The study confirmed, among other findings, that hydroxytyrosol significantly reduces the oxidation levels of LDL cholesterol (the so-called ‘bad cholesterol’), thus potentially improving cardiovascular health and reducing associated risks.

“Some extra virgin olive oil phenols contain precursors of this molecule. Once we consume extra virgin olive oil, our body reacts by producing hydroxytyrosol,” study co-author María-Carmen López de las Hazas told Olive Oil Times.

López is a researcher at the Laboratory of Epigenetics of Lipid Metabolism at the Research Institute on Food and Health Sciences (IMDEA) in Madrid.

The study involved a clinical trial during which 12 healthy participants received first a single 25-milligram dose of hydroxytyrosol, followed by a daily dose of 25 milligrams of hydroxytyrosol for one week.

The researchers documented a measurable decrease in oxidized LDL (oxLDL) levels following one week of daily hydroxytyrosol intake.

Reducing oxLDL is crucial as it plays a key role in developing atherosclerosis and cardiovascular diseases.

“We observed notable reductions in LDL oxidation after just one week, which surprised us because we initially believed it would take much longer to see any effect,” Alberto Dávalos, an IMDEA researcher and head of the project, explained.

“The potency of hydroxytyrosol as an antioxidant creates an antioxidant-rich environment in the plasma, protecting LDL from oxidative stress,” he added.

The researchers focused on extracellular vesicles to better understand the mechanisms behind hydroxytyrosol’s antioxidant activity. These vesicles are small molecules secreted by cells and circulate throughout the body, carrying substances and messages to other cells and tissues.

“We call them the cellular WhatsApp. They are small lipid-bound vesicles secreted by cells across all kingdoms of life, serving as critical communication vehicles between cells,” López and Dávalos explained.

Extracellular vesicles transport various biological molecules, including proteins, lipids and nucleic acids like microRNAs (miRNAs), influencing physiological processes and intercellular communication.

The research showed that hydroxytyrosol intake increases extracellular vesicle secretion and modulates their size and cargo potential, significantly impacting intercellular signaling pathways related to health and disease.

Additionally, researchers found that hydroxytyrosol intake affects miRNAs transported within extracellular vesicles. Micro ribonucleic acid molecules (miRNAs) are essential for regulating gene expression by determining the amount of protein produced from a gene.

miRNAs are involved in various physiological processes, including inflammation and cardiovascular health, and may protect against certain cancers and neurodegenerative conditions.

According to the researchers, hydroxytyrosol intake induced notable changes in the activity of specific miRNAs, with some becoming more active and others less active.

“miRNA-124, typically elevated in cardiovascular complications, was significantly decreased, which is beneficial,” López and Dávalos noted.

“Conversely, miRNA-590, important for heart repair after myocardial infarction, increased, indicating potential cardioprotective effects,” they explained.

“These miRNAs might serve as biomarkers or therapeutic targets, highlighting the promising impact of hydroxytyrosol,” the researchers emphasized.

“However, the long-term implications and exact mechanisms still need clarification through extended studies,” they cautioned.

Hydroxytyrosol’s potential impact on human health is also related to some unique properties researchers are exploring, especially its ability to cross the blood-brain barrier.

“Something relevant about hydroxytyrosol is that this is one of the few phenolic compounds that can be found in the brain, at least in several animal models,” Dávalos noted.

“Normal polyphenols cannot transport through the blood-brain barrier unless they have a transporter or a specific chemical structure. One possibility for how they cross the barrier is transport within extracellular vesicles,” he explained.

The blood-brain barrier is composed of highly specialized cells lining brain vessels. It serves as a protective shield that prevents bacteria, viruses and other potentially harmful molecules from accessing the brain. The barrier also regulates the entry of nutrients and other crucial substances.

According to the researchers, this discovery could have significant implications if future studies confirm that hydroxytyrosol is transported via extracellular vesicles in a larger population.

“This is relevant from a dietary point of view because when you consume polyphenol-rich extra virgin olive oil, a certain amount of hydroxytyrosol can be incorporated within extracellular vesicles, increasing its potential to cross the blood-brain barrier,” Dávalos explained.

“This mechanism opens exciting therapeutic possibilities, particularly regarding neurodegenerative diseases,” the researchers pointed out.

Still, the scientists emphasized that additional studies are necessary to thoroughly understand this cellular behavior and its implications.

“It is potentially a positive result to see hydroxytyrosol crossing the barrier, but increased permeability to beneficial substances transported in extracellular vesicles could also imply increased vulnerability to other compounds,” Dávalos warned.

“Additionally, if the blood-brain barrier is permeable enough to allow hydroxytyrosol through, other barriers like the placental barrier might also be crossed when transported in extracellular vesicles. This is an entirely new area to explore,” the researchers said.

According to the scientists, future research might investigate the relationship between hydroxytyrosol intake and endogenous antioxidant mechanisms, which are crucial processes naturally activated by the human body to combat oxidative stress.

“As humans, we obtain antioxidants through two mechanisms. One is endogenous, where our body produces antioxidants naturally. The other is exogenous, where we consume antioxidants through our diet,” López explained.

She noted that introducing potent antioxidants, including hydroxytyrosol, might decrease endogenous antioxidant production.

According to the researcher, this mechanism might not always be beneficial, especially under conditions of high oxidative stress.

“What could potentially happen is that consuming hydroxytyrosol initially helps fight oxidative conditions, but when hydroxytyrosol’s effect is exhausted, our endogenous antioxidant systems might remain inactive for a while, leaving us vulnerable,” López and Dávalos explained.

The researchers mentioned past experiences with antioxidants used in cancer prevention trials in the United States during the 1980s and 1990s.

“The intake of those synthetic antioxidants in large clinical trials led to negative outcomes, with increased mortality, especially among smokers,” they recalled.

However, the scientists highlighted a crucial difference: hydroxytyrosol is a naturally occurring molecule introduced under normal dietary conditions.

“This significantly changes the scenario. A balanced supplementation of antioxidants through dietary habits might be the optimal strategy to harness the best possible effects of hydroxytyrosol,” López and Dávalos concluded.

“Further studies are needed to fully understand these aspects,” they emphasized.

The supplement, sold commercially as Momast Plus 30 Bio (MP30B), is enriched with hydroxytyrosol, one of olive oil’s primary polyphenols, using a patented technique to extract the compound from olive mill wastewater.

Bioenutra, the company that manufactures MP30B, was not involved in the study.

Previous studies have found that the supplement exerts anti-inflammatory effects and removes reactive oxygen, which mitigated heart infections in in vivo studies.

In ex vivo studies, MP30B was also found to decrease the stiffness of the thoracic artery, which is thought to precede increased blood pressure.

The research also demonstrated that MP30B did not significantly alter the heart’s ability to pump blood effectively or impact the blood vessel function and health, known as cardiac and vascular parameters, in ex vivo studies.

“Based on these findings, we posit MP30B as a promising extract for cardiovascular disease prevention, and its specific antibacterial properties suggest its utility in preventing cardiac infections,” the researchers wrote.

Along with the promising health results from the study, the researchers said finding new uses for olive oil production byproducts helps increase the sustainability of the production process and substitutes a cost for millers with an additional revenue stream.

An estimated 30 million cubic meters of olive mill wastewater are produced yearly in the Mediterranean basin. Due to its high content of phenolic compounds, this wastewater must be treated before disposal.

“Olive mill wastewater poses an important waste management problem since the lack of conventional treatment can counteract its high toxicity,” the researchers wrote. “However, phenolic compounds in the wastewater represent an opportunity to ‘upcycle’ this waste to obtain high-added-value products.”

Their study, conducted on guinea pigs, found that Momast Plus 30 Bio inhibited the ability of enzymes to synthesize nitric oxide, a free radical, the overproduction of which can promote inflammation and oxidative stress.

“Our results suggest that MP30B can also interfere with inflammatory processes affecting the cardiovascular system by counteracting the deleterious effects caused by uncontrolled nitric oxide biosynthesis,” the researchers wrote.

They also found hydroxytyrosol’s antibacterial properties in MP30B, especially against infective endocarditis, a bacterial or fungal heart infection with a relatively high in-hospital mortality rate.

“Streptococci are among the most frequent causes of infective endocarditis,” the researchers wrote. “MP30B has actions on all types of streptococci tested.”

“Comparing the results of MP30B with those obtained using the reference antibiotic levofloxacin on Streptococcus pyogenes ATCC or FL, it is observed that MP30B is more potent both as a bactericidal and as a bacteriostatic on Streptococci FL; contrary to what was observed for levofloxacin whose actions are more significant in ATCC bacteria,” they added.

The researchers concluded that the hydroxytyrosol-enriched dietary supplement demonstrated potential as a food supplement to prevent cardiovascular diseases and suggested that further research should investigate its impact on breast cancer.

“Studies on the cardiotoxic effects of anti-tumor therapies demonstrate the protective action of hydroxytyrosol in breast cancer cardiotoxicity, increasing the potential applications of MP30B,” they wrote.

If confirmed by a Republican-led Senate, Kennedy would have wide-ranging authority over the U.S. Food and Drug Administration (FDA), which regulates about 80 percent of the country’s food supply.

While he is widely known for his anti-vaccine views, Kennedy is also a prominent and vocal critic of seed oils, bringing a long-simmering debate about their health impacts into the mainstream.

In an August interview with Fox News, Kennedy called seed oils “one of the most unhealthy ingredients” found in food and said they are “one of the worst things you can eat” since they are associated with “body-wide inflammation.”

Instead, Kennedy recommends replacing seed oils with beef tallow, made from the fatty tissue of cow organs. Searching Kennedy’s historical public statements and social media accounts found no mention of olive oil.

Researchers, including scientific members of the American Heart Association, have long argued that plant oils – mostly derived from seeds, especially canola, sunflower and soybean – are a healthier alternative to animal fat due to their unsaturated fat content.

“Very consistently, all the data say butter and lard are bad for our hearts,” said Christopher Gardner, a professor of medicine at Stanford University. “Studies show swapping out saturated fats and replacing them with unsaturated fats lowers the risk for heart disease.”

While Kennedy is among the most prominent critics of seed oils, there is a growing anti-seed oil influencer movement on social media.

Seed oil critics articulate two main arguments. The first is that seed oils are often contaminated by hexane, the chemical solvent used in most commercial seed oil production.

Hexane is known to be toxic to humans in gaseous form but is used as a liquid in seed oil production. The hexane evaporates during the heat treatment that seed oils undergo when refined.

However, the FDA does not regulate or monitor hexane residues in seed oils, so it is unclear whether or not trace amounts of hexane remain in commercially available seed oils.

The more common argument against seed oils is their high content of omega‑6 polyunsaturated fatty acids, especially linoleic acid, compared to olive oil and animal-derived fats.

Linoleic acid content is about 55 percent in soybean oil, nearly 70 percent in sunflower oil (less than five percent in high-oleic sunflower oil) and more than 20 percent in canola oil. By contrast, olive oil comprises 2.5 to 21 percent linoleic acid, while beef has about one percent linoleic acid content.

Seed oil critics argue that omega‑6 fatty acids are converted into inflammation-promoting arachidonic acids in the body. Indeed, arachidonic acid is widely acknowledged as a building block for compounds that cause inflammation, but it has also been shown to suppress pro-inflammatory compounds.

According to a 2017 meta-analysis of 30 randomized control studies involving 1,377 subjects published, linoleic acid had a minimal impact on blood concentrations of inflammatory markers. The researchers attributed this to the fact that only 0.2 percent of linoleic acid is converted into arachidonic acid.

