Along with a balanced diet and regular exercise, multivitamins are a good way to stay in good health. For just pennies a day, they may help lower your risk of cancer, heart disease and osteoporosis as well as prevent some birth defects. When undertaking body weight management, taking a multi-vitamin will keep you strong and healthy. Since you are changing your eating habits in one way or another, you want to make sure you are getting in a good amount of your essential vitamins and minerals. Look to include vitamins: A, D, E & B-Complex (B1, B2, B6, B12), minerals: calcium, magnesium, potassium, copper, manganese, chromium, zinc, iodine, boron, iron & selenium in addition to an anti-oxidant. There are many misconceptions about vitamins and the health benefits they offer.
Vitamins play an important role in keeping the body healthy. However, taking large doses of certain vitamins can actually be harmful. For most people, it is best to get the vitamins our bodies need from eating a variety of healthy, unprocessed foods rather than by taking supplements. Vitamin supplements are frequently misused and taken as a form of medicine to treat ailments such as colds or to counteract lifestyle issues such as stress. Contrary to popular belief, vitamins aren’t drugs or miracle cures. They are organic compounds that participate in various metabolic functions. High-dose supplements should not be taken unless recommended under medical advice. Isolating the ‘active ingredient’ is not the answer Proper balance and adequate levels of essential nutrients is important for a range of complex processes in our body. When vitamins are taken as supplements, they are introduced into the body at levels that could never be achieved by eating even the healthiest of diets. They are also sent in ‘alone’. When they occur in food, vitamins have many other companions to help them along the way. For instance, provitamin A (beta-carotene) in food is accompanied by hundreds of its carotenoid relatives. Simply taking a vitamin pill is not an instant fix for feeling run down or lacking in energy. It is the combination of a whole range of compounds (most of which we probably don’t even know about) in plant foods that gives us the protection. When you artificially remove one of them and provide it completely out of context, it may not be as effective and, in the case of some vitamins, can have negative effects
Recommended dietary intakes
 Many people mistakenly believe that since small amounts of vitamins are good for you, then large amounts must be better. In the case of vitamins, it is better to follow the rule of ‘less is more’. The vitamins A, D, E and K are fat soluble, which means they can be stored in the body. Taking high doses of these vitamins, especially vitamin A, over a long period of time can result in harmful levels in the body unless you have a medically diagnosed deficiency. Some of the water soluble vitamins can also cause side effects in high doses. For instance, vitamin B6 has been linked with nerve damage when taken in large doses. For a healthy adult, if supplements are used, they should generally be taken at levels close to the recommended dietary intake (RDI). High-dose supplements should not be taken unless recommended under medical advice. Deficiencies and illness
The human body is able to store vitamins. The fat soluble vitamins A, D, E and K can be locked away in the liver and body fat and stored for a long time. The water soluble vitamins, including B-complex and vitamin C, are mostly only stored for a shorter period of time. A vitamin deficiency takes weeks or months before it will affect your health. For instance, it would take months of no vitamin C before you developed scurvy. An occasional lapse in good eating will not harm you if your usual diet consists of a wide variety of fresh foods.
Sometimes supplements are needed
 Supplements do have a role to play for some groups of people. For instance, people on long-term restrictive weight loss diets or people with malabsorption problems such as diarrhoea, coeliac disease, cystic fibrosis or pancreatitis can benefit from supplements. Folic acid supplements are strongly recommend for women planning a pregnancy to reduce the risk having a baby with neural tube defects, like spina bifida. People who are advised by their doctor that they need to take vitamin supplements are encouraged to consult an accredited dietitian, who can work with their doctor to provide dietary advice related to the person’s situation. If you need to take a supplement, it is best to take multivitamins at the recommended dietary level, rather than single nutrient supplements or high-dose multivitamins.
The common cold and vitamin C
