Adherence to Plant-Based Mediterranean Diet May Reduce Cryptogenic Stroke Risk

Dietary composition, and more specifically adherence to a plant-rich diet, may significantly reduce the risk of cryptogenic ischemic stroke (CIS) in young adults, according to new data.1

These data were presented at the World Stroke Congress (WSC) 2026 in Seoul, South Korea, by Shakar Kutal, a doctoral researcher at Helsinki University Hospital. In an exclusive interview with HCPLive, Kutal discussed the implications of his findings – and how they can be adapted to everyday lifestyle interventions for stroke prevention.1

“It’s more of general health advice that should be given out to people, suggesting they focus more on plant-based items,” Kutal told HCPLive. “This study isn’t enough to prove that diet should be a bigger preventative measure, but more of a general type of health advice that should be given out to pretty much the entire population.”

Prior evidence has highlighted the connection between dietary patterns and stroke risk. The Mediterranean diet in particular, which is defined as a high intake of fruits, vegetables, whole grains, nuts, olive oil, and fish, has a variety of well-established cardiovascular benefits, and prior meta-analyses have identified a positive relationship between dietary adherence and reduced stroke risk.2

However, the etiology of early-onset ischemic stroke is largely undetermined, leading many to be classified as CIS. The specific role of diet as a risk factor in CIS is historically poorly understood; to this end, Kutal and colleagues undertook the present trial to assess the association between early-onset CIS and dietary habits. Patients aged 18-49 with a first-ever CIS were enrolled in the trial and were compared against sex- and age-matched stroke-free controls from 19 European centers.1

The team assessed dietary habits via a comprehensive questionnaire, while latent profile analyses identified distinct dietary patterns based on the components of the Mediterranean Diet Score (MDS). Kutal and colleagues calculated odds ratios (ORs) for CIS using multivariable logistic regression, adjusting for educational level, age, and traditional and non-traditional risk factors.1

A total of 1076 patients were included in the trial, of whom 538 were cases and 538 were controls. Among the case patients, the median age was 41 years (interquartile range [IQR], 34-46), and 47.2% were women. Over the course of the study, Kutal and colleagues found 3 dietary profiles, which included high-adherence (n = 289; mean MDS 30.9), low plant-based (n = 573; lowest vegetable and fruit intake; mean MDS 23.7), and meat-heavy (n = 142; highest meat intake; mean MDS 23.8).1

Compared to the high-adherence group, patients in the low plant-based profile were associated with a higher risk of CIS (OR, 1.53; 95% CI, 1.01-2.31) after full adjustment. Patients in the meat-heavy profile showed no substantial association with CIS risk, leading the team to conclude that plant incorporation represents a significant modifiable risk factor in this population.1

Kutal discussed the potential results of these data, highlighting dietary patterns as a potential biomarker for future research. Given the correlation between plant incorporation and CIS stroke risk, he believes this could be an effective predictor, provided further research supports these results.

“We have validated questionnaires and other measures, but it would be very interesting to have some type of a biomarker that would represent some type of dietary quality, and then studies based on following that,” Kutal said. “It would provide a more objective view towards the health risk of dietary habits.”

Editors’ Note: Kutal reports no relevant disclosures.

References

1. Kutal S. Association Between Dietary Habits and Cryptogenic Ischemic Stroke in Young Adults: A Case-Control Study. Presented at the World Stroke Congress (WSC) 2026, Seoul, South Korea. October 21-23, 2026.

2. Ungvari Z, Fekete M, Varga P, et al. Impact of adherence to the Mediterranean diet on stroke risk. Geroscience. 2025;47(3):3565-3581. doi:10.1007/s11357-024-01491-8