To eat a healthy, balanced diet, there are foods you should include in your diet and foods you should try to reduce.

1. Aim for at least five portions of fruit and veg per day
2. Reduce the amount of salt you eat
3. Make sure you’re eating enough fibre
4. Include wholegrains in your diet
5. Limit your sugar intake
6. Include protein in your diet
7. Reduce and replace saturated fats
8. Stay hydrated

1) Aim for at least five portions of fruit and veg per day

Ways to eat more fruit and vegetables

• Choose a colourful variety of fruits and vegetables. You could try courgettes, mango, berries, broccoli or peppers.
• Try making a simple vegetable soup to include a variety of vegetables in your diet.
• Tinned fruit and vegetables count towards your five a day and can be cheaper to buy than fresh versions. Choose fruit in natural juice rather than syrup, and vegetables in water with no added salt or sugar.
• Frozen vegetables and fruit are full of the same nutrients and fibre as fresh. They are often cheaper to buy than fresh and you have less food waste. Try adding some frozen berries to porridge or frozen chopped vegetables to a homemade pasta sauce.
• Try replacing crisps and chocolate with healthy snacks. For example, a piece of fruit, raw carrot sticks with some humous or a small handful of unsalted nuts.

2) Reduce the amount of salt you eat

Salt contains sodium which helps to keep your body fluids at the right level. If you have too much salt, the amount of liquid your body stores will increase. This raises your blood pressure. High blood pressure (hypertension) is the single biggest risk factor for stroke.

Eating too much salt can increase your risk of a stroke by up to 23%. By reducing the amount of salt you eat, you can lower your blood pressure and your risk of stroke.

How much salt do I need?

Adults should eat no more than 6g of salt a day, or about a teaspoon. Remember, there is a large amount of hidden salt in processed and ready-made foods.

A quick way to keep track of your salt intake is by reading the salt or sodium content on the food labels. Salt could be listed as either salt or sodium. Sodium is always a smaller number than salt, so multiply it by 2.5 to get the amount of salt.

• A high amount of salt is more than 1.5g per 100g, or 0.6g sodium.
• A low amount of salt is 0.3g or less per 100g, or 0.1g sodium.

Ways to reduce the amount of salt in your diet

• When comparing two similar products, try to go for the one with the lowest salt content.
• Try to avoid adding salt to your food during cooking and at the dinner table.
• Try using herbs, spices, garlic or lemon juice to add flavour instead of salt.
• Make your own sauces, pickles or chutney to control how much salt goes in, as many pre-made versions can be high in salt.
• Choose tinned fish in spring water instead of brine.
• Avoid high salt foods, supermarket readymade meals, and processed meat such as bacon, ham and sausages. Many other everyday foods can have a high salt content, such as tinned and packet soup, gravy granules, stock cubes and savoury snacks like crisps.
• Some cheeses can have a high salt content, but cheese also provides some healthy nutrients, such as protein and calcium. Check food labels to see if lower-salt versions are available and watch your portion sizes. A standard portion of cheese is 30g (about the size of small matchbox).

‘I’ve been trying to cook without salt. Instead, I add fresh ingredients like garlic, chillies, coriander and chives to flavour my meals.’

Olivia, stroke survivor

3) Make sure you’re eating enough fibre

Including fibre in your diet can help to reduce your risk of stroke. It also helps to keep blood sugar levels stable and helps you manage your weight.

You can find fibre in plant-based foods. The amount of fibre in food is often on the label. Sometimes, people may refer to fibre as insoluble and soluble fibre.

• Soluble fibre delays the time it takes for you to digest food, making you feel fuller for longer. It can regulate blood sugar levels and help reduce cholesterol. It does this by binding to excess cholesterol and fatty substances in the gut. This stops them from going into your bloodstream.
• Insoluble fibre shortens the time it takes for food to move through the bowel. It can also improve the balance of good bacteria in the gut.

How much fibre do I need?

Adults should aim to eat about 30g of fibre every day. One portion of fibre is about 7g. That is equivalent to a standard portion of wholemeal pasta (70g dry weight) or two slices of wholemeal bread.

Ways to boost your fibre intake

• Increasing soluble fibre:
  • You can find soluble fibre in grains like oats, barley and rye.
  • Fruit, vegetables and beans, pulses and peas (such as lentils, chickpeas or kidney beans) are other good sources.
• Increasing insoluble fibre:
  • Try eating the skin on fruit and vegetables like apples and potatoes.
  • Go for wholegrain varieties of starchy foods like pasta and bread.

4) Include wholegrains in your diet

Including wholegrains in your diet can help to prevent type 2 diabetes, heart disease and weight gain. Wholegrains are a good source of B-vitamins and folic acid, as well as both soluble and insoluble fibre.

Wholegrain means all three parts of the grain (skin, germ and seed) are contained within the food. When the skin (outer layer) is removed, the grain becomes ‘refined’, such as in white flour or white rice. The skin is where most of the fibre, vitamins and minerals are stored. This is why wholegrain foods tend to contain more vitamins and minerals than refined foods.

Ways to get more wholegrains in your diet

• Start off by adding wholegrains into some of your main meals. Try brown rice instead of white, or wholewheat pasta and wholewheat couscous.
• Look for wholegrain breakfast cereals.
• Choose wholegrain bread, and try bread made with rye and other grains.
• Oats can help lower cholesterol due to a type of soluble fibre called beta-glucan. Oat bran, rye and barley also contain beta-glucan. Having 3g beta-glucan a day can help reduce your cholesterol. Three reduced-salt oatcakes can provide about 1g and a 40g bowl of porridge can provide between 1-2g. Barley or pearl barley added into a stew can also contribute. If you cannot eat gluten or wheat, try alternative grains such as buckwheat, corn, rice, quinoa and millet.

