Mediterranean Diet Associated With Lower Risk Of All Stroke Types

Following a Mediterranean diet is associated with a lower risk of all types of stroke among women, according to a study published in Neurology^® Open Access, an official journal of the American Academy of Neurology. The study does not prove that the Mediterranean diet is the cause of the lower risk of stroke; it only shows an association.

The diet was associated with a lower risk of stroke overall, as well as ischemic stroke and hemorrhagic stroke. Ischemic stroke is caused when blood flow is blocked to part of the brain. It is the most common type of stroke. Hemorrhagic stroke is caused by bleeding in the brain.

The Mediterranean diet includes a high intake of vegetables, legumes, fruits, fish and healthy fats such as olive oil, and a low intake of dairy products, meats and saturated fatty acids.

“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.”

The study involved 105,614 women with an average age of 53 at the start of the study who had no history of stroke. The participants filled out a questionnaire at the start of the study about their diet. Participants were given a score of zero to nine based on how closely they followed the Mediterranean diet. People received one point if they consumed above the overall average in the population in these categories: whole grain cereals, fruits, vegetables, legumes, olive oil and fish, plus drinking a moderate amount of alcohol. They also received one point if they consumed a below-average amount of red meat and dairy products. A total of 30% of participants had scores of six to nine—the highest group. And 13% had scores of zero to two, the lowest group.

The participants were followed for an average of 21 years. During that time, 4,083 strokes occurred, with 3,358 ischemic strokes and 725 hemorrhagic strokes. For ischemic strokes, there were 1,058 among the 31,638 people in the highest group compared to 395 cases among the 13,204 people in the lowest group. For hemorrhagic stroke, there were 211 strokes among those in the highest group, compared to 91 among the lowest group.

When researchers adjusted for other factors that could affect stroke risk, such as smoking, physical activity and high blood pressure, they found that those in the highest 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.”

A limitation of the study is that people reported their own diet information, so they may not have remembered correctly.  

The study was supported by the National Institute of Neurological Diseases and Stroke.