Leonardo da Vinci and Stroke – Vegetarian Diet as a Possible Cause

Bogousslavsky J, Hennerici MG, Bäzner H, Bassetti C (eds): Neurological Disorders in Famous Artists – Part 3. Front Neurol Neurosci. Basel, Karger, 2010, vol 27, pp 000–000Bogousslavsky J, Hennerici MG, Bäzner H, Bassetti C (eds): Neurological Disorders in Famous Artists – Part 3. Front Neurol Neurosci. Basel, Karger, 2010, vol 27, pp 1–10

Leonardo da Vinci and Stroke – Vegetarian Diet as a Possible Cause

Serefnur Öztürka, Marta Altierib, Pina Troisib

aDepartment of Neurology, Ankara Numune Education and Research Hospital,

Ankara, Turkey, and bDepartment of Neurological Sciences, Clinica Neurologica A,

‘Sapienza’ University of Rome, Rome, Italy

AbstractLeonardo da Vinci (April 15, 1452 to May 2, 1519) was an Italian Renaissance archi-

tect, musician, anatomist, inventor, engineer, sculptor, geometer, and painter. It has been

gleaned from the many available historical documents that da Vinci was a vegetarian who

respected and loved animals, and that he suffered from right hemiparesis in the last 5 years of

his life. A vegetarian diet has both positive and negative infl uences on the cerebrovascular

system. In this report, a possible relation between a vegetarian diet and stroke is discussed

from various perspectives as related to Leonardo da Vinci’s stroke.

Copyright © 2010 S. Karger AG, Basel

Leonardo da Vinci: As a Vegetarian Artist

Leonardo da Vinci (born April 15, 1452 in Vinci; died May 2, 1519 in

Ambroise) was an Italian Renaissance architect, musician, anatomist, inven-

tor, engineer, sculptor, geometer, and painter (fi g. 1) [http://www.settemuse.it].

He has been described as the archetype of ‘Renaissance man’ and a universal

genius. Da Vinci is famous for his masterly paintings, among them ‘The Last

Supper’ and ‘Mona Lisa’, and is also known for his designs and inventions,

many of which anticipated modern technology, though few of them were con-

structed in his lifetime. In addition, he helped advance the study of anatomy,

astronomy, and civil engineering [http://www.artinvest2000.com; http://www.

leonardo2007.com; http://www.bilanciozero.net; http://www.centroarte.com;

http//italian.classic-literature.co.uk/leonardo-da-vinci].

The fi rst known biography of da Vinci was published in 1550 by Giorgio

Vasari in his ‘Vite de’ piu eccelenti architettori, pittori e scultori italiani’ (‘The

Dow

nloa

ded

by:

Hos

pita

l Chi

nese

Aca

d.of

Med

.

11

4.25

1.22

3.25

2 -

11/1

1/20

14 4

:17:

53 A

M

Öztürk/Altieri/Troisi 2

lives of the most excellent Italian architects, painters and sculptors’). Most of

the information collected by Vasari was from fi rst-hand accounts of da Vinci’s

contemporaries, and remains the preeminent reference in studying da Vinci’s

life [http//italian.classic-literature.co.uk/leonardo-da-vinci].

Born the illegitimate son of a notary, Piero da Vinci, and a peasant woman,

Caterina, at Vinci in the region of Florence, Leonardo was a man of univer-

sal genius and talent, who fully embodied the spirit of the Italian Renaissance,

leading to higher forms of expression in various fi elds of art and knowledge. As

a painter, sculptor, architect, engineer, anatomist, writer, musician and inventor,

he is considered one of the greatest geniuses of mankind.

Leonardo has often been described as a man whose unquenchable curiosity

was equaled only by his powers of invention [Richter, 1977]. He is widely consid-

ered to be one of the greatest painters of all time and perhaps the most diversely

talented person ever to have lived [http://manybooks.net/pages/davincietex-

t048ldvc10/0.html]. According to art historian Helen Gardner [1975], the scope

and depth of his interests were without precedent, and ‘his mind and personality

seem to us superhuman, the man himself mysterious and remote’ [Richter, 1977].

