Add stroke to the list of health problems caused by a Western diet rich in red meat, white flour and sugar, researchers said on Thursday.

A study of more than 71,000 nurses found those who ate a “prudent” diet rich in fruits, vegetables, fish, legumes and whole grains were less likely to have strokes than nurses eating a more typical American diet.

Writing in the journal Stroke, the team at the Harvard School of Public Health said its study was the first to examine overall dietary habits and stroke risk.

Health experts already say a diet high in animal fat, especially red meat, and low in fiber, fruits and vegetables raises the risk of heart disease, diabetes, some cancers and obesity.

Stroke is the third-leading cause of death in the United States, killing nearly 170,000 people in 2003.

“Several foods and nutrients have been linked to the risk of stroke; therefore, dietary modification may be an important way to reduce the risk of stroke,” said Teresa Fung, an assistant professor of nutrition at Simmons College School for Health Studies in Boston, who led the study.

“Because nutrients and food are consumed in combination, their cumulative effect on disease risk may be best investigated by considering the entire eating pattern.”

The researchers began studying 71,768 female nurses aged 38 to 63 in 1984 who had no history of heart disease or diabetes. They followed them until 1998, dividing them into two groups - “prudent” and “Western” eaters.

Each group was further divided into fifths, depending on a woman’s reported eating pattern.

There were 791 strokes during the 14-year study period.

The women who ate the “worst” Western diet had a 58 percent higher risk of stroke than women who ate the healthiest diets.

The nurses with Western eating habits were also more likely to smoke, less likely to take vitamins and to be less active, the researchers found.

SOURCE: Stroke, 2004.