While it is widely acknowledged that humans need dietary sources of omega‑3 and omega‑6 fatty acids to survive, seed oil critics argue that modern Western diets include too many omega‑6 fatty acids and too few omega‑3 fatty acids.

Indeed, the recommended omega-6-to-omega‑3 ratio is four to one. However, some researchers estimate that these proportions range from ten to one to thirty to one in the U.S.

Seed oil critics also frequently highlight the correlation between seed oil consumption in the U.S. and rising obesity, cardiovascular disease and diabetes as evidence of their negative health impact.

However, correlation is not the same as causation. Instead, some experts argue that rising seed oil consumption is directly linked to the dramatic increase in ultra-processed foods, which include seed oils as an ingredient and are widely viewed as responsible for the aforementioned chronic diseases.

Gardner further argued that ultra-processed foods are unhealthy primarily because of other ingredients, including high-fructose corn syrup, added sugar and sodium. “It’s hard to cast the blame on the seed oils when these foods contain so many other things,” he said.

Kennedy has also strongly opposed ultra-processed foods and has said he would prohibit their use in school lunches. However, the FDA has no formal definition for ultra-processed food, which would make any ban difficult to implement.

• Massachusetts General Hospital
• American Heart Association

The most common cardiac arrhythmia, atrial fibrillation, is characterized by rapid and irregular beating of the heart’s atrial chambers. The condition can contribute to or be a precursor of a wide range of complications, from chest pain and fainting to heart failure and stroke.

Despite advances in medical procedures and pharmaceutical treatments, the incidence of atrial fibrillation has been increasing worldwide, particularly in the so-called developed world.

For example, a major cohort study estimated a three percent increase in the United States annually from 2006 to 2018. This has led to a resurgence in interest in lifestyle management, of which diet is a significant aspect.

The researchers from the cardiology division of Baylor Scott & White Health Hospital, Texas, used a narrative synthesis approach to explore the impact of dietary interventions on atrial fibrillation and to assess the role that individual components of those interventions play.

The study found that the two dietary patterns most commonly associated with reduced incidences and improved outcomes were the Mediterranean and DASH diets.

Although the latter was linked to improved cardiovascular outcomes and decreased mortality, the researchers found that once other lifestyle factors were considered, there was no demonstrable effect on the specific incidence, recurrence or progression of atrial fibrillation.

On the other hand, the Mediterranean diet served as “a robust preventative strategy against the development of atrial fibrillation.”

In exploring the potential mechanisms behind this effect, the researchers posited several possible factors.

The first is the Mediterranean diet’s high percentage of fruits, vegetables and extra virgin olive oil. All three food groups provide antioxidants and polyphenols, which have proven anti-inflammatory and cardioprotective effects.

Oleuropein, for example, has demonstrated a capacity to significantly reduce blood pressure, aligning with the traditional use of olive leaf in treating hypertension.

Studies discussed in the paper also provide evidence for the anti-thrombotic and anti-arrhythmic properties of oleocanthal and hydroxytyrosol, compounds found almost exclusively in extra virgin olive oil.

These compounds have been shown to improve endothelial function and reduce platelet aggregation, thereby lowering the risk of events such as stroke in patients with atrial fibrillation.

The importance of olive-based compounds was further supported by a secondary analysis in 2014 of the PREDIMED trial, which revealed significant atrial fibrillation protection from a Mediterranean diet supplemented with extra virgin olive oil.

The researchers cited that analysis, which showed a 38 percent reduction in relative atrial fibrillation risk compared to other diets.

While the examined evidence strongly supported the role of antioxidants and polyphenols, particularly regarding direct links to reduced atrial fibrillation incidence, the researchers stress that the mechanisms in question remain relatively unexplored.

They conclude, therefore, that while each component warrants extensive further research, dietary interventions such as the Mediterranean diet should be considered holistically in the context of disease prevention.

This conclusion is based on the growing evidence showing that the Mediterranean diet is linked to significantly reducing cardiovascular events and diabetes mellitus, improved blood pressure, insulin resistance, lipid profiles and triglycerides, and significantly lower obesity rates.

• American Heart Journal

The cross-over study, published in the Journal of the American Heart Association (JAHA), found that individuals lost more weight and demonstrated lower LDL cholesterol levels after following a low-fat diet than the olive oil-enriched diet. However, some prominent researchers have criticized the study design.

“There’s some controversy and debate in the cardiovascular disease world around the effect of vegetable oils, including extra virgin olive oil, on risk factors,” said Andrea Krenek, a researcher at the University of Florida and co-author of the study.

“Mediterranean diets usually include a lot of extra virgin olive oil, while low-fat, plant-based diets often recommend avoiding it,” she added. “However, both diets are known to reduce heart disease risk.”

“This hadn’t yet been studied to our knowledge within a whole-food, plant-based vegan diet, so we aimed to design a study to investigate this research question,” Krenek explained. “There hasn’t been much previous evidence aiming to evaluate whether extra virgin olive oil specifically yields risk reduction compared to the rest of the plant-based pattern.”

The trial involved 40 people who were at risk for atherosclerotic cardiovascular disease. They followed two vegan diets, each for four weeks with a one-week washout period.

In one diet, participants used four tablespoons of California Olive Ranch extra virgin olive oil each day. They were instructed to consume the olive oil raw; otherwise, no direction was given on when or how to consume it. In the other diet, participants were told to use as little olive oil as possible, less than one tablespoon daily.

Both diets included whole fruits, vegetables, whole grains, legumes, nuts and seeds, excluding animal-based foods.

Between the two diet phases, participants had a one-week washout period in which they were allowed to return to their usual eating habits. This break is a common research practice to ensure that the first diet does not affect the results of the second one.

Researchers collected data on participants’ metabolism, clinical health, behavior and diet at the start and end of each diet period. As participants followed each diet, researchers measured how each affected them personally.

“Prior studies have shown that the processing of olive oil, spanning from refined to virgin to extra virgin, can impact lipid and inflammatory markers, so we provide extra virgin olive oil, which is also consumed in Mediterranean diets,” Krenek said.

The scientists found that both diets offered health benefits. “Both the high and low extra virgin olive oil diets reduced heart disease risk factors, including LDL cholesterol levels, compared to typical diets that include animal products,” Krenek said.

LDL cholesterol is often called “bad cholesterol” because it deposits plaque in the artery, which can build up and increase the risk of heart disease.

However, Krenek said there were significant differences between the two diets, particularly in key markers for heart disease risk.

“The low extra virgin olive oil diet yielded greater LDL cholesterol and lipid-lowering compared to the high extra virgin olive oil diet,” Krenek said. “When evaluating by diet order, those who started with the high extra virgin olive oil, then transitioned to the low extra virgin olive oil had a reduction in LDL.”

“In contrast, those who started with the low extra virgin olive oil, then added extra virgin olive oil for the second four weeks, low to high, had an increase in LDL,” she added. “This gave some interesting insight to inform future research questions.”

Overall, both diets reduced several important health markers related to heart health and inflammation.

Participants in the study experienced a reduction in body weight during both diet phases, with more weight loss observed during the low-fat diet.

The researchers said the weight loss suggests that even within a whole-food, plant-based vegan diet, the amount of added fats, including extra virgin olive oil, can affect overall energy balance and subsequent health markers.

The researchers observed increased dietary fiber consumption during both diet phases, which they said helped lower LDL cholesterol.

They added that the shift to unsaturated fats from whole foods and reduced saturated fats likely contributed to positive health outcomes.

According to Krenek, the most interesting findings of the study include that “both low and high extra virgin olive oil within a whole food, plant-based vegan diet support heart disease risk reduction compared to standard omnivorous patterns, though lower intake may yield greater lipid-lowering compared to relatively greater intake.”

“The addition of extra virgin olive oil after consuming smaller amounts may impede risk reduction,” she added.

However, Mary Flynn, the founder of the Olive Oil Health Initiative of Brown University’s Miriam Hospital, critiqued the study’s objectives and methodology.

“Extra virgin olive oil does not typically lower LDL cholesterol, and that has been known for a long time. Extra virgin olive oil will increase HDL and improve HDL function,” she said. “Polyunsaturated fats will lower LDL more than monounsaturated fats, but they will also oxidize the LDL, and oxidized LDL contributes to atherosclerosis.”

Flynn added that extra virgin olive oil’s primary health benefits regarding cardiovascular disease come from its phenols and not the fat.

She pointed to the results of a 2023 review for which she was the lead author. The study found that “extra virgin olive oil can decrease LDL‑c for baseline values greater than 120 milligrams per deciliter and increase HDL‑c with a linear increase with higher total phenol content” compared with other dietary fats or low-fat diets.

“Diets including daily extra virgin olive oil are effective for weight loss and long-term weight management,” the researchers wrote. “In addition, an extra virgin olive oil with a total phenol content of at least 150 milligrams per kilogram has been shown to decrease LDL oxidation.”

“While a diet that includes vegetable seed oil may decrease LDL more than extra virgin olive oil, a diet that includes daily extra virgin olive oil will produce healthier LDL as the particles will be larger and are less likely to be oxidized,” they added.

Flynn said one limitation of the study published in JAHA was the lack of details about the olive oil used. Researchers did not publish the phenol count, which Flynn said is essential for any study investigating the relationship between extra virgin olive oil and health outcomes.

Flynn also critiqued the researchers’ assessment of caloric and nutrient intake. She said diet recall is not the best way to assess calories since people’s memories of what and how much they have eaten in the past 24 hours are known to be flawed.

Finally, she added that weight before and after both sets of trials in the cross-over study was not recorded, which makes it more difficult to compare the results of the two diets for each grouping.

“I don’t find the study useful,” she said. “It doesn’t add to the literature in either direction.”

“There’s a lack of knowledge surrounding extra virgin olive oil, which is driven by health policies in this country,” Flynn added, noting that the American Heart Association has long advocated for low-fat diets irrespective of the type of fat consumed.

“Extra virgin olive oil is a different food. It’s the juice of the olive,” she said. “It’s the only food we have that has this range of health benefits. There’s no medicine or no food that can compete with extra virgin olive oil.”

For her part, Krenek cautioned against oversimplifying the results of the study.

“It’s always important to note big picture diet context, preferences and risk level in practice, as most people aren’t comparing between extra virgin olive oil and sources of whole food fats, such as avocados, nuts, seeds and olives,” Krenek said.

“The impact on risk factors all depended on what was being compared,” she added, referring to how the diets were measured against the participants’ usual eating habits.

The researchers said this study highlights the importance of focusing on the types of dietary fats and food choices rather than just the amount of fats, carbohydrates and proteins.

They warned of a few limitations of the study, including “a relatively short study period, a sample of predominantly well-educated white women – future studies are needed in larger, more diverse populations – and carryover effects, which means that the health status of participants at the start of the second diet period was not the same as the first.”

The researchers believe that the next steps in studying this area should include expanding the research to different populations and varying levels of heart disease risk.

The study found that greater adherence to the Mediterranean diet was associated with a 30 percent reduction in the risk of death from any cause and nearly a 60 percent reduction in cardiovascular mortality among cancer survivors.

“The impact of adhering to the Mediterranean diet is substantial. This was assessed independently of the therapies each patient received for their tumor,” said Marialaura Bonaccio, a researcher at the Laboratory of Molecular and Nutritional Epidemiology at the Neuromed Mediterranean Neurological Institute in Italy and co-author of the study.

