For each serving-per-day increase in fruit and vegetable intake, the risk of stroke was reduced by 6% (95% CI, 1 10). A subsequent analysis of the Nurses Health showed that increased intake of flavonoids, primarily from citrus fruits, was associated with a reduced risk of isch- emic stroke (RR, 0.81; 95% CI, 0.66 0.99; P=0.04). As high- lighted in the 2010 US Dietary Guidelines, most Americans obtain only 64% and 50% of the recommended daily con- sumption of vegetables and fruits, respectively.188 A randomized, controlled trial of the Mediterranean diet performed in 7447 individuals at high cardiovascular risk showed that those on an energy-unrestricted Mediterranean diet supplemented by nuts (walnuts, hazelnuts, and almonds) had a lower risk of stroke than people on a control diet (3.1 versus 5.9 strokes per 1000 person-years; P=0.003) and that those on an energy-unrestricted Mediterranean diet supple- mented by extra virgin olive oil had a lower risk of stroke than people on a control diet (4.1 strokes per 1000 person- In ecological studies,190 and meta- a higher level of sodium intake was associ- ated with an increased risk of stroke. In prospective studies, a higher level of potassium intake was also associated with a reduced risk of stroke.195 198 It should be emphasized that a plethora of methodological limitations, particularly dif- ficulties in estimating dietary electrolyte intake, hinder risk assessment and may lead to false-negative or even paradoxical results in observational studies. One trial tested the effects of replacing regular salt (sodium chloride) with a potassium-enriched salt in elderly Taiwanese In addition to increased overall survivorship and reduced costs, the potassium-enriched salt reduced the risk of mortality from cerebrovascular disease (RR, 0.50). This trial did not present follow-up BP measurements; hence, it is unclear whether BP reduction accounted for the beneficial effects of the intervention. 