Fig. 1. Portrait of Leonardo da Vinci.

With kind permission from the Ministerio

per i Beni e le Attività Culturali, Biblioteca

Reale, Turin, Italy.

Dow

nloa

ded

by:

Hos

pita

l Chi

nese

Aca

d.of

Med

.

11

4.25

1.22

3.25

2 -

11/1

1/20

14 4

:17:

53 A

M

Leonardo da Vinci and Stroke – Vegetarian Diet as a Possible Cause 3

The personality of Leonardo da Vinci was always surrounded by an aura of

mystery. He was sometimes not accepted and often closed out by ideology.

Aside from his artistic nature, Leonardo possessed highly unique and inter-

esting personal features. It is known that he was a vegetarian who respected and

loved animals [http//italian.classic-literature.co.uk/leonardo-da-vinci].

We have glimpses into his lifestyle from his own writings and from what was

written about him by the early biographers. Da Vinci’s refusal to eat animals and

his recognition of the cruelty of their mistreatment have been referenced. Jean

Paul Richter was historically the fi rst person to decipher Leonardo’s notebooks. In

his epochal ‘The Literary Works of Leonardo da Vinci’ [Richter, 1977] he wrote:

‘We are led to believe that Leonardo himself was a vegetarian from the following inter-

esting passage in the fi rst of Andrea Corsali’s letters to Giuliano de’Medici: “Alcuni gentili

chiamati Guzzarati non si cibano dicosa alcuna che tenga sangue, ne fra essi loro consentono

che si noccia adalcuna cosa animata, come it nostro Leonardo da Vinci”. (“Certain infi dels

called Guzzarati [Hindus] do not feed upon anything that contains blood, nor do they permit

among them any injury be done to any living thing, like our Leonardo da Vinci”).’ Giuliano

de’Medici, incidentally, was a patron of da Vinci and the brother of Pope Leo X.

Eugene Muntz [1898] wrote, ‘It appears from Corsali’s letter that Leonardo

ate no meat, but lived entirely on vegetables, thus forestalling modern vegetar-

ians by several centuries’.

In ‘The Mind of Leonardo da Vinci’ (1928), Edward MacCurdy wrote:

‘…Vasari tells, as an instance of his love of animals, how in Florence when he passed

places where birds were sold he would frequently take them from their cages with his own

hand, and having paid the sellers the price that was asked would let them fl y away in the air,

thus giving them back their liberty.’

In ‘Leonardo: Discovering the Life of Leonardo da Vinci’ Bramly [1991]

wrote: ‘Leonardo loved animals so much, it seems, that he turned vegetarian’.

Da Vinci was also referred to as a vegetarian in ‘Leonardo da Vinci – The Mind

of The Renaissance’ by Alessandro Vezzosi [1997], founder and director of the

Museo Ideale Leonardo da Vinci in Vinci, Italy [http://www.ivu.org].

Leonardo da Vinci: As a Stroke Victim

It has been ascertained from many documents that Leonardo da Vinci suf-

fered from right hemiparesis in the last 5 years of his life. Vezzosi [1997] stated

that the semi-paralysis of the right side of da Vinci’s body would not have affected

the left-handed artist’s ability to sketch, but did hamper his mobility: ‘It probably

prevented him from standing up to paint and from holding a palette – but he would

still have had enough strength to sit down and draw’. He further writes: ‘The paint-

ing shows us an elderly Leonardo with all the signs of age, with his right hand sus-

Dow

nloa

ded

by:

Hos

pita

l Chi

nese

Aca

d.of

Med

.

11

4.25

1.22

3.25

2 -

11/1

1/20

14 4

:17:

53 A

M


pended in a stiff, contracted position, held up by his robe as if it were a bandage’.

Vezzosi [1997] also reported that the paralysis would explain da Vinci’s inactivity

for the last 5 years of his life, with several of his paintings left incomplete.