The research letter, authored by a group of Italian scientists and published in JACC CardiOncology, also explored the shared risk factors between cardiovascular diseases and cancer.

“Many individuals who develop tumors also go on to develop cardiovascular diseases,” Bonaccio told Olive Oil Times. “Well-documented evidence suggests common risk factors for these two conditions.”

Both conditions share metabolic risk factors such as inflammation and oxidative stress. The Mediterranean diet, rich in anti-inflammatory and antioxidant foods, addresses these shared pathways.

The research used data from the broad Moli-sani study, which tracked approximately 25,000 adults from the Molise region of Italy for over a decade.

This new research focused on 802 participants, around 60 years old, who had a history of cancer at the start of the study. Their dietary habits and health outcomes were monitored over 13 years.

“All of the individuals we included had a tumor at the time they joined the Moli-sani study, regardless of the type of tumor,” Bonaccio said. “While earlier studies focused on the dietary impacts on specific types of tumors, our study had the advantage of extending the results to all cancer survivors.”

Participants were categorized based on their adherence to the Mediterranean diet, measured using a semi-quantitative food frequency questionnaire, and obtained a MedDiet score.

“Consistent with previous literature, we found that the most significant benefits were observed in those who strictly adhered to the Mediterranean diet,” Bonaccio said. “Occasional adherence did not yield measurable benefits.”

According to the research, patients with higher adherence to the Mediterranean diet tended to have a higher socioeconomic status and were more likely to be physically active. Their all-cause mortality rate was 32 percent lower than the other patients examined by the researchers.

During the 12.7 years of follow-up, a total of 248 all-cause deaths were recorded, including 59 cardiovascular deaths and 140 from cancer.

Researchers acknowledged some limitations to the study, as it is an observational study, meaning causality cannot be inferred directly. They also noted how self-reported dietary intake might be subject to misreporting.

“It was a small group of a given age, and that prevented us from obtaining specific data on cancer types or different impacts at different ages,” Bonaccio said.

According to Bonaccio, one of the study’s highlights is that it relates specifically to a Mediterranean population.

“A lot of research conducted in other countries evaluates the impact of the Mediterranean diet, but it is very interesting to measure them in a Mediterranean context,” she said.

“Mediterranean populations have a culture in which foods are combined in a certain way,” Bonaccio added. “In Italy, we never talk about pasta or legumes alone, as they are always combined. The way food is cooked enhances the nutritional properties of foods.”

On top of that, strict adherence to the Mediterranean diet also means avoiding most ultra-processed products.

“Taking the time needed to prepare a meal, transforming at home the fresh produce, using quality products such as olive oil, all of this does not happen if one looks for ready-to-eat off-the-shelf products,” Bonaccio explained.

The Italian scientist noted how the Mediterranean diet might play a more significant role in the future of nutrition.

“We are seeing more and more people diagnosed with cancer,” Bonaccio said. “That might come from improved diagnostic tools, but it also tells us that more and more people will need to associate a healthy diet with their treatments.”

While more research is needed, Bonaccio also stressed the significant studies currently being conducted, highlighting the role the Mediterranean diet and olive oil might play in the health of cancer patients.

“When we see that Mediterranean diet might reduce by 60 percent fatal stroke events in these patients, and that is just an example taken from our study, that tells us how this might be a good starting point for whoever has to deal with those diseases,” Bonaccio concluded.

CVDs encompass a range of conditions affecting the heart and blood vessels. The most prevalent among these are coronary heart disease, rheumatic heart disease and cerebrovascular disease.

The New York State Department of Health recently reported that about 695,000 Americans die from heart disease annually, representing one in five deaths in the country. Globally, the World Health Organization estimates that cardiovascular disease accounts for 32 percent of all deaths.

While cardiovascular diseases are triggered by various factors, including genetics, pollution and lifestyle, a growing body of research links daily consumption of extra virgin olive oil, the highest-quality olive oil category, to significantly reducing the risk of developing cardiovascular diseases.

The evidence behind olive oil’s decisive impact

A large-scale trial conducted on thousands of individuals in Spain during the 2010s demonstrated that adherence to the Mediterranean diet and daily consumption of olive oil significantly reduce cardiovascular events in at-risk patients compared to a generic low-fat diet.

The PREDIMED (PREvención con DIeta MEDiterránea) study, published in the New England Journal of Medicine, laid the foundations for further research worldwide.

The Seven Countries Study, conducted since the 1950s across the U.S., Finland, Netherlands, Italy, Greece, Yugoslavia and Japan, also confirmed the critical role of olive oil and the Mediterranean diet in reducing cardiovascular diseases.

This extensive epidemiological study involved 12,000 middle-aged men, revealing that daily consumption of unsaturated fats, such as olive oil, and adherence to the Mediterranean diet significantly lower heart disease risks.

These studies confirmed the significant impact of dietary behavior on cholesterol levels and other conditions related to the development of cardiovascular diseases.

As a result of these studies, hundreds of scientific publications have explored the unique role of olive oil in human health in recent decades.

Olive oil’s beneficial effects are attributed mainly to its high content of monounsaturated fats. The polyphenols found in the highest grade of olive oil, extra virgin olive oil, further enhance these health benefits.

The role of monounsaturated fatty acids (MUFAs)

Oleic acid, a monounsaturated fatty acid (MUFA), is a critical component of olive oil and is credited with many of the significant health benefits associated with its consumption.

“It is important to note that extra virgin olive oil consists of 60 to 83 percent MUFAs,” said Bruno Tuttolomondo, a full professor of internal medicine at the University of Palermo and director of the internal medicine with stroke care unit at Policlinico Hospital in Palermo.

“The remaining composition includes small percentages of saturated fatty acids, such as palmitic acid and stearic acid,” he added. “Along with polyunsaturated fats, monounsaturated fats are considered ‘good fats.’”

Tuttolomondo said research indicates that a high percentage of MUFAs play a crucial role in preventing cardiovascular diseases.

“This is because MUFAs influence cholesterol and LDL levels, reduce LDL oxidation and affect the composition of atherosclerotic plaques, thereby exerting a cardioprotective role,” he said.

LDL stands for a low-density combination of fat and protein. It is a type of cholesterol that can accumulate in the bloodstream and form plaques in the arteries, leading to atherosclerosis.

“MUFAs are not the only important components of extra virgin olive oil, but they are the most abundant,” Tuttolomondo said. “This alone qualifies extra virgin olive oil as one of the ‘good fats.’”

Polyphenols are critical to CVD risk reduction

Polyphenols are a diverse group of hundreds of substances found in many foods.

Extra virgin olive oil contains dozens of these polyphenols, which are rare and especially valuable due to their high bioavailability.

This means that, once consumed, they reach areas of the body where they can exert their effects, including potent antioxidant and anti-inflammatory properties.

“Polyphenols certainly play a role in cardiovascular health and are the subject of significant research due to their cardioprotective actions,” Tuttolomondo said.

One of the most researched polyphenols for cholesterol and cardiovascular diseases is oleuropein.

“Many researchers, including [Francesco] Violi’s team at La Sapienza University in Rome, are investigating oleuropein,” Tuttolomondo said. “They discovered that oleuropein helps stabilize lipid plaques and reduce LDL oxidation.”

“They also found that it modulates the impact of diabetes on vascular and cardiovascular health,” he added.

EVOO might enhance diabetes prevention

According to the World Health Organization, 422 million people have diabetes globally. Research has shown that extra virgin olive oil and adherence to the Mediterranean diet can significantly lower the risk of developing the disease.

Diabetes is linked to cardiovascular diseases because it can lead to excessive sugar in the blood, which can damage the blood vessels that supply the heart. This damage can reduce the supply of oxygen and nutrients to the heart, significantly increasing the risk of heart disease.

“For some time, the impact of extra virgin olive oil on diabetes was evaluated indirectly,” Tuttolomondo said. “In numerous studies, including those conducted by my research group, we analyzed adherence to the Mediterranean diet, which considers extra virgin olive oil the primary fat. It is well known that adherence to the Mediterranean diet results in a lower incidence of diabetes.”

Further research has built on these findings. “We now know that extra virgin olive oil and phenols such as oleuropein have effects similar to some compounds used in diabetes therapies, as they increase insulin sensitivity,” Tuttolomondo said.

“We now have strong evidence of the preventive role and regulation of glycemic levels by daily and regular consumption of extra virgin olive oil, especially when consumed for many years,” he added.

“While you cannot expect to lower blood sugar by simply eating a salad with extra virgin olive oil, daily, familial and traditional consumption of extra virgin olive oil has proven effective in reducing the prevalence of diabetes,” he noted.

Olive oil is the healthier, tastier fat choice

“One of the unique qualities of extra virgin olive oil is its flavor. In addition to its wide-ranging health benefits, it also offers an exquisite taste,” Tuttolomondo said. “No other cooking fat combines favorable organoleptic properties with beneficial nutrients like extra virgin olive oil. It is a small miracle, combining health and taste.”

However, he emphasized that other fats can also benefit human health.

“Consider polyunsaturated fats like Omega‑3 and Omega‑6, which have been shown to play a role in cardiovascular disease prevention. Still, none of them compare to extra virgin olive oil in daily use,” Tuttolomondo said. “Extra virgin olive oil is the centerpiece of every lunch and dinner for those who follow the Mediterranean diet.”

“When we talk about Omega‑3 and Omega‑6, we think of fats from blue fish or almond extracts. While some people eat five almonds for lunch, it’s impractical to base a diet on almonds,” he added.

Healthy fats like pumpkin seed or flaxseed oil have beneficial profiles but do not offer the same organoleptic properties as extra virgin olive oil.

“They are beneficial fats, but consider flaxseed oil; it has no flavor, so it cannot motivate people through taste,” Tuttolomondo said. “In my opinion, we need to attract people to prevention by appealing to their sense of taste.”

Meanwhile, avocado oil has been the subject of several studies. “From a palatability standpoint, it is virtually flavorless,” Tuttolomondo said. “It contains a significant amount of polyunsaturated fats, but I don’t think there are enough studies on its polyphenolic content.”

How much extra virgin olive oil should be consumed?

Extra virgin olive oil should be consumed daily to reap its health benefits.

However, not all extra virgin olive oils are the same. While oleuropein and other polyphenols can significantly benefit human health, the amount and type of phenols vary among extra virgin olive oils.

“Polyphenol content depends on factors including cultivar, cultivation area, processing methods, and external temperature,” Tuttolomondo said. “There is a threshold of polyphenol content that characterizes a high-quality extra virgin olive oil.”

“Polyphenols are one of the criteria for evaluating extra virgin olive oil,” he added. To have a significant effect, it should contain no less than 250 to 350 milligrams per kilogram.”

“It has been hypothesized that higher levels of polyphenols correspond to greater cardioprotective effects,” Tuttolomondo continued. “However, we should always remember the key role played by MUFAs, which are the foundation of all extra virgin olive oils.”

While excessive olive oil consumption can lead to excessive calorie intake, researchers have worked to define recommended daily doses of extra virgin olive oil.

“Many studies indicate that 20 grams of extra virgin olive oil can optimize the benefits of the Mediterranean diet,” Tuttolomondo said. “This equates to about one to one and a half tablespoons.”

“However, intervention studies have evaluated up to four tablespoons per day for cardiovascular effects,” he added. “Considering weight regulation and overall caloric intake, I would say that the more extra virgin olive oil we consume, the better.”

