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What percentage of strokes are diet-related?

John Hopkins Medicine states“A stroke is caused when blood flow to your brain is stopped or disrupted.There are 2 kinds of stroke: ischemic and hemorrhagic.Ischemic stroke. This is the most common type of stroke. It happens when a major blood vessel in the brain is blocked. It may be blocked by a blood clot. Or it may be blocked by a buildup of fatty deposits and cholesterol. This buildup is called plaque.Hemorrhagic stroke. This occurs when a blood vessel in your brain bursts, spilling blood into nearby tissues. With a hemorrhagic stroke, pressure builds up in the nearby brain tissue. This causes even more damage and irritation.”Diet is only one of the many risk factors for stroke. Here is a link that will give you more details on risk factors for stroke:Risk Factors for StrokeStroke occurs when blood flow to the brain is disrupted. A blood clot can block one of the vital blood vessels in the brain or a blood vessel in the brain can burst, spilling blood into surrounding tissues.https://www.hopkinsmedicine.org/health/conditions-and-diseases/stroke/risk-factors-for-strokeHere is the 2020 link to the American Heart Association report on strokes if you are looking for statistics. Take a look at these, and you will realize that it is not as black and white as you may imagine. It is a complex disease.Virani, S. S., Alonso, A., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., Carson, A. P., ... & American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. (2020). Heart disease and stroke statistics—2020 update: a report from the American Heart Association. Circulation, 141(9), e139-e596.

Is there any concept called a "Napoleon heart" in medicine?