Although suffering from a paralysis of the right hand, Leonardo continued

to draw and teach. He produced studies of the Virgin Mary from ‘The Virgin

and Child with St. Anne’ (fi g. 2); studies of cats, horses, dragons, St. George,

and on the nature of water; anatomical studies; and drawings of the Deluge and

of various machines.

All historical sources tell us that Leonardo da Vinci used his right hand

when creating all his artwork. There is no indication that he was left-handed.

However, he was better with his left hand than the normal right-handed person.

For example, da Vinci sometimes wrote his documents in mirror-writing with

Fig. 2. Leonardo da Vinci, The Virgin and Child with the Infant John the Baptist and

St. Anne. The Leonardo Cartoon (about 1499–1500). © The National Gallery, London.

Dow

nloa

ded

by:

Hos

pita

l Chi

nese

Aca

d.of

Med

.

11

4.25

1.22

3.25

2 -

11/1

1/20

14 4

:17:

53 A

M


his left hand, though he never painted with his left hand! The main historical

reference in this regard is from Antonio de’ Beatis, secretary of the Cardinal

Luigi d’Aragona, who, together with his master, paid a visit to Leonardo da

Vinci on October 10, 1517. Luckily for all historians he habitually wrote down

everything, quite literally, in his diary:

‘On the 10th of October 1517, Monsignor (the Cardinal Luigi d’Aragona) and the rest

of us went to see, in one of the outlying parts of Amboise, Messer Leonardo da Vinci the

Florentine… the most eminent painter of our time, who showed to his Eminence the Cardinal

three pictures: one of a certain Florentine lady (Pacifi cia Brandano or Isabella Gualanda),

painted from life, at the insistence of the late Giuliano de’Medici; the other of the youthful

St. John the Baptist; and the third of the Madonna and the Child in the lap of St. Anne, the

most perfect of them all. One cannot indeed expect any more good work from him, as a cer-

tain paralysis has crippled his right hand. But he has a pupil, a Milanese, who works well

enough. And although Messer Leonardo can no longer paint with the sweetness which was

peculiar to him, he can still design and instruct others…’ [Goldscheider, 1944].

The death of Leonardo has been described only by Vasari. He describes an

old and tired man, worn out by numerous ailments. At the same time also refers

to an ‘evil’ that plagued Leonardo and all the problems associated with this.

Then he informs us of how he died and he speaks of a ‘paroxysm’ as a ‘mes-

senger of death’. This term should be construed as an exacerbation of his ill-

ness. Leonardo was suddenly seized by a strange illness and death occurred in

a sudden and almost unexpected manner while he was talking to his illustrious

visitor, the King of France. He was placed on his bed and died in the arms of

the king. From such a description one would most likely imagine that a vascular

event affected the great Italian genius. One can clearly infer the nature of this

event, cardiac or cerebral. Vasari writes:

‘Finalmente venuto vecchio, stette molti mesi ammalato, e vedendosi vicino alla morte

si voles diligentemente informare delle cose cattoliche e della buona e santa religione cristi-

ana, e poi con molti pianti confesso e contrito, sebbene e’ non poteva reggersi in piedi, sos-

tenendosi nelle braccia di suoi amici e servi, volle divotamente pigliare lo Santissimo

Sacramento fuor del letto…contando il mal suo e gli accidenti di quello, mostrava tuttavia

quanto avea offeso Dio e gli uomini del mondo, non avendo operato nell’arte come si con-

veniva. Onde gli venne un parosismo messaggiero della morte, per la qual cosa rizzatosi il re

e presogli la testa per aiutarlo e porgergli favore, acciocché il male lo alleggerisse, lo spirito

suo che divinissimo era, conoscendo non potere avere maggior onore, spirò in braccio a quell

re nell’età sua d’anni settantacinque’ [http://biblio.signum.sns.it/cgi-bin/vasari/Vasari-all?

code_f=print_page&work=le_vite&volume_n=4&page_n=36].

Benefits of Vegetarianism versus Risks of Cerebrovascular Disease

Segasothy and Phillips [1999] reviewed the benefi cial and adverse effects

of vegetarian diets in various conditions. The vegetarian diet, which includes

Dow

nloa

ded

by:

Hos

pita

l Chi

nese

Aca

d.of

Med

.