Many people think that vitamin C helps prevent the common cold. Despite exhaustive research across the world, there is still no strong evidence to prove this. Some studies have shown that taking large doses of vitamin C (more than 1,000mg per day) continuously or at the start of a cold may ease some of the symptoms and the duration, on average, making it about half a day shorter. It does not prevent you catching a cold. You also need to consider the health risks associated with taking large doses of vitamin C. Large doses may cause nausea, abdominal cramps, headaches, fatigue, kidney stones and diarrhoea. It may also interfere with your body’s ability to process (metabolise) other nutrients – for example, it could lead to dangerously raised levels of iron. Excessive amounts of vitamin C in the body can also interfere with medical tests, such as diabetes tests, giving a false result. Adults need about 45mg of vitamin C per day and any excess amount is excreted. Stress, depression and anxiety Some vitamin and omega-3 fatty acid deficiencies can lead to emotional disturbances. However, if you are feeling run down, it is more likely to be due to stress, depression or unhealthy lifestyle habits (such as insufficient sleep or smoking) rather than a vitamin deficiency. Feeling under pressure doesn’t automatically lead to a vitamin deficiency, so taking a vitamin supplement won’t necessarily make the stressful feelings go away. More serious mental illnesses, such as schizophrenia and bipolar disorder, aren’t caused or prevented by vitamins, although a healthy diet and good nutrient intake can help support a person to better cope with their condition.
Vitamin E and heart disease
Vitamin E is widely promoted as a beneficial antioxidant that can help prevent heart disease. Unfortunately, several large-scale reviews have conclusively found no evidence that vitamin E supplements prevent death from heart disease. In fact, there may be greater risk of all-cause death from taking such supplements.
Cancer cures
Vitamin A in large doses does not cure cancer and can be toxic, particularly if taken as pills rather than food. There is some evidence that vitamin E could play a small role in preventing some cancers although, equally, there is evidence that it could hasten the onset of other types of cancer; however, this has not been conclusively proved or disproved. While it is argued by some that megadoses of antioxidants can help with the effectiveness of conventional cancer treatments, such as chemotherapy and radiotherapy, the evidence is far from supporting this. In fact, it has been shown that megadoses of antioxidants can actually interfere with some medical treatments of cancer by helping to protect the cancer cells that the therapies aim to eradicate.
Some research findings
A number of studies into supplement use have shown negative findings. For instance: Vitamin A (beta-carotene) was thought to reduce the risk of some cancers but has been linked to an increase in others, such as lung cancer in smokers, if taken in supplement form. Several long-term studies have shown that prostate, breast and lung cancer risk are not decreased by taking high-dose supplements containing vitamins E or C or selenium. People taking high-dose vitamin E supplements have been found to have higher rates of early death (mortality).
Anti-ageing vitamins
Vitamin E is often singled out as the potential fountain of youth. However, there is no evidence that taking large doses of any vitamin can either stall or reverse the effects of ageing. Neither can any one vitamin restore a flagging sex drive or cure infertility. Vitamins and chronic disease
In developed countries, vitamin deficiency is rare but the inadequate intake of some vitamins is not so rare and has been linked to a number of chronic diseases. These include cardiovascular disease, cancer and osteoporosis. There is ongoing research to study the effects of taking vitamin supplements to prevent chronic disease, and evidence around nutrition and diet is constantly changing. It is important you consult with your doctor before taking vitamin supplements in high doses.
Things to remember
Vitamins are not drugs or miracle cures. Taking large doses of vitamins can be harmful because your body only needs vitamins in very tiny amounts. Eating plenty of fruits, vegetables, whole grains and cereals will give your body most of the vitamins your body needs at the right level and in the right balance. Vitamin supplements can’t replace a healthy diet, but a general multivitamin may help if your diet is inadequate.
People who may need vitamin supplements include pregnant and breastfeeding women, people who consume alcohol in amounts over the recommended level, drug users and the elderly.

