Stroke remains a leading cause of death and long-term disability among women, and the risk rises sharply with age. This is particularly true after menopause. In fact, 1 in 5 women in the U.S. between the ages of 55 and 75 will experience a stroke, according to the Centers for Disease Control and Prevention. But a compelling new study suggests that one well-known eating pattern may significantly lower that risk.

If food is medicine, a study may have just identified a powerful prescription for preventing strokes. It found that women who most closely followed a Mediterranean-style diet had a markedly lower risk of stroke over more than two decades of follow-up.

The data used for this research were from women, but even though men were not participants, it is likely the associations seen in the results would also apply to men.

Women who most closely followed a Mediterranean-style diet had a markedly lower risk of stroke over more than two decades of follow-up.

The study analyzed data from the long-running California Teachers Study. Originally launched in 1995, the cohort included more than 133,000 female, public school teachers and administrators across California. Researchers focused on over 105,000 women who had no history of stroke at the start of the study. Participants ranged in age from 38 to 67, with an average age of 53.

Each woman completed a detailed food frequency questionnaire at the start of the study about her eating habits over the previous year. Using those responses, researchers calculated how closely each participant adhered to the Mediterranean diet using a nine-point scoring system.

Women earned points for consuming above-average amounts of vegetables, fruits, legumes, whole grains, olive oil and fish, and for moderate alcohol intake. They also earned points for eating less red meat and dairy than average. Higher scores reflected greater adherence. About 30 percent of participants scored between six and nine — indicating strong adherence — while 13 percent scored between zero and two.

The women were then followed for an average of 20.5 years. During that time, researchers identified 4,083 strokes through linked California hospitalization records and national health data. Of those strokes, 3,358 were ischemic — the result of a blocked blood vessel in the brain. A smaller number of women, 725, suffered hemorrhagic strokes, the result of bleeding in the brain.

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

Stroke prevention isn't only about medications and blood pressure checks. It begins in our kitchens.

Researchers noted that this was an observational study. It identifies an association between dietary habits and long-term stroke outcomes rather than proving that the Mediterranean-type diet directly prevents stroke, but the long follow-up period and large number of participants add weight to its findings.

The results also align with a growing body of research linking the Mediterranean diet to reduced risks of cardiovascular disease, dementia, diabetes and certain cancers. The consistency of these findings across different populations strengthens the argument that dietary patterns, not just individual nutrients, matter for long-term health.

For women concerned about stroke risk, especially as they approach or pass through menopause, the study's message is both practical and empowering. As Wang noted, “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.”

The takeaway? Stroke prevention isn't only about medications and blood pressure checks. It begins in our kitchens.

The study is published in Neurology Open Access.