• World Health Organization
• New York State Department of Health

The research suggests these lifestyle changes impact cardiovascular health by altering the colon’s bacterial composition and metabolite production.

The findings represent a substantial advancement in understanding preventive measures against cardiovascular diseases, which are the primary cause of death in developed nations.

The Mediterranean diet has long been associated with positive gut microbes and metabolites, yet its effect on the fecal metabolome is poorly understood.

The traditional Mediterranean diet involves a high intake of vegetables, fruits, legumes and nuts, moderate consumption of fish, low consumption of meat, moderate alcohol and extra virgin olive oil as the primary fat source.

Greater adherence to the Mediterranean diet correlates with beneficial gut bacteria and metabolites, attributed to increased fiber-degrading species and anti-inflammatory responses.

However, its effects on gut microbiota and plasma metabolome are inconsistent across studies, with unclear impacts on cardiovascular disease risk factors.

With the latest study, researchers aimed to assess the weight-loss impact of a year-long lifestyle intervention based on an energy-reduced Mediterranean diet with physical activity (intervention group) compared to an ad libitum Mediterranean diet (control group) on fecal metabolites, microbiota and their links to cardiovascular disease risk factors.

The intervention affected four stool metabolites, primarily composed of bile acids, ceramides, sphingosines, fatty acids, carnitines, nucleotides and purine and Krebs cycle metabolites.

The study involved 400 participants aged 55 to 75 at high cardiovascular risk, and data were collected at baseline and after a year.

The researchers found that the intervention group exhibited greater weight loss and improved cardiovascular risk factors compared to the control.

These changes were associated with alterations in cardiovascular disease risk factors. Moreover, certain gut bacteria genera were reduced, and alpha diversity increased in the intervention group.

The study’s results suggested an interplay between diet, metabolites and gut microbiota. While previous studies focused on plasma or urine metabolites, few explored the fecal metabolome.

Results from participants with obesity and metabolic syndrome indicated reductions in plasma cholesterol and fecal bile acid (metabolites involved in nutrient absorption) concentrations after the Mediterranean diet intervention.

The intervention enriched gut bacterial genera linked to bile acid metabolism and increased fecal cadaverine, which is associated with improved insulin sensitivity.

Participants in the intervention group showed more significant reductions in adiposity (fat tissue accumulation) and improvements in lipid profile and glucose markers.

Furthermore, decreases in the abundance of E. hallii and Dorea spp. were observed in the intervention group, linked to changes in fecal metabolites and cardiovascular risk factors.

E. hallii is implicated in glucose metabolism and insulin resistance, while Dorea spp. is associated with prediabetes and elevated blood glucose levels.

The researchers acknowledged that the study had some limitations. The participants were older Mediterranean adults with specific health conditions, so generalizing the results to other populations may not be appropriate.

Additionally, the sequencing method used in the study limits taxonomic profiling to the genus level, hindering differentiation between closely related bacteria and limiting the ability to infer functionality.

However, the study has notable strengths. Despite the non-representative sample, the findings are relevant for a significant portion of the global population at high risk of cardiometabolic diseases.

The randomized controlled design allowed for establishing causality and assessing intervention effects, with adjustments made for significant confounders, reducing residual confounding. Although the sequencing method has limitations, it is suitable for analyzing many samples.

Beyond individual health outcomes, the researchers said understanding the impact of these interventions on the gut microbiome sheds light on mechanisms underlying improved cardiometabolic biomarkers.

They hope this knowledge will inform targeted public health strategies and personalized health recommendations, tailoring interventions based on individual microbiome profiles for more effective prevention and management of cardiometabolic diseases.

• Ciberdem

The researchers carried out an umbrella review – a systematic review of previous reviews – of 45 pooled meta-analyses from 14 published review articles on the link between UPF and adverse health outcomes.

All the reviewed articles were less than three years old and included research data from almost 10 million people.

Previous research has associated highly processed food with poor health; however, no comprehensive review has yet assessed the accumulated scientific evidence.

In their research paper, published in the Journal of the British Medical Association (BMJ),
they found that higher consumption of UPFs can lead to a higher risk of a range of health conditions, including cardiovascular disease, mental disorders and even mortality.

“Consistent evidence shows that higher exposure to ultra-processed foods is associated with an increased risk of 32 damaging health outcomes including cancer, major heart and lung conditions, mental health disorders and early death,” Melissa Lane, the study’s lead author from Deakin University in Australia, told Olive Oil Times.

Some of the most common ultra-processed foods are mass-produced bread, sweetened cereals, ice cream, soft drinks, biscuits, sausages and instant soups.

More specifically, the researchers graded their evidence as convincing, highly suggestive, suggestive, weak, or no evidence if no association is established between the consumption of UPF and health issues.

Their review showed there is convincing evidence that higher UPF intake is directly associated with an almost 50 percent increased death risk due to cardiovascular disease and a 12 percent higher risk of type 2 diabetes.

Higher UPF consumption was also linked to a 21 percent increased risk of death from any cause and a 22 percent higher risk of depression, based on highly suggestive evidence.

The study also linked UPF to asthma and some types of cancer, although it stated that the evidence for this connection was limited.

UPF is also gaining ground among consumers worldwide, though its penetration is not ubiquitous in all countries and regions examined.

In some high-income countries, such as the United States and Australia, UPFs account for up to 58 percent and 42 percent of the total daily energy intake (the calories from available food). At the same time, they have also infiltrated the diets of many low- and middle-income countries such as Colombia and Mexico.

“Over recent decades, the availability and variety of ultra-processed products sold have substantially and rapidly increased in countries across diverse economic development levels, but especially in many highly populated low- and middle-income nations,” the authors wrote.

The study also shed some light on the mechanism underpinning the connection between UPF dietary patterns and poor human health, which requires further investigation as the researchers stressed.

They explained, nevertheless, that as ultra-processed foods displace more nutritious foods in diets such as fruits, vegetables, legumes and nuts, they reduce the intake of beneficial bioactive compounds, including polyphenols and phytoestrogens, which are estrogen-like compounds derived from plants and plant-based foods.

The resulting nutrient-deficient dietary pattern can lead to chronic disease development through various mechanisms in the human body, including inflammation.

“Ultra-processed foods, including packaged baked goods and snacks, fizzy drinks, sugary cereals and ready-to-eat or heat products, undergo multiple industrial processes and often contain colors, emulsifiers, flavors and other additives,” Lane said. “These products also tend to be high in added sugar, fat and salt but low in vitamins and fiber.”

Although some experts doubt whether the study establishes a cause-and-effect relationship between the consumption of UPF and poor health, others have supported its findings.

According to Chris van Tulleken, associate professor at University College London and leading expert on UPFs, who was not involved in the study, the findings are consistent with an ‘enormous number of independent studies’ that link a diet high in UPFs to a wide range of damaging health outcomes.

“We have a good understanding of the mechanisms by which these foods drive harm,” van Tulleken told The Guardian. “This is partly because of their poor nutritional profile – they are often high in saturated fat, salt and free sugar.”

Scientists have also suggested that a practical way to identify ultra-processed food is to review the ingredients list for constituents rarely or never used in a home kitchen, such as hydrogenated oils and high-fructose syrup or additives, such as flavor enhancers and artificial colors, that make the food product more palatable.

However, the common denominator of all highly processed foods is that they are almost exclusively produced on an industrial scale and contain several ingredients and substances rather than the intensity of processing their ingredients undergo.

Fruit-flavored yogurt, for example, which is classified as UPF, is hardly more processed than plain yogurt, except for the addition of extra ingredients.

The study authors noted that their umbrella review has certain limitations and further randomized controlled trials are required to establish causality.

They also said that their study’s findings are sufficient to urge governments and public authorities to take action to reduce people’s exposure to UPF and promote healthy eating.

“We note the consistent trend linking ultra-processed foods to poor health outcomes is sufficient to warrant the development and evaluation of government-led policy and public health strategies aimed at targeting and reducing dietary exposure to ultra-processed foods,” Lane said.

Nonetheless, in recent years, countries worldwide have recognized the importance of the widespread use of a healthy eating pattern in the population, including foods such as fruits, vegetables, legumes and whole grains in the dietary guidelines for their citizens.

Research has also indicated that a healthy eating pattern like the Mediterranean diet can be more cost-effective than other standard diets while offering higher nutritional value.

• The Guardian
• Euronews
• Future Learn

The study, published in Cardiovascular Diabetology, also confirmed metabolite profiles of virgin olive oil are associated with a lower risk of developing the disease than refined olive oil metabolite profiles.

The analysis was part of the PREDIMED study, a landmark clinical trial conducted in Spain that demonstrated the association between following a Mediterranean diet rich in extra virgin olive oil and cardiovascular health.

The study used data from about 2,000 participants, all at high risk of cardiovascular disease, who provided dietary information and blood samples.

The findings come from an investigation into the metabolomic profiles associated with the regular consumption of different types of olive oil. Metabolomics is the study of small molecules, known as metabolites, within cells.

Plasma metabolites are found in blood; researchers identified a pattern in their expression when olive oil is consumed.

Researchers employed machine learning to analyze the plasma metabolite profiles of olive oil consumption. They then correlated these profiles with the risk of type 2 diabetes and cardiovascular disease.

“Plasma metabolites are the result of various metabolic processes,” Marta Guasch-Ferré, co-author of the study and researcher at the University of Copenhagen’s public health department, told Olive Oil Times.

“Thanks to new metabolomic technologies, we can identify them just as in the past we identified biomarkers such as cholesterol or triglyceride,” she said. “Today, we can investigate those molecules and have a clearer picture of what is happening in the blood.”

“Plasma metabolites can change depending on factors such as what we eat. And they can help us predict the insurgence of diseases way ahead of their manifestation, even years or many years before,” Guasch-Ferré added.

While metabolites in the human body exist and form in many different states, exerting a range of distinct functions, researchers focused on those that correlated with nutrition, responded to dietary intake and could play a role in specific biological processes.

“We found some metabolites that were the same across the different kinds of olive oil, and others which were different and specific for each grade of olive oil,” Guasch-Ferré said.

“That is part of the novelty of this research. We identified what we call metabolomic signature, a cluster of different metabolites that include lipids, amino acids and others associated with different origins,” she added. “The metabolomic profile we found for extra virgin olive oil was also inversely associated with the risk of contracting cardiovascular disease in the future.”

Research from the PREDIMED study has already shown how extra virgin olive oil consumption has a healthy impact on cardiovascular disease.

“Adding the layer of new knowledge about the specific plasma metabolites, we can better understand the correlation between extra virgin olive oil and the biological processes it triggers. We can see those metabolites as a response to extra virgin olive oil intake,” Guasch-Ferré said.

Virgin olive oil consumption was found to lower cardiovascular disease risk, but it did not significantly affect type 2 diabetes risk. In contrast, the profile associated with refined olive oil consumption was associated with an increased risk of cardiovascular disease.

While the study focused on a sample of at-risk populations, the researchers noted how the beneficial impact of virgin and extra virgin olive oils goes way beyond such a specific sample.

“We all know how healthy extra virgin olive oil is for the general population,” Guasch-Ferré said. “What is less known, and it is part of ongoing research, is that even in small quantities, virgin olive oil consumption might carry significant benefits.”

“In populations who do not follow the Mediterranean diet or do not consume olive oil in the volumes typically consumed in olive oil-producing countries such as Spain or Italy, a healthy impact can still be detected,” she added.