Stroke is the interruption of blood to the brain. This may be due to blockage of a blood vessel in the brain or rupture of a blood vessel, causing bleeding in the brain or into the space surrounding the brain. The most common type of stroke is ischaemic, caused by a blood clot blocking an artery or blood vessel. The brain cells in the immediate area die and those in the surrounding areas are affected by the reduced blood flow. Once brain cells die, their functions die with them.

An estimated 150,000 people have a stroke in the UK each year.Stroke accounts for around 53,000 deaths each year in the UK. Stroke is the third most common cause of death in England and Wales, after heart disease and cancer. Stroke accounts for 9 per cent of all deaths in men and 13 per cent of deaths in women in the UK. Stroke has a greater disability impact than any other chronic disease. Over 300,000 people are living with moderate to severe disabilities as a result of stroke. The direct cost of stroke to the NHS is estimated to be £2.8 billion. The cost to the wider economy is £1.8 billion. The informal care cost is £2.4 billion. Stroke patients occupy around 20 per cent of all acute hospital beds and 25 per cent of long term beds. Stroke units save lives: for stroke patients general wards have a 14% to 25% higher mortality rate than stroke units. Each year over 130,000 people in England and Wales have a stroke. About 10,000 of these are under retirement age.

Stroke is influenced by different risk factors. Some of these – age, gender and family history – are beyond your control. However, you can substantially reduce your overall risk by making healthy changes to your diet and lifestyle.

TIA or transient ischaemic attack
A transient ischaemic attack (TIA) is often called a ‘mini stroke’. It is a powerful warning that a severe stroke may follow. The symptoms are identical to those of a full stroke, but disappear in a few minutes and last no longer than 24 hours. A TIA can appear hours, days, weeks or months before a full stroke but is more common within days or a few weeks. Just like full strokes, TIAs need emergency treatment and should not be ignored.

Warning signs
Stroke is a medical emergency. The longer a stroke remains untreated, the greater the degree of stroke-related brain damage. The warning signs of both stroke and TIA include:

• Sudden blurred or decreased vision in one or both eyes

• Numbness, weakness or paralysis of the face, arm or leg

• Difficulty speaking or understanding

• Dizziness, loss of balance

• Difficulty swallowing

• Severe headache.

High blood pressure
Blood pressure is a measurement of the force your blood puts on blood vessel walls as it travels through your body. High blood pressure is medically known as ‘hypertension’ and is one of the most important risk factors in stroke.

Normal blood pressure is around 120/80. High-normal blood pressure is between 120/80 and 140/90. If your blood pressure is consistently over 140/90, you have high blood pressure. The levels for normal blood pressure are a guide only. In general the lower your blood pressure, the lower your risk of stroke. Your doctor can talk to you about your blood pressure and risk of stroke and may recommend treatment if required.

You can control hypertension by reducing your weight, exercising regularly, eating a low salt, low fat and high fibre diet, and taking antihypertensive medication (if necessary).

Cigarette smoking
Smoking can increase your risk of stroke by increasing blood pressure and reducing oxygen in the blood. Seek advice on how to quit smoking by calling the NHS Free Smoking Helpline: 0800 022 4 332 Monday to Friday 9am to 8pm, Saturday and Sunday 11am to 5pm for guidance and support.

Diabetes
Diabetes can damage your entire circulatory system and is a risk factor for stroke. Type 1 usually occurs from a young age and is treated with insulin injections. Type 2 usually occurs from 30 years of age onwards and is treated with either tablets or, in some cases, insulin. Talk to your doctor about controlling diabetes if you are diabetic.

Other important risk factors
Other factors that can increase your risk of stroke include:

High cholesterol
High cholesterol is a contributing factor to blood vessel disease, which often leads to stroke. To reduce cholesterol in your blood, eat foods low in saturated fat. Choose lean meats and low fat dairy products. Your doctor may prescribe medication to lower your cholesterol but diet changes and exercise are still important.

Obesity
Being overweight or obese can increase the risk of stroke. Too much body fat can contribute to high blood pressure and high cholesterol and may lead to heart disease and type 2 diabetes. If you are unable to maintain your weight within recommended levels, ask a doctor or nutritionist for help.

Alcohol
Your risk of stroke may be reduced with moderate alcohol intake (one to two glasses a day). Excessive amounts of alcohol can raise blood pressure and increase your risk of stroke.
Diet and exercise
A diet low in fat and salt will reduce your risk of stroke. Eating a balanced diet of fresh foods (wherever possible) is recommended. Avoid processed or canned foods as they can be high in sodium, or salt. Check a food’s sodium content in the list of ingredients on the label (low salt food has a level of less than 120mg/100g).

