The researchers say this is compounded if those suffering a stroke have high levels of homocysteine, an amino acid acquired mostly from eating meat. The results - published in the current issue of Neurology, the medical journal of the American Academy of Neurology - indirectly add further clout to a Mediterranean-style diet. The Mediterranean diet is frequently touted for its positive effect on cardiovascular health because it encourages higher HDL, or "good", cholesterol levels through olive oil consumption, and can lead to lower LDL, or "bad", cholesterol levels because of less significant reliance on red meats than other traditional diets. "These findings show metabolic stress plays a significant role in stroke recovery," said study author George Newman, from the Albert Einstein Healthcare Network in Philadelphia, Pennsylvania and a member of the American Academy of Neurology. The researchers investigated the link between HDL cholesterol and homocysteine levels and the effects of metabolic stress on the body. The study - supported by the National Institutes of Health and the National Institute of Neurological Disorders and Stroke - involved 3,680 men and women over age 35 in the US, Canada, and Scotland who had suffered a mild to moderate stroke within the past three months. The participants underwent cognitive and disability tests and were followed for two years. The scientists found that several factors predicted memory and disability problems after stroke: increased age, non-Caucasian race, recurrent stroke, diabetes, stroke in the left hemisphere of the brain, higher levels of homocysteine and lower levels of HDL cholesterol. "People with low levels of HDL, high levels of homocysteine, and diabetes are twice as likely as those without such problems to have poorer cognitive function and greater disability after stroke," said Newman. "The study also found stroke recovery was the most difficult for people over the age of 57 with high levels of homocysteine, which is a risk factor for heart problems and associated with low levels of vitamin B6, B12, folic acid and kidney disease." According to the researchers, it is unclear why these factors are contributing to a slower stroke recovery and more research is needed. As consumers look for non-pharmaceutical ways to deal with their cholesterol, dietary supplements for cholesterol reduction are growing in popularity. The natural ingredients found in many of these supplements claiming to lower LDL cholesterol are garlic, vitamin E, fenugreek, artichoke extract, guggulipid, red yeast rice, pantethine, plan sterol/stanol and polymethoxylated flavones and phellodendron extracts.