Researchers in China studied over 2,000 adults aged 40 and older to understand which daily habits protect against stroke. They found that eating plenty of fruits and vegetables, staying physically active, maintaining a healthy weight, and not smoking significantly reduced stroke risk. The study showed that people with multiple unhealthy habits—like smoking, being overweight, and not exercising—had dramatically higher stroke risk. The good news: making even a few positive lifestyle changes can meaningfully lower your chances of having a stroke.

The Quick Take

  • What they studied: Which everyday habits and lifestyle choices affect whether people have strokes
  • Who participated: Adults aged 40 and older living in two communities in Shijiazhuang, China. About 2.27% of participants had experienced a stroke
  • Key finding: People who ate plenty of fruits and vegetables and stayed active had much lower stroke risk. Those with 6 or more unhealthy habits had 22 times higher stroke risk compared to those with 0-1 unhealthy habits
  • What it means for you: You can significantly reduce your stroke risk by making practical changes: eating more fruits and vegetables, exercising regularly, quitting smoking, and maintaining a healthy weight. Even small improvements matter

The Research Details

Researchers compared two groups of people: those who had experienced a stroke and those who hadn’t. They collected information about their eating habits, exercise routines, weight, smoking status, and other health factors. This type of study, called a case-control study, helps identify which habits are connected to stroke risk by looking backward at people’s lifestyles. The researchers used statistical analysis to separate which factors truly increased stroke risk from those that were just coincidental differences between groups.

Case-control studies are efficient for studying health problems like stroke that don’t happen to everyone. By comparing people who had strokes with similar people who didn’t, researchers can identify protective and harmful habits. This approach is faster and less expensive than following healthy people forward for years to see who develops strokes.

The study used standardized health screening forms and adjusted for confounding factors (other health conditions that might affect results). However, the study was conducted in one region of China, so results may not apply equally to all populations. The researchers used convenience sampling, which means they didn’t randomly select participants, which could introduce some bias. The study provides useful information but should be confirmed with additional research in different populations.

What the Results Show

The study identified three main lifestyle factors that protected against stroke: eating adequate fruits and vegetables, maintaining a balanced diet with appropriate meat-to-vegetable ratios, and staying physically active. Conversely, three factors significantly increased stroke risk: smoking, being overweight, and physical inactivity. The protective effects of good eating and exercise habits were independent—meaning they worked even after accounting for other health conditions. The cumulative effect was striking: people with multiple unhealthy habits faced dramatically higher risk. Those with 2-3 unhealthy habits had 1.75 times higher stroke risk, those with 4-5 unhealthy habits had 2.70 times higher risk, and those with 6 or more unhealthy habits had 22.67 times higher risk compared to people with 0-1 unhealthy habits.

Interestingly, the study found no significant connection between alcohol consumption and stroke risk, nor between preferring salty foods and stroke risk. This doesn’t mean these factors are unimportant—it may mean the effect was too small to detect in this particular study, or that other factors were more influential in this population.

These findings align with established medical knowledge about stroke prevention. Major health organizations consistently recommend the same lifestyle changes: eating fruits and vegetables, staying active, maintaining healthy weight, and avoiding smoking. This study provides additional evidence from a Chinese population that these recommendations are effective across different geographic regions and cultures.

The study was conducted in only two communities in one Chinese city, so results may not apply to all populations worldwide. The researchers used convenience sampling rather than random selection, which could mean the participants weren’t fully representative. The study looked backward at people’s habits, which relies on memory and self-reporting—people might not accurately remember their past behaviors. The study couldn’t prove that lifestyle changes directly cause lower stroke risk, only that they’re associated with it. Finally, the study didn’t measure how long people maintained healthy habits, which matters for real-world outcomes.

The Bottom Line

If you’re over 40, consider making these evidence-based changes: eat at least 2-3 servings of fruits and vegetables daily, aim for 150 minutes of moderate physical activity weekly, maintain a healthy weight for your height, and avoid smoking. These changes have strong evidence supporting their stroke-prevention benefits. If you drink alcohol, do so moderately. Start with one or two changes rather than trying to overhaul everything at once—small improvements still matter significantly.

Anyone over 40 should pay attention to these findings, especially those with family history of stroke, high blood pressure, or diabetes. People who currently smoke, are overweight, or are sedentary should prioritize these changes. If you have existing health conditions, discuss lifestyle changes with your doctor before starting, particularly regarding exercise intensity.

Some benefits appear quickly: blood pressure and blood sugar can improve within weeks of lifestyle changes. However, stroke risk reduction typically takes months to years of consistent healthy habits. Think of this as a long-term investment in your health rather than a quick fix.

Want to Apply This Research?

  • Track daily servings of fruits and vegetables (goal: 5+ servings) and weekly exercise minutes (goal: 150 minutes). Monitor these two metrics weekly to see cumulative progress toward stroke risk reduction
  • Use the app to set a specific, achievable goal: ‘Add one fruit or vegetable to each meal’ or ‘Walk for 30 minutes, 5 days per week.’ Log completion daily and celebrate weekly milestones to build momentum
  • Create a monthly dashboard showing your progress on key protective factors: fruit/vegetable intake, exercise frequency, weight trend, and smoking status. Review monthly to identify which habits are improving and which need more attention. Share progress with your healthcare provider during annual checkups

This research suggests associations between lifestyle factors and stroke risk but does not prove direct causation. These findings are based on a study in one region of China and may not apply equally to all populations. This information is educational and should not replace professional medical advice. If you have concerns about stroke risk, personal or family history of stroke, or existing health conditions, consult with your healthcare provider before making significant lifestyle changes. Always discuss new exercise programs with your doctor, especially if you have cardiovascular disease or other chronic conditions.