This is so awesome that I just had to answer this, even though it has nothing to do with medicine. This is a sordid tale which includes French history, a centuries old murder mystery with an anticlimactic end and Tollywood.I find that this "Napoleon Heart" term has been floating about on the Internet. Indians have been especially interested in talking about it, and they think Napoleon's heartbeat was too slow. Even on Quora, there have been a few questions asking the same thing. Was there anything special or wrong about Napoleon's heart? Did it play a part in his death? And why are Indians so interested? Let's find out!We ❤️ Napoleon - The world always laps up a good Napoleon anecdote.Anatomical Appearance of Napoleon's HeartSince this question is tagged with the "Medicine and Healthcare" tag, I won't disappoint.When Napoleon died, the autopsy report was prepared by a physician, François Carlo Antommarchi. The report found the cause of death to be stomach cancer; however, the physician never signed the report. [1]The official autopsy report, mentioned this about his heart:Report of Appearances on Dissection of the Body of Napoleon Bonaparte[. . .] The heart was of the natural size, but thickly covered with fat; the auricles and ventricles exhibited nothing extraordinary, except that the muscular parts appeared rather paler than natural. [2]There was some political flim-flam happening, though, and the physician refused to sign the report. He wrote a separate letter to the bereaved family with details of the body. He did not have anything to add about the heart though. The main point of contention was the liver.Report of Dr Antommarchi, charged with the opening of the emperor's body[. . .] The heart in a good state, enveloped in its pericardium, and covered with a little fat. [2]The Mystery of Napoleon's DeathSince then, many more theories have been laid out. Out of these, the most prevailing one has been that of arsenic poisoning, with the mode, motive and symptoms of poisoning getting more and more convoluted and fantastical with time. [3]One of the theories suggested that Napoleon's heart may have been affected by the arsenic as well as the substances given to treat him - calomel and tartar emetic - leading to a heart condition called Torsades de pointes. [4]If Napoleon had Torsades de pointes, this is what his ECG would have looked like - except ECG monitoring did not exist back thenThis condition is a rapid rhythm, that is, the heart beats chaotically fast and has a characteristic shape. So if Napoleon did have this heart condition due to arsenic exposure, it was postulated that it would have been fast, not slow rhythm.Most recently, a group of American, Canadian and Swiss researchers has recently "put an end to all doubt" by saying that Napoleon's doctor was right, it was stomach cancer after all. [5] They combined current medical knowledge and autopsy reports, memoirs of the physicians who treated Napoleon on the island, eyewitness accounts and medical histories of family members. Autopsy and physician descriptions revealed no signs of arsenic poisoning, such as hemorrhaging in the lining inside the heart, and no skin, lung or bladder cancers were present. [6]They concluded that an infection created a stomach ulcer which led to stomach cancer, and nothing could have saved him. Looks like the original unsigned autopsy report was right!Napoleon Bonaparte is likely to have had a long-standing H. pylori infection, which might have led to the development of a prepyloric ulcer that created the background for genesis of a gastric adenocarcinoma. A massive gastric hemorrhage that occurred in or around the advanced-stage gastric tumor can be considered to be the immediate cause of his death. This clinicopathologic reconstruction implies that even if the former Emperor had been released or had escaped from St Helena before 1821, his terminal condition would have prevented him from having a further major role in the theater of European history. [5]So there's no question of the heart being involved in his death.Was Napoleon Bradycardic?One of the earlier answers here suggests that Napoleon's heartbeat was unusually slow. 40 beats per minute, it said. A heartbeat of 40 beats per minute implies either a sick heart or a phenomenally athletic person. Athletic, Napoleon wasn't. That would imply Napoleon had Bradycardia.The only report we have of Napoleon's apparently slow heart rate comes from the memoirs of Madame de Rémusat, Josephine's lady-in-waiting. She wrote in her memoirs that Napoleon's personal physician, Dr. Corvisart told her Napoleon always complained that he had a "slow pulse" and that his blood ran "sluggishly". However, nowhere in Corvisart's memoirs does he mention "bradycardia" with respect to Napoleon. [2]Louis Constant Wairy, Napoleon's valet has also mentioned this in his memoir:A very remarkable peculiarity is that the Emperor never felt his heart beat. He has often said so both to M. Corvisart and to me, and more than once he had us pass our hands over his breast, so that we could make trial of this singular exception; we never felt any pulsation. [7]This word of mouth statement seems to have been repeated a few more times in various books, biographies, historical fiction, etc. and has in fact entered popular consciousness.Napoleon's heartbeat was extraordinarily slow, only 50. On St Helena, he'd tell Gourgaud that he had never felt his own heart beating. [8]But Sinus Bradycardia need not be a serious condition.Sir William Osler, founder of Johns Hopkins, once remarked that a slow pulse was sometimes normal and gave the example of Napoleon in this context. [9] The acceptable limits for heart rate have been set between 60 - 100 beats per minute, but these recommendations are "traditional" and have not been based on any systematic clinical studies. The limits were generally agreed upon by the New York Heart Association (NYHA) in 1953. Studies show that normal men and women have very wide spectrums of heart rates, with high standard deviations. Doctors still take precautionary measures for lower ranges of heart rates. However, sinus bradycardia occurs in normal children and adults, especially during sleep, where rates of 30 beats per minute and pauses up to 2 seconds are seen. Bradycardia is also seen in the absence of heart disease in the elderly, has no effect on longevity, and does not worsen prognosis in otherwise healthy subjects. [9]Seriously, Napoleon's health and every part of his body, has been examined and discussed ad nauseum - from arsenic in his hair, to his biting his fingernails, to the length of his penis, to his pituitary gland, to the mysterious jaundice that may have affected his liver and caused death, to the state of the stomach, to the epileptic seizures that affected him - so much so that a bradycardic heart was the least of his problems.All this has been known for years and there's no particular reason why Napoleon should be the poster boy of bradycardia.So why is this question about Napoleon's apparently bradycardic heart suddenly floating about on the Internet as if it's some kind of mysterious or superhuman condition?Turns out, there's a Telugu movie called Oosaravelli that is the source of this confusion.According to online forums, the opening dialogue in the movie, where the hero introduces himself by saying that he has a "Napoleon Heart". [10]Here are the delightful dialogues.Thanks to Deepu Bhar for help with the translation!Vadi blood.. vadi lagey.. B-negative...His Blood type, like him, is B negativeVadi naralu.., naralu kavu., High Tension wirelu....His nerves are not nerves, but High tension WiresAndari gunde nimshaniki dabai rondu sarlu kotukunte.. vaadidhi nalabhai sarle kotukuntundi..Everyone's heart beats 72 times. His however, beats 40 times only"NAPOLEON HEART" antaru., vadi valla heart stroke vadiki radu.. edhutodiki vastadi..It's called Napolean Heart. He will never get heart attacks. His opponents will get it because of him.Vadi body lo most dangerous part.. "kallu"..The most dangerous part in his body, his eyes!premaga chustunado, esadam anni chustunado avadiki ardam kadu....We can't understand whether he is gazing lovingly or bloodthirstily, everOkka mukaloo chapali ante.... Ordinary ga kanipiche extra-ordinary person...To cut a long story short, he is a person who looks ordinary but is extraordinary- Oosaravelli Intro Dialogue - NTR Jr.According to our intrepid hero, Napoleon's heart only needed to beat at a rate of 40 beats per minute, while the rest of us mortals have to make do with an ideal rate of about 72 beats per minute, and this makes him superhuman. This off-the-cuff remark led to a storm of questions on the Internet about a fabled obscure heart condition called Napoleon Heart.Funnily, in the same dialogue sequence, the hero also compared his nerves to high tension wires - wonder why we don't have questions about that floating about!The movie that started it all - if his heart isn't racing, I'm Mary, Queen of Scots!As to why an Indian movie dialogue writer is reading the memoirs of Madame de Rémusat, and advancing the legend of Napoleon - who knows?!Thanks for the A2A. Now we are all intimately acquainted with Napoleon's health problems!References[1] https://en.wikipedia.org/wiki/Napoleon#Death[2] Another Napoleonic Mystery - Napoleon's death[3] Cullen, W. R. (2008). Arsenophobia: A Connection between the Deaths of Infants and Napoleon I. In Is Arsenic an Aphrodisiac?: The Sociochemistry of an Element. (pp. 145-165). London: Royal Society of Chemistry.[4] Mari, F., Bertol, E., Fineschi, V., & Karch, S. B. (2004). Channelling the Emperor: what really killed Napoleon? Journal of the Royal Society of Medicine, 97(8), 397–399.[5] Lugli, A., Zlobec, I., Singer, G., Lugli, A. K., Terracciano, L. M. & Genta, R. M. (2007). Napoleon Bonaparte's gastric cancer: a clinicopathologic approach to staging, pathogenesis, and etiology. Nature Clinical Practice Gastroenterology & Hepatology, 4, 52-57. doi:10.1038/ncpgasthep0684[6] http://www.sciencedaily.com/releases/2007/01/070116131630.htm[7] Constant Wairy, Memoirs of Constant on the Private Life of Napoleon, his Family and his Court, Vol. 1, p. 319.[8] Austen, P. B. (2012). The Gathering Storm. In 1812: The March on Moscow, (pp. 247-260).[9] Kellett, J., Deane, B. & Gleeson, M. (2010). The Meaning of Vital Signs. In M. A. DeVita, K. Hillman & R. Bellomo (Eds.), Textbook of Rapid Response Systems: Concept and Implementation. (pp. 109-123). New York: Springer.[10] https://in.answers.yahoo.com/question/index?qid=20111015084602AAZ5Zgt

