Impact of adherence to the Mediterranean diet on stroke risk

Stroke is a leading cause of morbidity and mortality worldwide, and dietary patterns have emerged as a significant modifiable factor in stroke prevention. The Mediterranean diet, characterized by high intake of fruits, vegetables, whole grains, nuts, olive oil, and fish, has been widely recognized f...

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Published in:GeroScience Vol. 47; no. 3; pp. 3565 - 3581
Main Authors: Ungvari, Zoltan, Fekete, Mónika, Varga, Péter, Fekete, János Tibor, Buda, Annamaria, Szappanos, Ágnes, Lehoczki, Andrea, Mózes, Noémi, Grosso, Giuseppe, Menyhart, Otilia, Munkácsy, Gyöngyi, Tarantini, Stefano, Yabluchanskiy, Andriy, Ungvari, Anna, Győrffy, Balázs
Format: Journal Article
Language:English
Published: Cham Springer International Publishing 01.06.2025
Springer Nature B.V
Subjects:
Bias
Biomedical and Life Sciences
Cell Biology
Cerebrovascular disease
Cohort analysis
Diet
Diet, Mediterranean
Disease prevention
Fish
Fish oils
Geriatrics/Gerontology
Health planning
Health promotion
Healthy food
Heterogeneity
Humans
Ischemia
Life Sciences
Lifestyles
Meta-analysis
Molecular Medicine
Morbidity
Olive oil
Original
Original Article
Population
Prevention
Public health
Risk
Risk Factors
Risk reduction
Sequential analysis
Stroke
Stroke - epidemiology
Stroke - prevention & control
Vegetables
United States > US
Europe
Stroke prevention
Dietary intervention
Diet
Case–control
Meta-analysis
ISSN:2509-2723, 2509-2715, 2509-2723
Online Access:Get full text
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Summary:Stroke is a leading cause of morbidity and mortality worldwide, and dietary patterns have emerged as a significant modifiable factor in stroke prevention. The Mediterranean diet, characterized by high intake of fruits, vegetables, whole grains, nuts, olive oil, and fish, has been widely recognized for its cardiovascular benefits. However, its specific impact on stroke risk requires further elucidation. We conducted a comprehensive meta-analysis of 30 studies, including both cohort and case–control designs, to evaluate the relationship between adherence to the Mediterranean diet and the risk of stroke. A systematic search was performed across multiple databases, and a random-effects model was used to estimate pooled hazard ratios (HRs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I 2 statistic, and publication bias was examined through funnel plots and Egger’s regression test. Additionally, trial sequential analysis was conducted to determine the adequacy of the sample size. The meta-analysis revealed a significant reduction in stroke risk among individuals adhering to the Mediterranean diet, with a pooled HR of 0.88 (95% CI: 0.84–0.91). Notably, a significant heterogeneity was detected ( I 2  = 34%). The Z-score plot from trial sequential analysis confirmed that the sample sizes were sufficient to draw definitive conclusions. However, a potential publication bias was identified. The case–control studies confirmed a highly significant effect (HR = 0.54, 95% CI: 0.4–0.73). The funnel plots in both settings hinted at the presence of a potential publication bias, supported by a significant Egger’s test. Our findings provide robust evidence supporting the protective effect of the Mediterranean diet against stroke. Despite the presence of some heterogeneity and potential publication bias, the cumulative evidence suggests that promoting the Mediterranean diet could serve as an effective public health strategy for stroke prevention. Further research is recommended to explore the underlying mechanisms and to assess the diet’s impact across diverse populations.
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ISSN:2509-2723
2509-2715
2509-2723
DOI:10.1007/s11357-024-01491-8