As women age, their risk of stroke rises steadily, with a notable acceleration after menopause. Stroke remains one of the leading causes of death and long-term disability among women, affecting roughly one in five between the ages of 55 and 75 in the United States, according to data from the US Centers for Disease Control and Prevention. Against this backdrop, new long-term research suggests that everyday dietary choices may offer meaningful protection.
The Mediterranean diet, widely recognized for its emphasis on plant-based foods and healthy fats, has now been linked to a substantially lower risk of stroke in women over decades of follow-up. The findings add weight to growing evidence that nutrition plays a central role in cardiovascular and cerebrovascular health, particularly later in life.
Long-term dietary patterns and stroke outcomes
The study tracked more than 105,000 women enrolled in the California Teachers Study, a large prospective cohort that began in 1995. Participants, aged 38 to 67 at enrollment, provided detailed information about their eating habits, including portion sizes and food frequency over the previous year. Researchers used this information to assess how closely each woman followed a Mediterranean-style eating pattern.
Adherence was scored on a nine-point scale that rewarded higher consumption of vegetables, fruits, legumes, cereals, olive oil, fish, and nuts, alongside lower intake of meat and dairy and moderate alcohol consumption. Over an average follow-up period exceeding 20 years, women with higher adherence scores consistently showed lower rates of stroke.
By the end of the follow-up, those most closely aligned with the Mediterranean diet were 18% less likely to experience any type of stroke. The reductions extended across major subtypes, including a 16% lower risk of ischemic stroke, caused by blocked blood flow to the brain, and a striking 25% lower risk of hemorrhagic stroke, which results from bleeding within the brain. The findings were published in Neurology Open Access, underscoring their relevance to neurological as well as cardiovascular health.
Why the Mediterranean diet may be protective
The Mediterranean diet is rich in antioxidants, anti-inflammatory compounds, and unsaturated fats, all of which are believed to support vascular health. Olive oil, a central component of the diet, has been associated with improved cholesterol profiles and reduced arterial stiffness, while regular consumption of fruits, vegetables, and legumes contributes to better blood pressure control and glucose metabolism.
Previous research has linked this dietary pattern to lower risks of dementia, diabetes, depression, breast cancer, and overall cardiovascular disease. Large-scale trials such as the PREDIMED study have demonstrated fewer major cardiovascular and cerebrovascular events among participants following a Mediterranean diet, reinforcing the biological plausibility of the new findings.
What stood out in this research was the apparent benefit for hemorrhagic stroke, a subtype less commonly associated with lifestyle modification. Experts note that while factors such as high blood pressure are known contributors, the role of diet in reducing bleeding risk in the brain has been less clear. The results suggest that a nutrient-dense, predominantly plant-based eating pattern may influence vascular integrity in ways not fully understood.
Implications for women’s health after menopause
Stroke risk increases for women during and after menopause due to hormonal changes, shifts in fat distribution, and a higher prevalence of conditions such as hypertension and diabetes. Researchers involved in the study emphasized that diet represents a modifiable factor at a life stage when other risks may be rising.
Institutions such as National Jewish Health and City of Hope highlight the growing importance of preventive strategies that combine nutrition, physical activity, and overall lifestyle changes. While the study did not track dietary changes over time or measure olive oil intake repeatedly, its long follow-up and large sample size strengthen the case for dietary consistency.
For women navigating midlife and beyond, the findings suggest that adopting and maintaining a Mediterranean-style diet could play a meaningful role in reducing the likelihood of both ischemic and hemorrhagic stroke, reinforcing nutrition as a cornerstone of long-term brain and heart health.