For example, research published in 2020 in the United States suggested that consuming half a tablespoon of olive oil daily might prevent cardiovascular disease among people not considered at risk.

“In PREDIMED, average olive oil consumption was about 30 grams per day, while in the U.S. study, it did not exceed 10 grams,” Guasch-Ferré said. “Still, the benefits were there, and we could see how consuming olive oil was better than, for instance, butter.”

“From a public health perspective, there are significant benefits to quality olive oil consumption for all population segments,” she concluded.

The researchers analyzed data from 1,001 United Kingdom-based participants. They found that higher-quality snacking, including consuming foods closely associated with the Mediterranean diet, was linked to better blood lipid and insulin responses.

According to Kate Bermingham, a researcher and study presenter at ASN, the research was part of a more extensive study known as PREDICT, the largest personalized nutrition study in the world.

“The aim of this snacking study was to answer key questions relating to whether the act of snacking per se is associated with unfavorable cardiometabolic health outcomes or whether the quality of snack foods is more important,” she told Olive Oil Times.

“To date, surprisingly little has been published on snacking despite it accounting for 20 to 25 percent of energy intake, making this a valuable resource paper which we hope will be of interest,” Bermingham said, adding that more than two-thirds of people reported snacking daily.

Simon Poole, a physician and nutrition instructor for the Olive Oil Times Education Lab, who was not involved in the study, agreed that the study’s results are fascinating.

“The results appear to show that it is possible to see differences in markers of good health such as blood glucose, cholesterol, triglycerides, and insulin resistance based on peoples’ reported snacking habits,” he told Olive Oil Times. “Higher-quality snacks were associated with better results, even though the period of the study was only a few days.”

“We found that the amount you snack didn’t have a major impact on health,” Bermingham added. “It was the quality of snacks that was linked with your health.”

The time that people snack is a critical factor; snacking late at night reduces overnight fasting time and is associated with unfavorable blood sugar and fat levels. Snacking is an independent modifiable dietary feature that may be targeted to improve health.

According to Medical News Today, the study participants were approximately 73 percent female, with an average body mass index (BMI) of 25.6, classified as slightly overweight.

Data relied on self-reporting of quality, quantity and timing. Participants self-reported cardiometabolic markers, including blood lipids, glucose and insulin levels.

“High cholesterol levels and markers of poor glucose metabolism observed in this study with low snack quality have been linked with an increased risk of heart disease and type 2 diabetes,” Poole said.

High-quality snacks were foods containing significant amounts of nutrients relative to calories. For the study, participants monitored their snack intake over two to four days.

On average, 95 percent of the participants ate at least one daily snack. The average of snacks per day was 2.28, making up about 22 percent of daily calories.

“Many people believe snacking is an unhealthful dietary behavior,” Bermingham said. “This research addresses key questions on whether snacking is associated with unfavorable health outcomes or whether it is all about the quality of foods eaten as a snack.”

“This work is particularly timely given the growing habit of snacking, a huge variety of snack foods on the market and the prevalence of nutrition-associated disease,” she added.

Poole said that while snacks contribute a small part of a person’s total dietary intake, they still have a tangible impact on health markers.

“Advertisers of poor-quality processed snacks might encourage consumers to believe that such ‘treats’ can be part of a healthy lifestyle, but it is clear that regular consumption can have negative effects,” he said.

According to the Harvard T.H. Chan School of Public Health, snacks may be part of a healthy diet but can also lead to health problems. Ideal snacks often feature nutrient-dense snacks such as raw vegetables, fresh fruit, nuts and plain yogurt.

Harvard outlines a self-directed process to incorporate snacks into a meal plan and ensure snacks are working beneficially in the overall diet.

The steps involve self-reflection and mindfulness to understand the mechanisms of snacking. Self-inquiry includes understanding when snacking occurs, why snacking occurs, what snacks are satisfying, and how much is enough to satisfy snacking urges.

Harvard describes the qualities of different snacks by their characteristics, such as crunchy, creamy, sweet or savory. Within each quality, consider nutritious snack selections to satisfy a particular quality. For instance, crunchy snacks could include raw vegetable sticks, nuts, seeds, whole grain crackers or an apple.

In addition to quality, snack timing plays a significant role in blood glucose and lipid levels. The U.K. researchers found that consuming most snacking calories after 9 p.m. was linked to worse blood glucose and lipid levels.

The researchers noted that snacking frequency, calorie count, or food quantity were not linked with any measures of cardiometabolic health.

Snacks, especially quality snacks, can contribute to health and nutrition. Rather than being considered a problematic category, snacking can be reframed as a time to enhance nutritional quality.

“There is nothing wrong with snacking when good quality foods are consumed such as a piece of fruit, vegetables like carrots or celery dipped in hummus, a few olives or a handful of unsalted nuts,” Poole said.

Poole shared his go-to combination for a healthy snack as a Mediterranean diet specialist.

“My favorite Mediterranean-style snack combines fresh berries, nuts, and seeds with Greek yogurt and a sprinkle of nutmeg,” he said.

“This provides a satisfying and tasty combination of ingredients beneficial for glucose metabolism, insulin sensitivity, and the gut microbiome, with healthy fats beneficial for cholesterol levels as well as plenty of polyphenol compounds that have beneficial antioxidant and anti-inflammatory effects,” Poole added.

This new research highlights that snacking quality is more important than the quantity or frequency of snacking.

“Advising the public to choose high-quality snacks such as nuts over highly processed unhealthful snacks is likely beneficial,” Bermingham said. “Another important factor is the timing, with late-night snacking unfavorable for health.”

“This may mean that universally, snacking late in the evening and interrupting the overnight fasting window is detrimental to health,” she concluded.

• King’s College London
• Medical News Today
• Harvard T.H. Chan School of Public Health

“The improvement in fitness we observed in participants with better diets was similar to the effect of taking 4,000 more steps each day,” Michael Mi, a cardiologist at Boston’s Beth Israel Deaconess Medical Center and study author, told Medical News Today.

Mi describes the study as observational, exploring the relationship between diet, fitness and metabolism.

The data suggests that eating a healthy diet may be associated with better metabolic health. The study examined participants’ blood samples for metabolites associated with poor diet or favorable diet and fitness.

While the metabolic data confirms that eating healthily is related to better fitness, it was inconclusive that eating well caused better fitness or that better fitness inspired healthier eating.

Researchers studied 2,380 people in the Framington Heart Study, 54 percent of whom were women with an average age of 54.

Participants were evaluated for physical fitness, food frequency, fasting blood concentrations of 201 metabolites and a dietary quality evaluation.

The dietary quality was assessed by two measures associated with good heart health: the Alternative Healthy Eating Index (AHEI) and the Mediterranean-Style Diet Score (MDS). In both indexes, the higher score indicates a better outcome.

According to Natalie McCormick, a medical research fellow at Harvard Medical School, “AHEI is more oriented toward reducing the risk of chronic disease.”

Researchers examined the connection between fitness and diet, evaluating factors such as daily physical activity level, energy intake, body mass index, smoking status, cholesterol, blood pressure, diabetes, age and sex.

Compared to an average score, the data for AHEI was 67, an increase of 13 points. The data for MDS was approximately 12, a five-point increase above the average.

Getting 10,000 steps per day is considered the gold standard for health. However, Jack Craig, a certified personal trainer for Inside Bodybuilding, told Medical News Today the average number of steps per day most sedentary people are getting in the United States is 4,000.

“Mediterranean diets are among the most notorious heart-healthy diets,” he added. “They are rich in ingredients. Walking throughout the day, even in short five-minute breaks, can reduce blood pressure and blood sugar, as well as elevate your mood.”

Walking is a top recommendation from the American Heart Association (AHA) and provides an important stimulus for balance, bone density, flexibility and muscle development.

AHA notes that 10,000 steps a day may seem too intimidating for beginners. However, Amanda Paluch, an assistant professor at the University of Massachusetts’ School of Public Health and Health Science, said 5,000 to 6,000 steps may benefit heart health.

“The message is to move more,” Paluch said. “Just getting incremental increases in your steps could be meaningful in your cardiovascular health.”

According to a Stanford study, walking boosts creative inspiration. The study found that creative thinking skyrocketed by 60 percent.

To take this into daily practice, Stanford researchers recommend looking for opportunities to swap sitting for standing. For example, consider turning a work meeting into a walking meeting. Find ways to integrate bursts of physical activity into the day.

Ruth Mercurio, the owner of We Olive and a former member of the board of directors for the California Olive Oil Council, told Olive Oil Times that her company promotes the Food and Drug Administration’s qualified health claim for olive oil.

“At We Olive, we proudly promote the FDA’s recommendation of consuming at least two tablespoons of extra virgin olive oil daily for longevity, as it unlocks many wonderful health benefits.

“Extensive studies over the past 50 years consistently reveal that incorporating extra virgin olive oil into your diet significantly lowers the risk of heart disease, stroke and mortality,” she added. “Additionally, it aids in regulating insulin levels, strengthening the immune system, reducing the risk of certain cancers and promoting improved digestive and brain health.”

Shaana Rahman, the owner of BoccaBella Farms, told Olive Oil Times that research into the antioxidants and anti-inflammatory bioactive compounds in extra virgin olive oil continues to return exciting results.

“The process of making a true extra virgin olive oil protects the phenols in the olive oil, which are thought to be one of the keys to extra virgin olive oil’s health benefits,” she said. “It’s so important for people to understand the difference in grades of olive oil and how the olive oil is processed, as that can make a big difference in the potential health benefits.”

According to Kathy McManus, director of the Department of Nutrition at Brigham and Women’s Hospital, it is easy to incorporate healthy AHEI foods into the daily diet.

Top choices to focus on include vegetables, fruit, whole grains, vegetable protein, fish and healthy fats.

In a Harvard Medical School interview, McManus offers suggestions for easy dietary upgrades.

She suggested choosing five vegetables a day. Aim for four servings of fruits daily and five to six servings a day of whole grains. Emphasize vegetable protein and a weekly dose of fish. Enjoy the benefits of unsaturated fats, such as olive oil. Swap saturated fats such as butter in favor of healthy oils.

“An easy way to incorporate olive oil into your health routine is by adding two tablespoons into your morning smoothie,” Rahman said.

Richard and Myrna Meisler, owners and farmers of the San Miguel Olive Farm, shared a unique perspective on the health benefits of high-quality extra virgin olive oil.

“Richard is celebrating his 85th birthday on Friday, and Myrna just turned 84,” they said. “We are full-time users of our healthful olive oil and work pretty much full-time in our business. Twenty-one awards at NYIOOC World Olive Oil Competition… that should tell the story.”

• Harvard Medical School
• Medical News Today
• Stanford University

In addition, the survey found that one in 10 Americans consider fast food the most heart-healthy diet, with parents twice as likely to opt for a fast food diet than non-parents.

On the other hand, only 15 percent of the respondents were aware of the health benefits of the Mediterranean diet.

The researchers polled 1,000 Americans aged 18 years or older from various U.S. regions and of different ethnicities, education levels and household incomes.

Forty-six percent of participants responded that healthy food is comparatively expensive.

Another significant barrier for Americans when opting for a healthy eating pattern is the lack of time for preparing healthy meals, cited by 23 percent of the participants.

One in five survey participants also identified the lack of knowledge of healthy cooking practices as a barrier to healthy eating, despite that almost two-thirds (70 percent) responded that they prepare meals at home at least four days a week.

The survey also showed that access to healthy food is more challenging for Black Americans than White Americans (20 percent compared to 15 percent).

