- A long-term study of more than 100,000 women found that those who most closely followed a Mediterranean-style diet had a lower risk of stroke over about two decades.
- The association covered both ischaemic and haemorrhagic strokes, with a particularly notable reduction for haemorrhagic stroke.
- The results show correlation rather than proof, but add to evidence that diet patterns matter for brain and heart health.
Stroke remains one of the leading causes of death and disability, and prevention is heavily shaped by everyday risk factors such as blood pressure, smoking, and metabolic health.
A large long-term study now adds more evidence that diet patterns may also make a meaningful difference, particularly for women.
Researchers followed 105,614 women with no history of stroke at the start of the study.
The average age at baseline was 53. Each participant completed a detailed dietary questionnaire, and researchers scored their eating habits on a 0-9 scale based on how closely they matched a Mediterranean-style pattern.
In this scoring system, participants gained points for eating more than the population average of key Mediterranean diet components, including whole grains, fruit, vegetables, legumes, olive oil, and fish. They also gained a point for moderate alcohol intake. They gained another point for eating less red meat and less dairy than average.
Around 30% of participants scored 6-9, placing them in the highest adherence group, while about 13% scored 0-2, the lowest group.
The women were followed for an average of 21 years.
Over that period, researchers recorded 4,083 strokes, including 3,358 ischaemic strokes and 725 haemorrhagic strokes. Ischaemic strokes are caused by a blockage reducing blood flow to the brain, while haemorrhagic strokes involve bleeding in the brain due to a ruptured vessel.
When the researchers accounted for other stroke risk factors such as smoking, physical activity, and high blood pressure, the Mediterranean diet pattern still showed a significant association with lower stroke risk.
Women in the highest Mediterranean diet group were about 18% less likely to experience any stroke compared with women in the lowest group. Their risk of ischaemic stroke was about 16% lower, and their risk of haemorrhagic stroke was about 25% lower.
The haemorrhagic finding stood out because fewer large studies have examined diet in relation to bleeding-type strokes.
While the study cannot prove the diet directly prevents stroke, the breadth of the association suggests the overall eating pattern may support vascular health in more than one way.
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- Study finds men and women follow Mediterranean diet in different ways
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As with most large diet studies, there are limits.
Dietary data was self-reported, so some participants may not have recalled or recorded their intake accurately.
Diet can also change over time, while the study used baseline measurements. And because this is observational research, it cannot exclude all unmeasured factors that might influence both diet and stroke risk.
Even with those caveats, the message is consistent with broader cardiovascular guidance: diets built around vegetables, legumes, whole grains, fish, and olive oil – alongside less red meat and fewer saturated fats – are associated with better long-term outcomes.
For people living with diabetes, these patterns often align well with goals for weight, blood pressure, cholesterol, and overall cardiometabolic risk reduction.
