Will an Orange a Day Keep Strokes Away?

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Alvin B. Lin, MD, FAAFP

Associate Professor of Family and Community Medicine, University of Nevada School of Medicine

Adjunct Professor of Family Medicine and Geriatrics, Touro University Nevada College of Medicine

Advisory Medical Director, Infinity Hospice Care

Medical Director, Lions HealthFirst Foundation

Dr. Lin maintains a small private practice in Las Vegas, NV. The posts represent the views of Dr. Lin, and in no way are to be construed as representative of the above listed organizations. Dr. Lin blogs about current medical literature and news at http://alvinblin.blogspot.com/.


Following yesterday's apple analogy, I'm sure we've all also heard that an apple a day will keep the doctor away. Well, in a prospective study released early online prior to print publication in April in Stroke, consumption of citrus fruit and juice was associated with a decrease risk of ischemic stroke in women. Just how did the authors arrive at their conclusion?

Well, they followed 69,622 women for 14 years of the Nurses' Health Study and collected food frequency questionnaires every 4 years. After taking into account all the usual confounders, they noted that those who consumed the highest quintile of flavanone had a 20% lower risk of ischemic stroke compared to those in the lowest quintile of consumption. The good news is that citrus fruits and juices are the main dietary source of said flavanones. On a per gram consumption basis, oranges and grapefruits have more flavanones than their juice counterparts, plus less sugar and more fiber. However, as a nation, we tend to consume our citrus in juice rather than fruit form.

The findings of this observational study are in concert with most previous studies demonstrating a link between consumption of more fruits and vegetables and lower risk of stroke. However, in the past, we had not been able to pinpoint one or more specific food items as having greater value than others. To be safe, we need stronger, more robust evidence prior to making a declarative statement of cause and effect. On the other hand, it's difficult to imagine any harm from encouraging the consumption of more citrus fruit from a public health perspective (avoiding the excess calories associated with juices).