“In today’s fast-paced world, Americans are pressed for time, and as a consequence, heart-healthy diet and exercise choices may be impacted,” Cleveland Clinic said in a press release. “The survey found that many Americans are unclear on which diets are healthiest for their hearts.”

The Centers for Disease Control and Prevention, the national public health agency of the United States, says heart disease is the most common cause of death among men, women and people of most racial and ethnic groups in the United States.

According to Julia Zumpano, a registered dietician at the Cleveland Clinic, people in the U.S. are highly exposed to food ingredients widely considered unhealthy.

“The SAD diet (Standard American Diet) is very high in saturated fat and simple sugars and inadequate in fruit, vegetables, legumes and fish,” she told Olive Oil Times. “SAD diet includes a large amount of processed and convenience foods.”

Zumpano also identified various reasons behind Americans considering fast food eating a healthy pattern.

“It is a combo of lack of information and convincing themselves that potatoes (fries) are a vegetable,” she said. “I think that some Americans feel that some choices at fast food can be considered healthy (yogurt parfait, salad, soup, etc.), therefore can classify it as healthy food.”

On the other hand, the dietician attributed the low level of awareness Americans exhibited of the Mediterranean diet’s health benefits to a lack of information.

“[The fact that only 15 percent of respondents were familiar with the heart-healthy benefits of the Mediterranean diet] was very surprising to me,” she said. “I do feel that people are unfamiliar with what a Mediterranean diet entails, therefore, may not consider it healthy due to lack of understanding.”

She also noted that it took a long time before the health benefits of the Mediterranean diet were acknowledged.

“The Mediterranean diet tends to be higher in fat, which for decades was not considered healthy,” she said. ”People may not realize the importance the type of fat plays on heart health.”

Meanwhile, an independent survey carried out last year by Finance Buzz, a personal finance online service, found that a plurality of survey participants (35 percent) were willing to try the Mediterranean diet even though the cost of buying healthy food weighs heavily on them.

According to dietician Kelly LeBlanc from Oldways, a nonprofit organization that promotes cultural food traditions, the Mediterranean diet is not as expensive as it might appear when broken down to its core.

“The Mediterranean diet is based on ‘peasant foods’ like legumes, whole grains and seasonally available vegetables, which are consistently less expensive than meat and highly processed snack foods,” LeBlanc said.

“Families trying to eat healthy on a budget can take many lessons from the resourcefulness of traditional Mediterranean cooking.”

On the other hand, Zumpano noted that the rising cost of buying healthy food is a deterrent for people in the U.S. trying to eat healthily.

However, she pointed out that by removing unnecessary items from their shopping lists, Americans can free up more money for purchasing healthy food.

“I do feel that some foods associated with being healthy can cost more, although traditional whole foods such as produce (fresh, frozen or canned without added salt or sugar), grains, legumes, nuts and seeds, meats and plant oils should be foundational,” she said.

“When other snack foods and beverages – such as soda, chips, crackers, dry cereal bars – are avoided, this leaves extra money to purchase the whole foods.”

Reflecting on the survey’s findings, Samir Kapadia, chairman of cardiovascular medicine at the Cleveland Clinic, noted that most heart disease is preventable through a healthier diet, regular exercise, and not smoking.

“We want to emphasize how important it is to make a heart-healthy lifestyle a priority for everyone,” Kapadia added. “While years of poor diet and exercise choices can damage the heart, there’s always an opportunity to adopt a healthier lifestyle.”

• Cleveland Clinic
• Finance Buzz
• U.S. News & World Report

Tedros Adhanom Ghebreyesus, the WHO director general, warned that many countries have not yet developed policies to eliminate the ubiquitous presence of trans fatty acids from processed food.

According to the WHO, 500,000 deaths are caused annually by trans fats in common processed foods.

Ghebreyesus noted how early adopters of laws that ban trans fats, such as Denmark, have decreased the incidence of cardiovascular disease and fatal heart attacks significantly.

Ghebreyesus referred to research recently published in Plos One, which found an 11-percent decrease in trans-fat-related mortality in Denmark from 1991 to 2007.

The WHO chief said trans fat could easily be replaced in baked foods, frying oils, fried foods and solid fats, including margarine and vegetable ghee.

Ghebreyesus added how high-oleic vegetable oils should be the primary alternative since they are “healthier, no more expensive and taste good too.”

In the WHO’s documents about replacing trans fat, the organizations’ authors listed vegetable oils such as canola and rapeseed among the main alternatives, followed by sunflower, corn and soybean.

They explained that other healthier oils, such as olive oil, are not considered on a global scale as efficient replacements as they “are not used extensively because of their limited availability and high cost.”

According to International Olive Council data, global olive oil production and consumption has reached about 3 million tons in the past few years. While these figures have tripled in the last six decades, they represent only a fraction of the global vegetable oils volumes.

Figures released by the Organization for Economic Cooperation and Development (OECD) show that global vegetable oil consumption reached almost 210 million tons and is projected to exceed 246 million tons by 2029.

According to WHO, more than 100 countries are still failing to remove or decrease trans fat in their food supplies. As a result, the WHO estimates that approximately five billion people are still exposed to the harmful effects of trans fats.

No progress has been made in some countries where trans-fat-induced cardiovascular disease is believed to hit the highest: Australia, Pakistan, Iran, Egypt, Azerbaijan, South Korea, Bhutan, Nepal and Ecuador.

The WHO has proposed two policy alternatives to its member countries. The first is focused on limiting trans fat to a maximum of two grams per 100 grams of total fats in food. The second is to ban the production or use of partially hydrogenated oils, considered the most relevant source of trans fat.

Ghebreyesus praised the 2019 decision by the United States Food and Drug Administration, which labeled trans fats as an excessive risk to human health, which created a de facto ban.

“To date, more than 40 countries accounting for more than one-third of the world’s population had implemented one of WHO’s best-practice policies on trans fat,” Ghebreyesus wrote.

“A further 17 countries, with an additional 400 million people, are using less restrictive policies but are still on a good path towards implementing WHO’s package of recommended best practices,” he added.

Among the progress being made, Ghebreyesus highlighted the commitment of the International Food and Beverage Alliance to eliminate trans fat from their members’ products – including The Coca-Cola Company, Unilever, Nestle, McDonald’s and Ferrero – by 2023.

• Director General’s note
• Who Report

However, not all olive oil is created equally. Most celebrated health benefits of olive oil belong to a single grade: extra virgin olive oil.

Extra virgin olive oil is made solely by mechanical methods, without heat or powerful petrochemical solvents used to produce refined olive oil and nearly every other edible oil. As a result, extra virgin olive oil retains the compounds that endow its numerous health benefits.

Thousands of studies have been published linking extra virgin olive oil consumption with a wide range of benefits, from its well-known heart-healthy qualities to more obscure ones, such as increasing testosterone in men with insufficient levels.

But what is it that makes extra virgin olive oil better than the rest? And why exactly is Homer’s “liquid gold” good for you?

Monounsaturated fats promote heart health

For thousands of years, the people of the Mediterranean basin have consumed olive oil as the main source of dietary fat.

Anecdotal evidence suggested they lived longer and healthier lives than their animal-fat-consuming neighbors to the north and across the Atlantic.

In 1958, Ancel Keys, a physiologist at the University of Minnesota, postulated a correlation between people’s diets and the observed incidents of coronary heart disease.

Keys’ landmark Seven Countries Study was the first to suggest that not all dietary fats are created equal.

The study’s findings showed that Greeks had lower rates of heart disease despite their high-fat diet, with olive oil being the main source of fat.

Other countries with high-fat diets from meat had higher rates of heart disease, suggesting that the type of fat consumed made a difference. The findings propelled the Mediterranean diet to popularity and fame outside of the Mediterranean basin.

Olive oil is about 73 percent monounsaturated fat by volume. The other 25 percent is saturated fats (14 percent) and polyunsaturated fats (11 percent).

Monounsaturated fats are fat molecules with fewer hydrogen atoms bonded to their carbon chain and a curved double-carbon bond, which makes them liquid at room temperature.

All fats – from saturated and trans to monounsaturated and polyunsaturated – help the body absorb vitamins and minerals, build cell membranes and are essential for the mechanisms that cause blood clotting, muscle movement and inflammation.

Substituting saturated and trans fat with monounsaturated fat helps to lower low-density lipoprotein (LDL) cholesterol, also known as ‘bad cholesterol,’ which reduces the risk for heart disease and stroke.

In short, the fat type of extra virgin olive oil is mostly comprised is partially responsible for its cardiovascular health benefits.

Polyphenols are the powerful antioxidants that make extra virgin olive oil superior

While its monounsaturated fat content is certainly one of the main drivers behind olive oil’s heart health, its myriad of other benefits are ascribed to its phenolic content.

Polyphenols are attributed to 99 percent of olive oil’s health benefits, according to Nasir Malik, a plant physiologist at the United States Department of Agriculture’s research service.

Polyphenol is an umbrella term for a class of organic chemicals found in several types of plants and works as a powerful antioxidant. More than 8,000 polyphenols have been identified, and extra virgin olive oil has 25 different polyphenols.

Hundreds of studies over the years have shown that polyphenols are responsible for a range of benefits from lowering the risk of prostate and breast cancer to mitigating the effects of dementia.

What does the latest research say about the health benefits of extra virgin olive oil?

New research on the health benefits of olive oil is constantly being published by both publicly funded and private entities. We’ve included some of the most salient points below to help parse the vast amount of information available on the topic.

Extra virgin olive oil and cardiovascular disease

According to the World Health Organization, cardiovascular disease is the leading cause of death globally.

In 2019 alone, an estimated 17.9 million people died from cardiovascular diseases, including heart attacks and strokes. The World Health Organization estimated cardiovascular disease was responsible for nearly one-third of global deaths that year.

However, an April 2020 study published in the Journal of the American College of Cardiology concluded that consuming just a half-table spoon (8.8 milliliters) of olive oil daily could lower the risk of contracting heart disease by 14 percent. Researchers arrived at this result after monitoring health and diet data from 93,000 adults for 24 years.

Although the researchers told Olive Oil Times that it was impossible to know what grade of olive oil the participants consumed (i.e., refined, virgin or extra virgin), they said that the benefits were more likely to have come from EVOO.

Extra virgin olive oil consumption helps to lower the risk of contracting cardiovascular disease in a few key ways.

EVOO improves endothelial function

One small-scale study published by the Yale-Griffin Prevention Center at Yale University in February 2021 found that high-polyphenol extra virgin olive oil consumption improved endothelial function in adults at risk of contracting type 2 diabetes.

Endothelial function measures how well blood vessels expand when blood is pumped through them and is an independent predictor for cardiovascular disease.

The polyphenols in the extra virgin olive oil modulated oxidative stress in the blood vessels, lowering inflammation, a common symptom in many heart disease and stroke patients.

Extra virgin olive oil consumption reduces blood pressure

A separate study from researchers in Australia found that consuming four tablespoons (60 milliliters) of high-polyphenol extra virgin olive oil “significantly reduced” peripheral and central systolic blood pressure.

Previous research published in The Lancet demonstrated that lowering systolic blood pressure reduced cardiovascular disease, coronary heart disease, stroke and heart failure risk.

EVOO lowers ‘bad’ cholesterol and raises ‘good’ cholesterol

Cholesterol is a waxy substance that circulates in the blood and helps to construct cells, make vitamins and produce hormones. There are two types of cholesterol: LDL or ‘bad’ cholesterol and high-density lipoprotein (HDL) or ‘good’ cholesterol.

