Hyperinsulinemia and Stroke: How Their Association Implicates Carbohydrates in Obesity
Hyperinsulinemia has been shown to associate closely with a wide variety of diseases, including stroke, type II diabetes, Alzheimer disease, cancer, and obesity. These relationships seem to be important and robust. But what do these associations tell us? Specifically, what might they imply about the fundamental cause of why we gain weight and why it's so hard to lose weight?
First, for evidence that hyperinsulinemia, stroke, and obesity do indeed associate, click here or here.
Second, in terms of how this relates back to our primary question about what makes us fat, let's again turn attention to our two theories:
The Caloric Balance Hypothesis tells us nothing about why obesity might associate with stroke.
The Lipophilia Hypothesis tells us that stroke and obesity are different manifestations of a common underlying problem: a diet that contains too many carbohydrates.
Here are some articles that seem to advocate for the Lipophilia Hypothesis perspective.
1. 'Refined carbohydrates increase the risk of stroke.'
"High intake of carbohydrates has negative effects on blood fats and sugar metabolism... This study [from the January 2005 issue of the American Journal of Epidemiology]... included over 78,000 women in the course of over 18 years [and] showed that a high glycemic diet was positively associated with the risk of hemorrhagic stroke... The authors speculate that one possible mechanism to explain the increase in stroke risk is that diets high in carbohydrate and low in protein may increase blood pressure, where high blood pressure is a strong risk factor for stroke. The authors also note that, "high carbohydrate intake has been associated with an increased C-reactive protein (a marker of inflammation), probably representing an exacerbation of insulin resistance, which may be related to higher risk of stroke." 
2. Gary Taubes' book Good Calories, Bad Calories builds a compelling case that dietary carbs can cause stroke. See the chapter on the Significance of Diabetes, in which he details precisely how chronic carb consumption can lead to vascular disease, diabetes, hyperinsulinemia and stroke.
3. Here's a randomly selected study published in The American Journal of Epidemiology 2005 'Carbohydrate intake, glycemic index, glycemic load, and dietary fiber in relation to risk of stroke in women.'
The authors argue that:
"In analyses adjusting for non dietary risk factors... carbohydrate was associated with elevated risk of hemorrhagic stroke when the extreme quintiles were compared... but not with ischemic stroke."
They later report:
"Findings suggest that high intake of refined carbohydrate is associated with hemorrhagic stroke risk, particularly among overweight or obese women."
If carbohydrate intake predisposes overweight women to stroke, this would provide compelling evidence once again that Lipophilia is correct and that Caloric Balance doesn't work.