vegetables100,101 and following the Mediterranean diet96 and the DASH (Dietary Approaches to Stop Hypertension) diet,103 reflected in the AHA/American College of Cardiology (ACC) guideline on lifestyle management to reduce PAR for stroke for the lowest versus the highest tertile of the modified Alternative Healthy Eating Index is 18.8% (99% CI, 11.2 29.7).5a In the United States, the REGARDS cohort study (Rea- sons for Geographic and Racial Differences in Stroke Study) identified higher adherence to the Southern diet (high in added fats, fried food, eggs, processed meats, and sugar-sweetened beverages) was associated with a 39% increased risk of stroke (hazard ratio [HR], 1.39 Sodium and potassium con- sumption, unlike many vitamins and minerals in foods, can be adjusted without altering overall dietary pat- Both high potassium consumption106 and low are associated with lower stroke rates. No evidence supports potassium-based inter- ventions for CVD reduction26 ; no dietary interventions of increased potassium consumption alone in stroke survivors were identified. 