High LDL cholesterol levels are bad for the cardiovascular system because they contribute to fatty buildups in the arteries – known as atherosclerosis – which increases the risk of heart attack and stroke.

On the other hand, HDL cholesterol carries LDL cholesterol away from the arteries and takes it to the liver to be broken down and removed from the body.

As previously mentioned, the monounsaturated fat in extra virgin olive oil also helps to lower LDL cholesterol.

However, a 2015 study determined that the polyphenols found in extra virgin olive oil also play a significant role by preventing HDL cholesterol from being damaged by oxidative stress, which improves its ability to transport LDL cholesterol away from the arterial walls.

Extra virgin olive oil helps regulate blood glucose levels

An estimated 422 million people have diabetes globally. Of these, about 90 percent have type 2 diabetes.

Type 2 diabetes is caused when cells in the body do not normally respond to insulin, so the pancreas continues to produce more of it to try and elicit a response.

This causes blood sugars to rise to unhealthy levels, leading to other health problems such as heart disease, vision loss and kidney disease.

There is no cure for diabetes, but extra virgin olive oil consumption has been linked to some benefits in diabetic people.

A 2017 study found that participants who consumed high levels of polyphenols had a 57 percent lower chance of developing type 2 diabetes over two to four years.

One of the reasons why the consumption of polyphenols lowered the chances of an individual’s developing type 2 diabetes may be that polyphenols help stimulate insulin secretion, which moves sugar from the bloodstream and deposits it into cells. This keeps blood sugar levels stable.

Furthermore, a 2017 meta-analysis of four cohort studies comprising 15,784 participants found that people who consumed the highest levels of olive oil had a 16-percent reduced risk of type 2 diabetes compared to those who consumed the lowest amounts.

Polyphenol-rich diets are linked to lower fasting blood sugar levels and higher glucose tolerance, reducing the risk of contracting type 2 diabetes.

Olive oil and cancer prevention

Along with cardiovascular disease, cancer is one of the leading causes of death worldwide. According to the WHO, 10 million people died from cancer in 2020.

However, landmark research in 2015 demonstrated that oleocanthal, a polyphenol found in extra virgin olive oil, can disrupt and even kill cancer cells.

Oleocanthal does this by causing a rupture in part of the cancerous cells, which releases an enzyme that causes the cell’s death without harming healthy cells.

EVOO-based treatments show promise in fighting breast and colon cancer

This study had a snowballing effect in the cancer research world and has led to the development of oleocanthal-based treatments against certain forms of breast cancer.

Researchers at the University of Louisiana-Monroe previously found that an oleocanthal-based treatment may suppress the initiation and progression of triple-negative breast cancer, the most deadly kind.

Previous epidemiological studies of Mediterranean populations following a traditional Mediterranean diet rich in extra virgin olive oil found lower cases of breast cancer and colon cancer than other European or North American populations.

A study published in 2014 demonstrated that in a laboratory setting, hydroxytyrosol, secoiridoids and lignans, three types of polyphenols, inhibited the growth of colon cancer cells.

The polyphenols did so by mimicking the signal sent by estrogen receptor β, which is the body’s natural defense against the growth of cancer cells in the colon. The disease only begins to proliferate when the signals this receptor sends fade.

According to the WHO, breast cancer is the most common type of cancer and the fifth-most deadly. Colon cancer is the third most common and second most deadly.

Mediterranean diet associated with lower risk of bladder and prostate cancer

Since the discovery of the role of polyphenols in fighting cancer development in the mid-2010s, plenty of research has been dedicated to the role of the Mediterranean diet in fighting cancer.

Along with EVOO, the Mediterranean diet includes consuming plenty of fruits, vegetables, seeds and whole grains, many of which contain other polyphenols.

A meta-analysis of 13 studies conducted in 2019 found that medium to high adherence to a traditional Mediterranean diet appeared to have a protective effect against bladder cancer.

While the researchers could not isolate any particular food that appeared to be having the desired effects against bladder cancer, experts suggested how the foods combined during digestion and their anti-inflammatory properties played a role in yielding the results.

Consuming a Mediterranean diet has also been associated with a decreased risk of prostate cancer in men. Diets high in trans fats and saturated fats lead to oxidative stress in bladder cells, leading to DNA damage. This DNA damage may lead to cell mutations, causing cancerous tumors.

However, the polyphenols found in extra virgin olive oil and other foods of the Mediterranean diet have the opposite effect, preventing oxidative stress in these cells and, therefore the development of cancerous tumors.

Extra virgin olive oil and dementia

Researchers warn that by 2050, more than 153 million people could have dementia worldwide, nearly triple that of 2019.

However, lower levels of dementia have been observed in populations living in the Mediterranean region for many years.

Observational and controlled trials have shown that adherence to the Mediterranean diet and extra virgin olive oil consumption is associated with improved memory and cognition in the elderly.

Alzheimer’s disease is the most common type of dementia. It begins to occur when deposits of beta-amyloid proteins form plaque in the brain that eventually disrupts nerve cell functions and causes neurons to die.

Laboratory and animal experiments have both demonstrated that oleocanthal promotes the production of two other proteins that play an important role in preventing plaque buildup in the brain.

Further research also showed that oleocanthal modulates the complementary peptide C3a receptor 1 (C3AR1).

In Alzheimer’s patients, C3AR1 overworks and causes inflammation that impairs the function of the innate immune system. The oleocanthal’s anti-inflammatory properties prevent C3AR1 from overworking and reduce the inflammation linked to Alzheimer’s and other neurodegenerative diseases.

EVOO has other health benefits too

While extra virgin olive oil’s health benefits are most widely associated with mitigating the risk of cardiovascular disease and dementia and preventing cancer, numerous other studies show a range of benefits from its consumption for other parts of the body.

For example, a 2021 study found that following the Mediterranean diet may delay the onset of Parkinson’s disease by up to 17 years for women and eight years for men.

Parkinson’s disease is a degenerative disease of the central nervous system that has no cure. Researchers said that the polyphenols found in extra virgin olive oil protect against the disease by reducing oxidative stress in the brain.

Another study published last year showed that diets high in monounsaturated fast, such as the Mediterranean diet, boosted testosterone levels in men with insufficient amounts. Low levels of testosterone in men have been linked in previous studies to depression, cardiovascular disease, diabetes and dementia.

Researchers in Spain also published a study in 2021 that found systemic lupus erythematosus patients who followed the Mediterranean diet experienced an improvement in the course of the disease.

Lupus, an autoimmune disease, has no cure, but patients who followed the Mediterranean diet had lower rates of obesity and cardiovascular disease, both of which are common comorbidities for patients.

This article section could be extended into a book, if not an encyclopedia. Some studies link adherence to the Mediterranean diet with lower levels of rheumatoid arthritis in smokers, decreased risk of the small for gestational age condition in newborns, improved stress management and restored healthy gut bacteria in the digestive tract, which helps with weight loss.

Summing it all up

Extra virgin olive oil’s monounsaturated fat content and its polyphenols provide innumerable health benefits.

EVOO is the keystone ingredient of the Mediterranean diet. It is no coincidence the eating program was just named the best overall diet for the fifth year running by U.S. News & World Report.

Consuming between one and four tablespoons (18 and 70 milliliters) of extra virgin olive oil per day will begin to provide the many health benefits associated with Homer’s “liquid gold.”

However, extra virgin olive oil is far from a silver bullet. To enjoy its health benefits, extra virgin olive oil consumption should be part of a nourishing diet along with plenty of exercise and other healthy lifestyle choices (i.e., drinking alcohol in moderation, not smoking and finding ways to destress).

Where to find the best extra virgin olive oil

The retail finder on the Official Guide to the World’s Best Olive Oils makes it easy to find award-winning extra virgin olive oils near you or through online retailers.

Common causes of illness or death, such as cardiovascular and respiratory diseases, diabetes, cancer and neurodegenerative disorders connected to brain aging, are curtailed up to 20 or 30 percent by the long-term use of healthy unsaturated olive oil.

The latest research published in the Journal of the American College of Cardiology by a team of scientists from the Harvard T.H. Chan School of Public Health’s nutrition department investigated the impact of olive oil on a large sample of the American public for the first time.

“In two large cohort studies with up to 30 years of follow-up, people who ate higher amounts of olive oil showed a lower risk of all-cause and cause-specific mortality compared to people who never or almost never eat olive oil,” Marta Guasch-Ferre, a senior research scientist at the Harvard T.H. Chan School of Public Health and co-author of the study, told Olive Oil Times.

The scientists used multivariable-adjusted models to examine the results of the Nurses’ Health Study and the Health Professionals Follow-up Study conducted between 1990 and 2018, which involved more than 60,000 women and more than 31,000 men.

All subjects were free of cardiovascular disease and cancer at the beginning of the study. Their diets were assessed every four years.

The researchers found that those who consumed olive oil more often would have a 19-percent lower risk of dying from cardiovascular disease, 17 percent from cancer and 18 percent from respiratory disease.

They also found that deaths occurring due to neurodegenerative diseases fell by 29 percent.

The research highlights how even a partial substitution of daily saturated fat consumption with olive oil can still carry significant benefits.

“Replacing 10 grams of margarine, butter, mayonnaise or dairy fat with the same amount of olive oil was associated with eight to 34 percent lower risk of total and cause-specific mortality,” Guasch-Ferre said.

According to the researchers, there is a growing body of literature about the benefits of reducing animal fat and saturated fat intake in favor of vegetable oils.

“The main message is that our results provide further support for recommendations to replace saturated fat and animal fat with unsaturated plant oils, such as olive oil, for the prevention of premature death,” Guasch-Ferre said.

Olive oil culture and olive oil’s health benefits are not yet widespread in American culture, while fats such as butter and margarine are a well-established part of most people’s diet.

Researchers hope that their findings will also help both patients and the general public better understand the significant impact of healthier fats and how to implement them into their diets.

“Indeed, the consumption of olive oil was lower than other studies I have conducted previously in Mediterranean populations,” Guasch-Ferre said. “Also, another limitation was that we could not differentiate among grades of olive oil.”

“It is known that extra-virgin and virgin are a good source of healthy fats, but they also contain high amounts of other bioactive compounds such as polyphenols and antioxidants that have shown anti-inflammatory and antioxidant properties,” she added.

“In our study, we showed that in statistical models when olive oil was replacing butter, mayonnaise, margarine and other animal fats, it was associated with lower risk of total mortality and mortality from causes such as cancer, cardiovascular disease or neurodegenerative diseases,” Guasch-Ferre continued.

Previous studies have shown how specific olive oil contents may affect cancer progression and serve as treatment therapies.

For example, the National Cancer Institute is researching oleocanthal, a polyphenol, for its potential to help prevent breast cancer. Researchers from the University of Louisiana-Monroe are also investigating the use of oleocanthal in treating the deadliest type of breast cancer.

Other research has demonstrated how olive oil consumption could positively impact neurodegenerative diseases, such as Alzheimer’s disease, by preventing the buildup of plaque in the brain.

Olive oil-specific properties were taken into account by Harvard researchers while investigating their association with reduced mortality among olive oil consumers.

“Several mechanisms could account for the associations,” Guasch-Ferre said. “Olive oil is high in oleic acid and is less susceptible to oxidation than more unsaturated fatty acids. It has also been observed that olive oil can have favorable effects on endothelial dysfunction, hypertension, inflammation, insulin sensitivity and diabetes.”

