THE MEDITERRANEAN diet, a dietary pattern rich in fruits, vegetables, whole grains, legumes, fish, and olive oil, has long been associated with better cardiovascular health. New evidence from a large USA cohort study suggests it may also lower the risk of different types of stroke in women, including both ischaemic and haemorrhagic events.
Stroke occurs when blood flow to the brain is interrupted, either by a clot (ischaemic stroke) or bleeding (haemorrhagic stroke), and remains a leading cause of death and long-term disability worldwide.
Mediterranean Diet and Long-Term Stroke Risk
The findings come from the California Teachers Study, a large prospective cohort that has followed female educators and administrators for more than two decades. Researchers examined whether adherence to the Mediterranean diet at baseline was associated with future stroke risk.
Dietary patterns were assessed using a validated food frequency questionnaire, with participants assigned a Mediterranean diet score ranging from 0 to 9. Higher scores reflected closer adherence to the diet’s core components, such as higher intake of plant-based foods and healthier fats.
Lower Risk Across Stroke Subtypes
Among more than 105,000 women followed for an average of 20 years, just over 4,000 strokes occurred. The majority were ischaemic strokes, with a smaller number of haemorrhagic strokes.
After adjusting for a wide range of factors, including age, lifestyle behaviours, and vascular risk factors, women with the highest Mediterranean diet scores had a significantly lower risk of stroke. Compared with those with the lowest scores, high adherence was associated with an 18% lower risk of total stroke, a 16% lower risk of ischaemic stroke and a 25% lower risk of haemorrhagic stroke.
Implications for Women’s Health and Prevention
Importantly, the study did not rely on short-term dietary changes but assessed long-term outcomes following baseline dietary habits. The consistency of associations across stroke subtypes strengthens confidence in the findings, although the observational design means causality cannot be confirmed. Potential limitations include reliance on self-reported diet and the possibility of residual confounding.
The results reinforce dietary counselling as a cornerstone of stroke prevention in women, alongside blood pressure control, smoking cessation, and physical activity. While the Mediterranean diet is not a substitute for medical management of vascular risk, it represents a practical, low-risk strategy that may deliver long-term protection.
Reference
Sherzai AZ et al. Mediterranean diet and the risk of stroke subtypes in women: the California Teachers Study. NOA. 2026;DOI:10.1212/WN9.0000000000000062.