A good balance between exercise and food intake is important to maintain a healthy body weight. People who participate in moderate activity are less likely to have a stroke. Try to build up to at least 30 minutes of moderate physical activity most days of the week. Talk to your doctor about an exercise program – people with high blood pressure should avoid some types of exercises.

Irregular pulse (atrial fibrillation)
You are more at risk of stroke if you have an irregular pulse due to the condition atrial fibrillation (AF). Your doctor can diagnose this condition and advise you on how best to manage this if it happens. If you experience symptoms such as palpitations, weakness, faintness or breathlessness, it is important to see a doctor for diagnosis and treatment.

Risk factors beyond your control
Stroke is influenced by some risk factors that are outside a person’s control. These include:

• Age – the majority of people who suffer from stroke are 65 years or older.

• Gender – men are at higher risk than women.

• Family history – a family history of cerebrovascular disease may make you more susceptible to stroke.

Statistics on stroke
Each year over 130,000 people in England and Wales have a stroke:

• One in three people die within a year of having a stroke.

• Stroke kills more women than breast cancer.

• Almost one in five people who experience a stroke are under the age of 55.

• Men are more likely to suffer a stroke and at a younger age.

Things to remember

• Stroke may occur due to blockage of a blood vessel in the brain or rupture of a blood vessel, causing bleeding in the brain or into the space surrounding the brain.

• Many strokes are avoidable and can be caused by unhealthy diet and lifestyle choices.

• Some of the major risk factors for stroke include high blood pressure, cigarette smoking and diabetes.

Stroke prevention

Strokes can be fatal but the risk can be reduced. Many stroke risk factors are lifestyle related, so everyone has the power to reduce their risk of having a stroke. Some stroke risk factors, such as gender, age and family history, can’t be controlled.

Lifestyle factors that increase your risk of stroke include high blood pressure, smoking, diabetes, high blood cholesterol levels, heavy drinking, a diet high in salt and fat and lack of exercise. You can reduce your risk of having a stroke by making a few simple lifestyle changes.

Causes of stroke
‘Stroke’ is a term used to describe the interruption of blood flow to an area of the brain. This can occur in the following ways:

• Haemorrhagic stroke – an artery may rupture and cause bleeding into the brain tissue.

• Ischaemic stroke caused by atherosclerosis – an artery may become blocked by progressive thickening of its walls.

• Ischaemic stroke caused by embolism – a clot blocks an artery and prevents blood getting to part of the brain.

The brain cells in the immediate area are killed because they are deprived of oxygen. The dead area that results from stroke is known as an infarct. Without prompt medical treatment, the area of brain cells surrounding the infarct will also die.

Risk factors
Some stroke risk factors can’t be controlled. These include gender, age and family history. However, many stroke risk factors are lifestyle related. Everyone can reduce their risk of having a stroke by making a few simple lifestyle changes.

Lifestyle-related factors that increase your risk of stroke include:

• High blood pressure

• Cigarette smoking

• Diabetes

• High blood cholesterol levels

• Heavy drinking

• High fat, low fibre diet

• Lack of exercise.

It has been reported that the use of some birth control pills may increase a woman’s risk of stroke, but the evidence is limited.

Reduce high blood pressure
High blood pressure (hypertension) is the most significant risk factor for stroke. Blood pressure refers to the pressure inside the arteries. Hypertension means that the blood is exerting more pressure than is normal or healthy. Over time, this weakens and damages blood vessel walls, which can lead to cerebral haemorrhage.
Hypertension may also cause thickening of the artery walls, resulting in narrowing and eventual blockage of the vessel (ischaemic stroke). In atherosclerosis (hardening of the arteries), the pressure of your pumping blood could ‘hose off’ debris from damaged artery walls. The circulating debris (embolism) can cause a stroke by lodging in and blocking a blood vessel of the brain.

Strategies to reduce high blood pressure include:

• Check your blood pressure regularly and know your numbers.

• Maintain a healthy weight for your height.

• Exercise regularly.

• Choose a low fat, high fibre diet.

• Reduce or eliminate salt from your diet.

• Limit your alcohol intake to two or less standard drinks per day.

• Stop smoking.