11

4.25

1.22

3.25

2 -

11/1

1/20

14 4

:17:

53 A

M


fruits, vegetables, complex carbohydrates, soy bean, legumes, nuts and soluble

fi ber, could lower the risk of cardiovascular disease through multiple mecha-

nisms such as lowering cholesterol and the benefi cial effect of antioxidant vita-

mins, folic acid, linolenic acid and fi ber [Segasothy and Phillips, 1999].

Some studies have reported the benefi cial effect of a vegetarian diet with

respect to vascular diseases. A vegetarian diet with comprehensive lifestyle

changes for 1 year showed signifi cant overall regression in coronary atheroscle-

rosis [Gould et al., 1992]. An inverse association between fruit and vegetable

consumption and stroke has been suggested. In a population-based longitudi-

nal study of 832 middle-aged men with over 20 years of follow-up, for each

increment of three servings of fruits and vegetables per day, there was a 22%

decrease in the risk of all stroke [Gillman et al., 1995].

From another perspective, however, a vegetarian diet can be seen to have

some adverse effects, and there may in fact be a relation between a vegetarian

diet and stroke. For example, while a vegetarian diet can be useful for a short

duration, its effects over the long term must be argued as contributing to stroke

risk. Adverse effects of a vegetarian diet include the following: while most veg-

etables oils are low in saturated fatty acids, some are rich in them, and a high

intake is associated with elevated plasma cholesterol levels and may be associ-

ated with atherosclerosis [Council on Scientifi c Affairs, 1990]. The Nutrition

Committee of the American Heart Association concluded that trans fatty acid

has adverse effects on cholesterol profi les [Lichtenstein, 1997].

It has been shown that vegetarians have a higher risk of stroke since their

intake of total fat and saturated fat is low, and their serum cholesterol level

is low [Segasothy and Phillips, 1999]. As a possible mechanism, it has been

suggested that low-fat vegan diets tend to downregulate systemic insulin-like

growth factor (IGF)-I activity, which acts on vascular endothelium to activate

nitric oxide synthase, thereby promoting vascular health; this downregulation of

IGF could thus be expected to increase stroke risk in vegans [McCarty, 2003].

In addition, there is important proof showing a relationship between a veg-

etarian diet and levels of vitamin B12, folic acid and homocysteine. Substantial

nutritional defi ciencies in these three vitamins along with mild hyperhomo-

cysteinemia, perhaps through an interplay with the classical cardiovascular risk

factors (highly prevalent in this population), could further aggravate the risk of

coronary artery disease [Iqbal et al., 2005]. The intake of vitamin B12 is lower

in vegetarian diets and defi ciencies in this vitamin have been reported in veg-

etarians, especially in vegans, and this defi ciency leads to an increase in plasma

homocysteine concentration [Abdulla et al., 1981; Huang et al., 2003; Sanders

et al., 1978].

In one study, homocysteine values and lipid parameters were measured in

groups of adults consuming alternative nutrition (vegetarians/lacto-ovo/vegans)

Dow

nloa

ded

by:

Hos

pita

l Chi

nese

Aca

d.of

Med

.

11

4.25

1.22

3.25

2 -

11/1

1/20

14 4

:17:

53 A

M


and compared with a group consuming traditional diets (omnivores, general

population). The frequency of hyperhomocysteinemia was 53% in vegans and

28% in vegetarians vs. 5% in omnivores. It was concluded that low lipid risk

factors but higher fi ndings of mild hyperhomocysteinemia in vegetarians indi-

cated a diminished protective effect of alternative nutrition in cardiovascular

disease prevention [Krajcovicová-Kudlácková et al., 2000].

