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Impact of adherence to the Mediterranean diet on stroke risk
Zoltan I. Ungvari, Mónika Fekete, Péter Varga, János Tibor Fekete, Alessia Buda, Ágnes Szappanos, Andrea Lehoczki, Noémi Mózes et al.. GeroScience, 2025-01-07
Topic: Risk, prevention and care in population studies
Abstract 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.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Ungvari, Z. I., Fekete, M., Varga, P., Fekete, J. T., Buda, A., Szappanos, Á., et al. (2025). Impact of adherence to the Mediterranean diet on stroke risk. GeroScience. https://doi.org/10.1007/s11357-024-01491-8
Vancouver
Ungvari ZI, Fekete M, Varga P, Fekete JT, Buda A, Szappanos Á, et al. Impact of adherence to the Mediterranean diet on stroke risk. GeroScience. 2025. doi:10.1007/s11357-024-01491-8. PMID: 39777701.
BibTeX
@article{ungvari2025-39777701,
author = {Ungvari, Zoltan I. and Fekete, Mónika and Varga, Péter and Fekete, János Tibor and Buda, Alessia and Szappanos, Ágnes and Lehoczki, Andrea and Mózes, Noémi and others},
title = {{Impact of adherence to the Mediterranean diet on stroke risk}},
journal = {GeroScience},
year = {2025},
doi = {10.1007/s11357-024-01491-8},
pmid = {39777701},
url = {https://doi.org/10.1007/s11357-024-01491-8}
}
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Key findings
- Abstract Stroke is a leading cause of morbidity and mortality worldwide, and dietary patterns have emerged as a significant modifiable factor in stroke prevention.
- 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 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.
Why it matters
This meta-analysis of 30 studies found that adherence to the Mediterranean diet was associated with a significant reduction in stroke risk, with a pooled hazard ratio of 0.88. It concerns stroke prevention and does not address Alzheimer's disease treatment, cure or prevention.
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Study details
- Study designmeta-analysis
- Effect sizeHR = 0.54
- Evidence strengthHigh
How this study scored 67/100
Published in a peer-reviewed journal, and it is a meta-analysis pooling many studies. Scored zero for sample size and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (GeroScience) |
| Journal's citation record | 1 / 4 | GeroScience: journal h-index 83 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A meta-analysis pooling many studies |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | A review of other studies — randomization is not credited here |
| Times cited | 3 / 7 | Cited 32 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 10.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 5 / 6 | Cited 27.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 3 other studies in this library |
| Still being cited | 2 / 4 | Cited 32 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Balázs Győrffy: h-index 81 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Oklahoma: institution h-index 716 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 9 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39777701) |
| Free to read | 2 / 2 | Free to read |
| Total | 67 / 100 | — |
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