Women who most closely followed a Mediterranean-style diet were less likely to experience stroke over about 21 years of follow-up, according to research published Feb. 4, 2026, in Neurology Open Access. The observational study found lower rates of both ischemic and hemorrhagic stroke among participants with the highest diet-adherence scores, though it cannot prove the diet itself prevented strokes.
Research published on February 4, 2026, in Neurology Open Access, a journal of the American Academy of Neurology, examined whether women’s adherence to a Mediterranean-style diet was associated with their long-term risk of stroke.
The study followed 105,614 women with no history of stroke at the start of the research, with an average age of 53. Participants completed a diet questionnaire at baseline, and researchers assigned each person a Mediterranean diet score from 0 to 9. The scoring awarded points for consuming more than the population average of whole-grain cereals, fruits, vegetables, legumes, olive oil and fish, and for moderate alcohol intake, while also awarding a point for consuming less than average red meat and dairy products.
About 30% of participants scored 6 to 9 (highest adherence) and 13% scored 0 to 2 (lowest adherence). Participants were followed for an average of 21 years. Over that period, researchers recorded 4,083 strokes, including 3,358 ischemic strokes and 725 hemorrhagic strokes. Among women in the highest-scoring group, there were 1,058 ischemic strokes and 211 hemorrhagic strokes, compared with 395 ischemic strokes and 91 hemorrhagic strokes in the lowest-scoring group.
After adjusting for other factors linked to stroke risk—such as smoking, physical activity and high blood pressure—women in the highest diet-score group were 18% less likely to have any stroke than those in the lowest group. The adjusted risk was 16% lower for ischemic stroke and 25% lower for hemorrhagic stroke.
“Our findings support the mounting evidence that a healthy diet is critical to stroke prevention,” said Sophia S. Wang, PhD, of City of Hope Comprehensive Cancer Center in Duarte, California, in materials accompanying the publication. She added that the association with hemorrhagic stroke was of particular interest because fewer large studies have examined that subtype.
The Mediterranean-style eating pattern highlighted in the report emphasizes vegetables, fruits, legumes, fish and olive oil, while limiting dairy products, meat and foods high in saturated fats. Wang also cautioned that further research is needed, adding: “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.”
Researchers noted limitations, including that dietary information was self-reported, which can affect accuracy, and that the study design shows an association rather than proving that the diet directly prevents strokes. The research was funded by the National Institute of Neurological Disorders and Stroke.