In a study in an elderly population investigating the relation between homo-

cysteine blood concentrations and vitamin intake, the predominant cause of ele-

vated homocysteine blood concentrations was inadequate blood folate [Selhub

et al., 1995]. In the study by Hung et al. [2002] on the effects of a lacto-vege-

tarian diet on vitamin B status and plasma homocysteine level, fasting plasma

homocysteine was inversely correlated with plasma folate and vitamin B12 in

the vegetarian group. Multiple regression analysis revealed that plasma folate,

vitamin B12 and creatinine were independent determinants of homocysteine

variation and contributed to 38.6% of homocysteine variation in the vegetar-

ian versus omnivore group. In addition, fasting plasma homocysteine in the

vegetarians correlated negatively with serum threonine, lysine, histidine, argin-

ine and cysteine, and these amino acids contributed to 38.7% of homocysteine

variation. It was concluded that a lacto-vegetarian diet is associated with mildly

elevated fasting plasma homocysteine levels presumably due to lower levels of

plasma vitamin B12 [Hung et al., 2002].

Hyperhomocysteinemia is accepted as an important risk factor of stroke.

Elevated plasma total homocysteine is a strong, graded, independent risk fac-

tor of stroke, myocardial infarction, and other vascular events [Spence et al.,

2005]. The relation between hyperhomocysteinemia and a vegetarian diet seems

important and may show an aspect of the vegetarian diet and stroke risk rela-

tionship. In patients with non-valvular atrial fi brillation hospitalized for cardiac

reasons, increased fasting total plasma homocysteine levels were independently

associated with a history of ischemic stroke [Loffredo et al., 2005].

In a retrospective cohort study of 5,056 men and women aged 35–79 years,

there was a 69% increased risk of coronary mortality among those with the

lowest quartile compared with the highest quartile of serum folate [Morrison

et al., 1996]. Results from the Nurses’ Health Study demonstrated a signifi cant

inverse relation between a dietary intake of folate and vitamin B6 and mortal-

ity from cardiovascular disease during a 14-year follow-up of 80,082 women

[Rimm et al., 1998].

Studies have shown that high plasma homocysteine concentrations and

low concentrations of folate and vitamin B6 are associated with extracranial

carotid artery stenosis and an increase in the risk of stroke [Perry et al., 1996;

Selhub et al., 1993]. A total homocysteine level of >10.2 μmol/l is associated

with a doubling of vascular risk, and a total homocysteine level of >20 μmol/l is

Dow

nloa

ded

by:

Hos

pita

l Chi

nese

Aca

d.of

Med

.

11

4.25

1.22

3.25

2 -

11/1

1/20

14 4

:17:

53 A

M


associated with an 8-fold increase in vascular risk [Graham et al., 1997; Nygord

et al., 1997].

Folic acid supplementation has been shown to be highly effective in reduc-

ing plasma homocysteine levels [Bouchey et al., 1995]. Supplementation with

folic acid, pyridoxine and vitamin B12 is associated with regression of athero-

sclerotic plaque in the carotid artery [Peterson and Spence, 1998]. It has been

suggested that an increase in folic acid and reduction in homocysteine level

would potentially prevent an important number of deaths from vascular causes

[Bouchey et al., 1995]. Each 100-μg/day increase in folate is associated with a

5.8% lower risk of coronary heart disease [Rimm et al., 1998].

The mechanisms by which homocysteine may cause vascular disease

include a propensity for thrombosis and impaired thrombolysis [Nishinaga

and Shinada, 1994; Simioni, 1999] and increased oxidation of low-density

lipoprotein and lipoprotein(a) [Leerink et al., 1994]. Vitamin therapy with

folate, pyridoxine (B6), and cobalamine (B12) reduces the total homocysteine

level and reverses endothelial dysfunction induced by high total homocysteine

[Brattström, 1996; Chambers et al., 1998; Van den Berg et al., 1994]. To

decrease the homocysteine level, B12, betaine, and thiols must be used together

[Spence et al., 2005].

Conclusion

Leonardo da Vinci may have suffered from the adverse effects of his veg-

etarian diet [Ozturk, 2009]. His stroke, which resulted in right hemiparesis,

may have been related to an increase in homocysteine level because of the long

duration of his vegetarian diet. We are not aware of any indication suggesting

a cardiac cause or of any other major stroke risk factor. Leonardo da Vinci,

regarded as the archetypal universal genius, could perhaps have continued to

build upon his collection of masterful works had he not suffered from limiting

paresis.

