Mediterranean diet lowers risk of all types of strokes in women

Researchers from a large and lengthy observational study report that adherence to a Mediterranean diet is associated with a lower risk of all types of strokes among women.

The findings were published on February 4, 2026, in Neurology Open Access, an official journal of the American Academy of Neurology.

“Our findings support the mounting evidence that a healthy diet is critical to stroke prevention,” said study author Sophia S. Wang, PhD, of City of Hope Comprehensive Cancer Center in Duarte, California. “We were especially interested to see that this finding applies to hemorrhagic stroke, as few large studies have looked at this type of stroke.”

As background, the authors noted that previous research had linked the Mediterranean diet to lower incidences of cardiovascular and neurodegenerative diseases, and overall mortality. But there have been limited findings about the relationship between the Mediterranean diet and stroke subtypes.

The California Teachers Study is a prospective study that enrolled female educators and administrators in 1995–1996. Thereafter, the researchers identified incident strokes in the study cohort using California state hospitalization data and national death records from 1996 to 2020.

The study included 105,614 women with an average age of 53 at baseline. None had a history of stroke.

At enrollment, each subject completed a dietary questionnaire. They received a score of zero to nine based on how closely they adhered to the Mediterranean diet.

They got one point if they consumed above the overall average in the general population in the following categories: whole grain cereals, fruits, vegetables, legumes, olive oil and fish, plus drinking a moderate amount of alcohol.

They received one point if they consumed a below-average amount of red meat and dairy products.

Thirty percent of the subjects were in the highest scoring group of six to nine. Thirteen percent were in the lowest scoring group of zero to two.

The investigators tracked the subjects for an average of 21 years.

During that period, 4,083 strokes occurred, 3,358 ischemic strokes and 725 hemorrhagic strokes.

There were 1,058 ischemic strokes among 31,638 subjects in the highest Mediterranean diet group compared to 395 ischemic strokes among 13,204 subjects in the lowest group.

For hemorrhagic stroke, there were 211 strokes among those in the highest Mediterranean diet group, and 91 among the lowest group.

After adjusting the data for other factors that could affect stroke risk — smoking, physical activity and high blood pressure — they found that those in the highest Mediterranean diet group were 18% less likely to have a stroke than those in the lowest group. They were 16% less likely to have an ischemic stroke and 25% less likely to have a hemorrhagic stroke.

“Stroke is a leading cause of death and disability, so it’s exciting to think that improving our diets could lessen our risk for this devastating disease,” said Wang. “Further studies are needed to confirm these findings and to help us understand the mechanisms behind them so we could identify new ways to prevent stroke.”