Researchers studied 676 older adults to understand how diet affects hardening of blood vessels in the brain, a condition that can lead to strokes. They found that while eating healthy didn’t directly prevent this problem in everyone, it made a big difference for people who already had heart disease or high blood pressure. Those who followed Mediterranean or MIND diets (which emphasize vegetables, fish, and nuts) had fewer brain vessel problems. The study suggests that if you have heart disease or high blood pressure, paying attention to what you eat might help protect your brain health.

The Quick Take

  • What they studied: Whether eating certain types of healthy diets could prevent or reduce hardening of blood vessels inside the brain, especially in people with heart problems or high blood pressure.
  • Who participated: 676 older adults (average age 91 years old at the time of study, mostly women) who had either high blood pressure, a history of heart attack, or both. Researchers looked at their eating habits and medical records.
  • Key finding: For people with a history of heart attack, those who ate Mediterranean or MIND-style diets had significantly lower chances of developing severe brain vessel hardening. People with high blood pressure also showed some benefit, though the results were less clear-cut.
  • What it means for you: If you have high blood pressure or have had a heart attack, eating a Mediterranean or MIND diet (lots of vegetables, fish, whole grains, nuts, and olive oil) may help protect your brain blood vessels. However, this doesn’t mean diet alone prevents all brain vessel problems—it’s one piece of a larger health picture.

The Research Details

This was a long-term study that followed older adults over time, collecting information about what they ate and their medical history. On average, researchers tracked participants for about 6 years before examining their brain tissue after death to see if blood vessels had hardened. The researchers looked specifically at major blood vessels at the base of the brain (called the circle of Willis) and counted how many fatty deposits had built up, how many vessels were affected, and how blocked the vessels were. They created a scoring system from 0 to 3 to measure severity.

The researchers compared three different healthy eating patterns: the Mediterranean diet (which focuses on olive oil, fish, vegetables, and whole grains), the DASH diet (which emphasizes fruits, vegetables, whole grains, and low-fat dairy), and the MIND diet (which combines the best parts of Mediterranean and DASH diets and specifically includes brain-healthy foods like berries and leafy greens).

To make sure their results were fair, they adjusted their analysis to account for age, sex, education level, how many calories people ate, and genetics (specifically a gene called APOE4 that affects brain health).

This research approach is important because it actually examined real brain tissue instead of just relying on what people remember about their eating habits. The researchers could see exactly how much hardening had occurred in the brain’s blood vessels, which is more accurate than other methods. By looking at people with specific health conditions (high blood pressure and heart disease), they could understand whether diet helps the people who need it most.

This study has several strengths: it included a large number of participants, used actual brain tissue examination (the gold standard for accuracy), and adjusted for many factors that could affect results. However, the study only looked at older adults (average age 91), so results may not apply to younger people. Also, researchers relied on people remembering what they ate years earlier, which can be inaccurate. The study was done after people died, so we can’t know if diet changes could have prevented problems if people had changed their eating habits earlier.

What the Results Show

The most important finding was that diet’s effect on brain blood vessel hardening depended on whether someone had a history of heart attack. For people who had experienced a heart attack, eating a Mediterranean diet was associated with 12% lower odds of severe brain vessel hardening, and following a MIND diet was associated with 31% lower odds. This is a meaningful difference.

For people with high blood pressure alone (without a heart attack history), the relationship between diet and brain vessel hardening was weaker and less clear. The MIND diet showed a slight protective effect, but the results were borderline and not as strong as in the heart attack group.

Interestingly, having high blood pressure itself was strongly linked to brain vessel hardening—people with high blood pressure were about 60% more likely to have this problem. However, a history of heart attack alone wasn’t directly linked to brain vessel hardening in this study, though the numbers suggested a possible connection.

About half of all participants (53%) had mild brain vessel hardening, 21% had moderate hardening, and only 4% had severe hardening. This shows that brain vessel hardening is common in very old age but severe cases are less frequent.

The study found that the protective effect of healthy eating was specific to certain groups. The benefit appeared strongest in people with a heart attack history, less clear in people with only high blood pressure, and not present in people without either condition. This suggests that diet may be most helpful for people whose blood vessels have already been damaged by heart disease.

Previous research has shown that Mediterranean and MIND diets help protect heart and brain health in general populations. This study adds important new information by showing that these diets may be especially valuable for people who already have heart disease. It also confirms that high blood pressure is a major risk factor for brain vessel hardening, which aligns with what doctors have long known.

Several limitations should be considered: First, this study only included very old adults (average age 91), so we don’t know if the same benefits would apply to younger people. Second, researchers asked people to remember what they ate, which people often get wrong. Third, the study couldn’t prove that diet caused the lower rates of brain vessel hardening—it only showed an association. Fourth, the study was done after death, so we can’t know if changing diet earlier in life could have prevented problems. Finally, the study was relatively small for some groups, which means some findings might have happened by chance.

The Bottom Line

If you have high blood pressure or have had a heart attack, consider adopting a Mediterranean or MIND diet. This means eating more vegetables, fruits, whole grains, fish, nuts, and olive oil, while eating less red meat and processed foods. This recommendation has moderate confidence based on this study combined with other research showing these diets are heart-healthy. However, diet is just one part of managing your health—continue taking medications as prescribed and follow your doctor’s other recommendations.

This research is most relevant for older adults with high blood pressure or a history of heart attack. If you fall into these categories, discussing dietary changes with your doctor or a dietitian could be helpful. People without these conditions may still benefit from healthy eating for other reasons, but this study doesn’t specifically address them. Anyone with a history of stroke or brain disease should definitely talk to their doctor about diet and brain health.

Brain vessel changes happen slowly over many years, so you wouldn’t expect to feel immediate benefits from dietary changes. However, eating a healthier diet may help prevent future problems. It typically takes months to years of consistent healthy eating to see measurable changes in blood vessel health. The best approach is to view dietary changes as a long-term investment in your health rather than expecting quick results.

Want to Apply This Research?

  • Track daily servings of brain-healthy foods: leafy greens (goal: 1+ servings), berries (goal: 1+ servings), fish (goal: 2-3 times per week), nuts (goal: 1 ounce daily), and olive oil use (goal: 2+ tablespoons daily). Log these weekly to monitor adherence to MIND or Mediterranean diet patterns.
  • Start by adding one Mediterranean or MIND diet element per week: Week 1 add berries to breakfast, Week 2 switch to olive oil for cooking, Week 3 add a fish meal, Week 4 include leafy greens in lunch. Use the app to set reminders for these new habits and track completion.
  • Create a weekly MIND/Mediterranean diet score (0-10 scale) based on how many recommended foods you ate that week. Track this monthly to see trends. Also monitor blood pressure readings if you have a home monitor, as this study shows blood pressure control is important. Share your diet tracking data with your doctor at annual checkups to discuss whether your eating patterns align with your health goals.

This research suggests associations between diet and brain blood vessel health in older adults with specific health conditions, but does not prove cause and effect. If you have high blood pressure, a history of heart attack, or concerns about stroke risk, consult your healthcare provider before making significant dietary changes. This information is not a substitute for medical advice, diagnosis, or treatment. Always discuss dietary modifications with your doctor or a registered dietitian, especially if you take medications that may interact with dietary changes. The study was conducted in very old adults (average age 91), so results may not apply to younger populations.