References

Abdulla M, Andersen I, Asp N-G, Berthelsen K, Birkhed D, Dencker I, et al: Nutrient intake and health status of vegans. Chemical analysis of diet using duplicate portion sampling technique. Am J Clin Nutr 1981;34:2464–2477.

Bouchey CJ, Beresford SAA, Omenn GS, Motulsky AG: A quantitative assessment of plasma homo-cysteine as a risk factor for vascular disease. JAMA 1995;274:1049–1057.

Bramly S: Leonardo: Discovering the Life of Leonardo da Vinci (Reynolds S: English translation). Staten Island, Brainiac Books, 1991.

Brattström LE: Vitamins as homocysteine-lowering agents. J Nutr 1996;126:51276–51280.

Dow

nloa

ded

by:

Hos

pita

l Chi

nese

Aca

d.of

Med

.

11

4.25

1.22

3.25

2 -

11/1

1/20

14 4

:17:

53 A

M


Chambers JC, McGregor A, Jean-Marie J, Kooner JS: Acute hyperhomocysteinemia and endothelial dysfunction. Lancet 1998;351:36–37.

Council on Scientifi c Affairs: Saturated fatty acids in vegetable oils. JAMA 1990;263:693–695.Gardner H: Gardner’s Art through the Ages, ed 11. Boston, Wadsworth, 1975.Gillman MW, Cupples LA, Gagnon D, Posner BM, Ellison RC, Castelli WP, et al: Protective effect of

fruits and vegetables on development of stroke in men. JAMA 1995;723:113–117.Goldscheider L: Leonardo da Vinci, ed 2. London, Phaidon Press, 1944, p 20.Gould KL, Omish D, Kirkeeide R, Brown S, Stuart Y, Buchi M, et al: Improved stenosis geometry

by quantitative coronary arteriography after vigorous risk factor modifi cation. Am J Cardiol 1992;69:845–853.

Graham IM, Daly LE, Refsum HM, Robinson K, Brattstrom LE, Ueland PM, et al: Plasma homo-cysteine as a risk factor for vascular disease. The European Concerted Action Project. JAMA 1997;277:1775–1781.

Huang YC, Chang SJ, Chiu YT, Chang HH, Cheng CH: The status of plasma homocysteine and related B-vitamins in healthy young vegetarians and nonvegetarians. Eur J Nutr 2003;42:84–90.

Hung CJ, Huang PC, Lu SC, Li YH, Huang HB, Lin BF, et al: Plasma homocysteine levels in Taiwanese vegetarians are higher than those of omnivores. J Nutr 2002;132:152–158.

Iqbal MP, Ishaq M, Kazmi KA, Yousuf FA, Mehboobali N, Ali SA, et al: Role of vitamins B6, B12 and folic acid on hyperhomocysteinemia in a Pakistani population of patients with acute myocardial infarction. Nutr Metab Cardiovasc Dis 2005;15:100–108.

Krajcovicová-Kudlácková M, Blazícek P, Babinská K, Kopcová J, Klvanová J, Béderová A, et al: Traditional and alternative nutrition–levels of homocysteine and lipid parameters in adults. Scand J Clin Lab Invest 2000;60:657–664.

Leerink CB, van Ham AD, Heeres A, Duif PH, Bouma BN, von Rijn HJ: Sulfhydryl compounds infl uence immunoreactivity, structure, and functional aspects of lipoprotein(a). Thromb Res 1994;74:219–232.

Lichtenstein AH: Trans fatty acids, plasma lipid levels and risk of developing cardiovascular disease: a statement for health care professionals from the American Heart Association. Circulation 1997;95:2588–2590.

Loffredo L, Violi F, Fimognari FL, Cangemi R, Sbrighi PS, Sampietro F, et al: The association between hyperhomocysteinemia and ischemic stroke in patients with non-valvular atrial fi brillation. Haematologica 2005;90:1205–1211.