Why do the 2015 Dietary guidelines specify reducing added sugar?

Added sugar can still be natural sugar. The recommendation is simply to cut down on foods that add sugar as a way to cut sugar intake in general.Your body still breaks down these sugars the same ways. It doesn’t make a difference if it is cane sugar, corn sugar, honey, agave, or whatever new natural sweetener is in vogue.What is important is reducing sugar intake in general. There is more sugar in most foods than people realize. The American Heart association says that men should consume no more than 9 teaspoons per day, and women just 6 per day. However, the general rule, is 10%. This means a 2000 calorie diet should only contain 200 calories of sugar, or 36g. (9 teaspoons total)For instance, a serving (8oz) of plain milk contains 12 grams of sugar. That is three teaspoons of sugar. So, the amount of sugar in a single serving of milk, is about half of the allotted sugar for a woman in a day.A can of Coke has 39g of sugar in it. That is almost 10 teaspoons… More than anyone should have in a day!A serving of fresh sqeezed orange juice contains 19g of sugar.One slice of white bread contains 1.5g of added sugar. This does not include the additional carbohydrates that your body will process as sugar.A cup of Yoplait original has 27g of sugar (almost 7 teaspoons!) and the light version has 14g (3.5 teaspoons).In an average serving of raspberry vinaigrette, there are 5g of sugar. That’s more than a teaspoon.A serving of Prego Pasta Sauce has 10g of sugar in it. That’s 2.5 teaspoons.As you can see, there is a lot of sugar lurking out there. While eating “natural” sugars found in fruits and vegetables is not a bad thing, all of the added sugars in the foods we eat are a bad thing.If I eat in one day:Breakfast: 2 eggs, 2 pieces of toast, glass of orange juiceLunch: Turkey sandwich, yogurtDinner: Spaghetti, salad w/dressing, glass of milkI’ve just eaten upwards of 20 teaspoons of sugar in my day. If I add a can of coke in there somewhere, its now 30 teaspoons of sugar.You can easily see how this can get out of hand…

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