• Take antihypertensive medications to help control high blood pressure.

Quit smoking
Smoking can double or even quadruple your risk of stroke. Some of the chemical ingredients in cigarette smoke (such as nicotine and carbon monoxide) accelerate the process of atherosclerosis. Clots are more likely to form because smoking thickens the blood and makes clotting factors, such as platelets, much more ‘sticky’. Cigarette smoke forces arteries to constrict – a narrowed diameter makes it harder for the thickened blood to move through the vessels.

Strategies to quit smoking include:

• Seek advice on how to quit smoking by calling the NHS Free Smoking Helpline: 0800 022 4 332 Monday to Friday 9am to 8pm, Saturday and Sunday 11am to 5pm for guidance and support or see your doctor for information and advice.

• Decide on a strategy, such as ‘cold turkey’ or using nicotine replacement therapy.

• Keep a smoking diary so that you are aware of your smoking triggers (such as stress or boredom).

• Decide on a quit date.

• Ask your family and friends for support.

• Don’t be discouraged by a slip-up. If you smoke a cigarette, put it behind you and keep going.

Manage your diabetes
Diabetes is a chronic condition in which the body is unable to utilise blood sugar. A person with diabetes is around twice as likely to have a stroke as someone of the same gender and age who doesn’t have diabetes. This is because the high blood sugar levels contribute to the development of atherosclerosis. It is very important that diabetes be kept under control.

Strategies to reduce the effects of diabetes include:

• See your doctor regularly for check-ups.

• Monitor your blood sugar levels regularly.

• Maintain a healthy weight for your height.

• Exercise regularly.

• Choose a low fat, high fibre diet.

• If you are on medication, make sure you are taking it correctly.

Keep cholesterol levels in check
Cholesterol is a fat-like substance that is made by the human body. It has many essential roles to play, but it becomes a problem if levels in the blood are too high. Blood cholesterol contributes to the formation of a substance called atheroma, which sticks to artery walls and leads to atherosclerosis.

Strategies to lower blood cholesterol levels include:

• Have your blood cholesterol levels checked regularly by your doctor.

• Switch to a high fibre diet.

• Reduce your intake of saturated fats (commonly found in animal products).

• See your doctor for information and advice. Medications may be recommended.

Avoid heavy drinking
Some studies have indicated that drinking moderate amounts of alcohol (such as one or two standard drinks per day) can actually reduce the risk of stroke. However, people who drink heavily are three times more likely to have a stroke, regardless of their age. It is important to limit your alcohol intake.

Suggestions include:

• Limit your consumption to no more than two standard drinks per day.

• Have at least two alcohol-free days every week.

• See your doctor for information and referral if you are finding it difficult to limit your alcohol intake.

Eat a healthy diet
Various studies show that diet is an important risk factor in the development of stroke. Suggestions include:

• Limit or moderate salt intake.

• Choose fresh rather than processed foods.

• Increase your intake of vegetables, fruit and whole grains.

• Cut out or reduce sugary and fatty foods like cakes, lollies and junk food.

• See a dietitian who can help you plan a well-balanced low fat, high fibre diet.

Exercise regularly
A sedentary lifestyle increases the likelihood of obesity, high blood pressure and high blood cholesterol levels. These are all important risk factors for stroke.

Suggestions include:

• See your doctor for a check-up if you haven’t exercised for a while.

• Choose a range of activities you enjoy.

• Start your new exercise program slowly and only increase the intensity and duration as you become fitter.

• Exercise with a friend or join a team sport to add a fun social element to the activity.

• Remember to warm up and cool down.

• Contact a physiotherapist or gymnasium instructor for advice and information regarding appropriate exercise.

• Try to get moderate exercise for at least 30 minutes on (at least) five days of the week.

Things to remember

• A stroke interrupts blood flow to an area of the brain.

• Most stroke risk factors are lifestyle related, so everyone has the power to reduce their risk of having a stroke.

• Some stroke risk factors, such as gender, age and family history, can’t be controlled.

• Lifestyle factors that increase your risk of stroke include high blood pressure, smoking, diabetes, high blood cholesterol levels, heavy drinking, high salt and high fat diet and lack of exercise.