McCarty MF: IGF-I activity may be a key determinant of stroke risk–a cautionary lesson for vegans. Med Hypoth 2003;61:323–334.

Morrison HI, Schaubel D, Desmeules M, Wigle DT: Serum folate and risk of fatal coronary heart dis-ease. JAMA 1996;275:1893–1896.

Mü ntz E: Leonardo da Vinci, Artist, Thinker and Man of Science. London, Heinemann, 1898.Nishinaga M, Shinada K: Heparan sulfate proteoglycan of endothelial cells; homocysteine suppresses

anticoagulant active heparan sulfate in cultured endothelial cells. Rinsho Byoni 1994;42:340–345.

Nygord O, Nordehaug JE, Refsum H, Voland PM, Farstad M, Vollset SE: Plasma homocysteine levels and mortality in patients with coronary artery diseases. N Engl J Med 1997;337:230–236.

Ozturk S: Leonardo Da Vinci (1452–1519) as a stroke victim: hemiparesis a result of a vegetarian diet? J Med Biogr 2009;17:7.

Perry IJ, Refusm H, Morris RW, Ebrahim SB, Ueland PM, Shaper AG: Prospective study of serum total homocysteine concentration and risk of stroke in middle-aged British men. Lancet 1996;348:1120–1124.

Peterson JC, Spence JD: Vitamins and progression of atherosclerosis in hyper-homocysteinemia (letter). Lancet 1998;351:263.

Richter JP: The Literary Works of Leonardo da Vinci Compiled and Edited from the Original Manuscripts by Jean Paul Richter: Commentary by Carlo Pedretti. Berkeley, University of California Press, 1977.

Rimm EB, Willett WC, Hu FB, Sampson L, Colditz GA, Manson JE, et al: Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. JAMA 1998;279:359–364.

Dow

nloa

ded

by:

Hos

pita

l Chi

nese

Aca

d.of

Med

.

11

4.25

1.22

3.25

2 -

11/1

1/20

14 4

:17:

53 A

M


Sanders TA, Ellis FR, Dickerson JWT: Hematological studies on vegans. Br J Nutr 1978;40:9–15.Segasothy M, Phillips PA: Vegetarian diet: panacea for modern lifestyle diseases? QJM 1999;92:531–

544.Selhub J, Jackues PF, Boston AG, D’Agastino RB, Wilson PWF, Belanger AJ, et al: Association between

plasma homocysteine concentrations and extracranial carotid artery stenosis. N Engl J Med 1995;332:286–291.

Selhub J, Jackues PF, Wilson PW, Rush D, Rosenberg IH: Vitamin status and intake as primary determi-nant of homocysteinemia in an elderly population. JAMA 1993;270:2693–2698.

Simioni P: The molecular genetics of familial venous thrombosis. Baillieres Best Pract Res Clin Haematol 1999;12:479–503.

Spence JD, Bang H, Chambless LE, Stampfer MJ: Vitamin Intervention for Stroke Prevention trial: an effi cacy analysis. Stroke 2005;36:2404–2409.

Van den Berg M, Franken DG, Boers GH, Blom HJ, Jacobs C, Stehouwer CD, et al: Combined vitamin B6 plus folic acid therapy in young patients with arteriosclerosis and hyperhomocysteinemia. J Vasc Surg 1994;20:933–940.

Vezzosi A: Leonardo da Vinci. The Mind of Renaissance (translated from French). New York, Abrahams, 1997.

Dr. Serefnur ÖztürkDepartment of Neurology 1Ankara Numune Education and Research HospitalTR–06420 Ankara (Turkey)Tel. +90 31 250 84501, Fax +90 31 243 16090, E-Mail [email protected]

Dow

nloa

ded

by:

Hos

pita

l Chi

nese

Aca

d.of

Med

.

11

4.25

1.22

3.25

2 -

11/1

1/20

14 4

:17:

53 A

M

Leonardo da Vinci and Stroke – Vegetarian Diet as a Possible Cause

Documents

Transcript of Leonardo da Vinci and Stroke – Vegetarian Diet as a Possible Cause