5) Limit your sugar intake

Some foods and drinks contain a lot of added sugar. You may hear these called ‘free sugars’. Free sugars are added sugars and sugars found naturally in foods such as honey, syrups, unsweetened fruit or vegetable juices, smoothies and purées.

Eating too much sugar in your diet may mean that you’re eating too many calories. This can cause weight gain, which increases your risk of stroke, heart disease and type 2 diabetes. It can also lead to tooth decay.

Foods which often contain added sugar include:

• Fizzy drinks and some squashes – a high intake of sugary drinks has been linked to an increased risk of stroke.
• Biscuits, cakes, jams, sweets and chocolate.
• Ready-made pasta sauces.
• Cereals like muesli, cornflakes and granola.
• Tomato ketchup and baked beans.
• Some foods sold as 'low fat' may contain extra sugar

Try to limit your sugar intake by eating no more than 30g of added sugar a day. This is about seven teaspoons of sugar. This may sound a lot, but one can of fizzy drink may contain more than eight teaspoons, so try swapping to water or other sugar-free drinks to help limit your sugar intake.

6) Include protein in your diet

Protein helps the body repair cells and maintain muscle strength. Protein is found in foods like meat, poultry (chicken and turkey), fish, eggs, pulses (such as lentils) and beans. Dairy products, nuts and meat alternatives also include protein.

How much protein do I need?

The NHS Eatwell Guide recommends about 45g of protein a day for an average woman and 55g for an average man, which is around two portions a day. However, if you’re aged over 65, you may need more protein than that, to help maintain muscle mass as you age. One portion of protein is roughly about the size of the palm of your hand.

Ways to include protein

• Aim to keep your intake of saturated fat low by choosing lean cuts of meat.
• Aim for two servings of fish per week, including oily fish, like mackerel, salmon, sardines or trout.
• Aim to spread your protein intake evenly throughout the day, eating a similar amount for each meal.
• Limit red meat. Red meat can be a good source of protein and nutrients. However, red meat can also be high in saturated fat, which can raise your cholesterol, a risk factor for stroke. National stroke guidelines recommend limiting your red meat intake.
• Limit processed meats. Eating processed meat, such as sausages or bacon, regularly may increase your risk of stroke by around 17%, compared with eating none.
• Use beans and pulses as an alternative protein source to meat in dishes like curries and casseroles.
• Look for lower-fat versions of dairy products, such as skimmed or semi-skimmed milk and plain or low-fat yoghurt with no added sugar, if you are trying to lose weight or manage cholesterol levels.

Remember nuts are high in calories, so you only need a small handful.

7) Reduce and replace saturated fats

We all need a small amount of fat in our diet. It is a valuable source of energy and it helps the body absorb certain nutrients. It can also provide substances called essential fatty acids that the body cannot make itself. However, too much fat in your diet may mean you’re eating too many calories. This can cause weight gain, which can increase your risk of stroke.

There are different types of fats which do different things:

• Unsaturated fats are mainly found in fish and in plant-based foods, like nuts and seeds or the oils that come from them. Eating small amounts of unsaturated fats (instead of saturated fats) can help to prevent blocked arteries and blood clots, which can cause strokes.
• Saturated fats can raise cholesterol in your blood, which can lead to blocked arteries and heart disease. Saturated fats are mainly found in meat and dairy products, including fatty red meat, processed meats, butter, cream and cheese. Palm oil, coconut oil, lard and ghee are also high in saturated fat. Reducing the amount of saturated fat in your diet will help keep your heart healthy.
• Trans fats are artificial fats mostly found in processed foods like cakes, biscuits, margarine and fast foods. Trans fats can raise the ‘bad’ cholesterol and reduce the ‘good’ cholesterol in your blood. This can increase your risk of stroke and heart disease. Trans fats are made from liquid oils being turned into a solid fat by a process called hydrogenation. They are usually called hydrogenated fats on food labels.
• Omega 3 and omega 6 fatty acids are types of polyunsaturated fat. These are known as essential fatty acids. Omega 3 and omega 6 fatty acids tend to be found in oils from plants, like rapeseed oil and sunflower oil, and in oily fish. They are also found in nuts and seeds, such as walnuts and flax seeds, and soya products. There is no strong evidence to say for sure if omega 3 and omega 6 fatty acids reduce the risk of stroke. However, research has shown that when you include them in your diet, together they work well at helping you manage ‘good’ and ‘bad’ cholesterol. It’s best to get them from your diet, as there’s no clear evidence that omega 3 supplements can reduce your risk of cardiovascular disease.

Ways to reduce saturated fats

• Try eating more foods that contain healthy fats, such as salmon, sardines and avocado.
• Swap to small amounts of vegetable oil, such as rapeseed oil, if you’re using oil for cooking.

8) Stay hydrated

It’s important to drink enough and stay hydrated to help with your recovery.

The NHS Eatwell Guide recommends you drink six to eight cups or glasses (about 1.2l to 1.6l) of fluid a day. You may need to drink more, for example, when you’re ill, during warm weather or if you’re exercising, to avoid becoming dehydrated. Water, low-fat milk and sugar-free drinks, including tea and coffee, all count towards your fluid intake.

You need to drink enough throughout the day. If you do not drink enough, you may become dehydrated, which can make you very ill. Signs of dehydration include having dark yellow wee or feeling thirsty or dizzy.

Tips for drinking enough fluids

• Try using prompts like setting an alarm on your phone or putting a note on your fridge to remind you to drink regularly.
• Make drinking regularly part of your daily routine, such as having a drink with each meal and taking a bottle of water with you if you’re going out.

If you’re having problems swallowing, staying hydrated may be more difficult. Contact your stroke team or GP as they may be able to refer you to a speech and language therapist.

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