Following a Mediterranean diet appears to be significantly associated with a lower risk of stroke, according to a new long-term study in women. Although further research is needed to establish exactly how the two are related, the results are promising for the future fight against the disease, which affects around 15 million people each year.

Researchers from the United States and Greece have published findings on the effect of the Mediterranean diet on stroke risk in women. neurology open accessJournal of the American Academy of Neurology. The study looked at health data for 105,614 women living in California, with an average age of 53 years at the start of the study and an average follow-up of 20.5 years.

Study participants were asked to report dietary data. Depending on your answers and how closely you followed the Mediterranean diet, you were given a score from 0 to 9. Eating more whole grain cereals, fruits, vegetables, legumes, olive oil, and fish improved scores. Scores increased when red meat and dairy intake was below average. Overall, approximately 30% of women had a score of 6 to 9, while 13% only achieved a score of 0 to 2.

The scientists also adjusted the data to account for factors associated with a reduced or increased risk of stroke, such as smoking, physical activity, and high blood pressure.

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During a mean follow-up period of 20.5 years, 4,083 stroke events were recorded. Of those, 3,358 had ischemia, meaning blood flow to part of the brain was blocked. Of those, 725 were hemorrhagic, defined as cerebral hemorrhage.

When these stroke events were matched with dietary data, the scientists found that women in the highest group (thus most adherent to the Mediterranean diet) were 18% less likely to develop a stroke than women in the lowest group. The risk of having an ischemic stroke was reduced by 16%, and the chance of having a hemorrhagic stroke was 25% lower.

“Our findings support the growing body of evidence that a healthy diet is important for stroke prevention. We were particularly interested to see that our findings also apply to hemorrhagic strokes, as few large-scale studies have investigated this type of stroke,” one of the study authors, Sophia Wang of City of Hope Comprehensive Cancer Center, said in a press release.

This study is an important step toward a better understanding of stroke, as 15 million people around the world experience a stroke each year, of which around 5 million die and a further 5 million remain disabled. Although scientists were able to prove a link between diet and stroke, further research is needed to identify the processes behind this association and include data on male participants.