“We examined the impact as a whole, and also importantly, the hypothetical effects of reducing other fats by increasing olive oil intake,” she added.

In an accompanying editorial on the Journal, Susanna Larsson of Uppsala University in Sweden noted how more research is needed to fully understand olive oil’s impact on health.

“To summarize, the current study and previous studies have found that consumption of olive oil may have health benefits,” she wrote. “However, several questions remain. Are the associations causal or spurious? Is olive oil consumption protective for certain cardiovascular diseases (e.g., stroke and atrial fibrillation) only or also for other major diseases and causes of death? What is the amount of olive oil required for a protective effect?”

“More research is needed to address these questions,” she concluded.

• Journal of the American College of Cardiology
• Journal of the American College of Cardiology

Many would point to extra virgin olive oil as a prominent source of monounsaturated fats, which is associated with weight loss and lowering the risk of cardiovascular disease, among other benefits.

However, Nasir Malik, a plant physiologist at the United States Department of Agriculture’s research service, said olive oil’s health benefits are almost entirely derived from a class of organic chemicals known as phenolic compounds – or polyphenols.

“The health benefits of olive oil are 99 percent related to the presence of the phenolic compounds, not the oil itself,” he told the Washington Post in 2012.

What are polyphenols?

Polyphenol is an umbrella term for a large family of naturally occurring plant compounds comprising multiple phenol units acting as antioxidants.

There are 8,000 types of polyphenols and more than 100 different types of foods with at least one milligram of polyphenols per 100 grams or milliliters of food or beverage. These vary widely from fruits and vegetables to whole grains and seeds.

According to Phenol-Explorer, a database, 25 polyphenols are found in extra virgin olive oil. Of these 25, the most significant are tyrosols – including oleuropein, hydroxytyrosol and oleocanthal.

Polyphenols are found most abundantly in extra virgin olive oil, and some polyphenols are present in virgin olive oil.

Refined olive oil only has trace amounts of the polyphenols, which are removed during the refining process and added back in when the refined oil is blended with small quantities of virgin or extra virgin olive oil before it is bottled sold.

Polyphenols lower heart disease risk

Polyphenols have been linked in hundreds of studies to various health benefits.

Chief among these health benefits is lowering the risk of heart disease, mainly due to their antioxidant properties. Antioxidants help reduce chronic inflammation, the primary risk factor for heart disease.

Two recent studies – one published in the International Journal of Molecular Sciences and the other in the Journal of Oxidative Medicine and Cellular Longevity – linked polyphenol-enriched diets to lower blood pressure and LDL (low-density lipid) cholesterol, colloquially known as ‘bad cholesterol,’ and increased levels of HDL (high-density lipid) cholesterol, or ‘good’ cholesterol.

The consumption of polyphenols has also been associated with lowering the risk of blood clots by preventing excess platelet aggregation.

Polyphenols decrease diabetes risk

Along with providing benefits for heart health, polyphenols have also been shown to lower blood sugar levels, which decreases the risk of type 2 diabetes.

A 2017 study published in the British Journal of Medicine found that participants eating large amounts of polyphenol-rich foods had a 57-percent lower chance of developing type 2 diabetes over two to four years than people who consumed very low amounts of polyphenols.

One reason may be that polyphenols help stimulate insulin secretion, which helps move sugar from the bloodstream and deposit it in the cells. This keeps blood sugar levels stable.

Polyphenol-rich diets are also linked to lower fasting blood sugar levels and higher glucose tolerance, which are essential for reducing the risk of contracting type 2 diabetes.

Polyphenols may help cancer and dementia patients

Though researchers are the first to admit that many more studies need to be done on the subject, polyphenols have also been linked to a lower risk of prostate and breast cancer.

Some studies conducted on the subject suggest that polyphenols block the growth and development of these types of cancer cells.

As a result, a separate study suggested oleocanthal-based treatments may be effective as part of targeted therapy for some types of breast cancer patients.

The researchers behind this study also found that oleocanthal regulates abnormalities in a receptor responsible for the development of Alzheimer’s disease.

In Alzheimer’s patients, the receptor becomes over-stimulated and promotes inflammation. Therefore, researchers hypothesize that oleocanthal may regulate the receptor and decrease inflammation.

Polyphenols restore gut bacteria

Along with helping prevent certain chronic diseases, some scientific studies also show that high-polyphenol extra virgin olive oil promotes the growth of beneficial gut bacteria, which helps with digestion.

One study demonstrated that adherents to the Mediterranean diet, which includes polyphenols from several of its components besides olive oil, had a more diverse gut bacteria associated with better weight management.

Polyphenols also add plenty of flavor to EVOO

Along with endowing extra virgin olive oil with its many health benefits, polyphenols also contribute to the flavor profiles of the oil.

The presence of polyphenols contributes to astringency, bitterness and pungency. Depending on the types of olives and when they are harvested will impact which of these attributes can be sensed in an EVOO.

Astringency is the puckering sensation created by tannins, a type of polyphenol. Astringency is associated with early harvested and robust extra virgin olive oils. Astringency is mostly noticed when tasting the oil on its own and is less apparent when cooking with an EVOO.

On the other hand, bitterness – due to oleuropein – is one of the less sought-after flavors in most foods but is an excellent indicator that an extra virgin olive oil has been made with fresh olives. As with certain types of beer, chocolate and coffee, bitterness is an acquired taste, the appreciation of which comes over time.

Meanwhile, pungency is the stinging sensation in the throat, mostly associated with oleocanthal. Occasionally the sensation, similar to that of chili peppers, is strong enough to force a cough.

Tips for selecting high-polyphenol EVOO

While few brands list the polyphenol contents of their EVOOs directly on the label, there are a few tricks to finding high-polyphenol EVOO at any store or market.

The first is to check the label to see if the olives were harvested early. Polyphenols accumulate in the olives earlier than the oil and steadily decrease as the fruit matures. Therefore, an early harvest extra virgin olive oil has more of them.

Next, consumers should keep their eyes peeled for Coratina, Cornicabra, Maurino, Picual and Mission monocultivars or Tuscan blends. These olive varieties have the highest levels of polyphenols.

Additionally, olives harvested in temperate climates instead of arid ones also have higher levels of polyphenols. This is likely due to the olives’ maturation rate in these specific climates.

Finally, if none of this information is readily available, select robust EVOOs over mild or delicate ones. The oils are robust (as previously discussed) due to the presence of polyphenols.

Where can I find the best extra virgin olive oil?

The retail finder on the Official Guide to the World’s Best Olive Oils makes it easy to find award-winning extra virgin olive oils near you or through online retailers.

The AHA guidance lists 10 dietary features that improve cardiometabolic health and reduce the risk of cardiovascular disease, from eating plenty of fruits and vegetables to limiting the intake of alcohol.

However, notably absent from the AHA’s dietary guidance is a recommendation to consume extra virgin olive oil instead of tropical oils and plant fats.

As recently as March 2020, the AHA acknowledged that “olive oil may help lower the risk of heart disease” and is “beneficial as a substitute for butter or mayonnaise,” but did not specifically recommend olive oil consumption in its latest dietary guidance.

Instead, the AHA’s fifth feature of a heart-healthy diet simply recommends using liquid plant oils rather than tropical oils, animal fats and partially hydrogenated fats.

The organization listed olive oil as a plant-based source of monounsaturated fat, along with canola oil, high oleic acid safflower and sunflower oils, peanuts, tree nuts and the butter derived from both. However, the AHA stopped short of explicitly endorsing extra virgin olive oil.

“The 2021 Dietary Guidance to Improve Cardiovascular Health emphasizes the importance of dietary patterns, with less focus on individual foods and more focus on individual choice,” Maggie Francis, an AHA spokeswoman, told Olive Oil Times. “The guidance is intended to support people in making heart-healthy eating decisions that fit various lifestyles, environments and cultures.”

“Robust scientific evidence demonstrates the cardiovascular benefits of dietary unsaturated fats (polyunsaturated and monounsaturated fats), particularly as a replacement for saturated and trans fats,” she added. “Olive oil is one of several examples the statement provides that people can choose as a source of monounsaturated fat.”

While monounsaturated fats are widely considered to promote cardiovascular health, a recent study from Yale University showed that polyphenols in extra virgin olive oil also contributed to heart health.

However, Alice Lichtenstein, the lead author of the guidance, also emphasized selecting the best available food options rather than recommending specific foods.

“The way to make heart-healthy choices every day is to step back, look at the environment in which you eat, whether it be at home, at work, during social interaction, and then identify what the best choices are,” she said. “And if there are no good choices, then think about how you can modify your environment so that there are good choices.”

The AHA’s complete list of dietary recommendations included:

Along with listing the dietary features to promote cardiometabolic health, the AHA also addressed the structural challenges of widespread adherence to heart-healthy dietary patterns in the United States.

“The food environment has a substantial influence on people’s food choices, diet quality and subsequently cardiovascular health at many levels, making it difficult for many Americans to adhere to heart-healthy dietary patterns,” the AHA wrote.

The organization cited socioeconomic factors, such as structural racism and neighborhood segregation, targeted marketing of unhealthy foods and beverages and food and nutrition insecurity as the biggest challenges facing the widespread adoption of their guidelines.

While acknowledging that there are no easy fixes to problems that have been entrenched in the United States’ food environment for decades, the AHA said efforts to combat nutritional misinformation among the public and healthcare professionals and introducing food and nutrition education back into all levels of public education would help.

“Creating an environment that facilitates, rather than impedes, adherence to heart-healthy dietary patterns among all individuals is a public health imperative,” the AHA concluded.

• Medscape
• American Heart Association

A quick search online would have one believe that the edible oil extracted from the wick, meat and milk of the coconut palm fruit can do everything. Its consumption is touted as a miracle weight loss solution, a way to lower cholesterol, an aphrodisiac and even a cure to Alzheimer’s disease.

Indeed, coconut oil enjoys cult-like support from its fans, so much so that when the American Heart Association cautioned that overconsumption of coconut oil poses a greater risk than lard consumption for the heart, the online fury was palpable.

“The coconut industry – or some other industry – is promoting coconut oil,” said Frank Sacks, the lead author of that advisory and a cardiovascular disease prevention research at the Harvard T.H. Chan School of Public Health. “People are gullible and will listen to advertising, especially when it comes to foods.”

As with many things in life that sound too good to be true, there are certain stipulations and limitations to the benefits provided by coconut oil consumption.

Composition of coconut oil

In order to cut through the myths and misinformation that abound about the product, it is helpful to first understand what coconut oil actually is.

Unlike olive oil or other vegetable oils, coconut oil is usually solid at room temperature. This is because it comprises mostly saturated fats – about 87 percent, to be exact. By way of comparison, butter is only 63 percent saturated fat and extra virgin olive oil is only 14 percent saturated fat.

Saturated fat consumption increases plasma low-density lipoprotein (LDL) cholesterol concentrations. High levels of LDL cholesterol are widely linked to atherosclerosis since the LDL cholesterol deposits some of its cholesterol load onto the arterial wall as it travels through the bloodstream, leading to inflammation and in the worst cases, obstruction of the arteries.

In contrast, a 2015 study from the University of California-Davis Olive Center found that consuming 20 grams, 1.5 tablespoons, of extra virgin olive oil each day for at least six weeks may lower the concentration of LDL cholesterol in the blood.

However, the proponents of coconut oil tend to brush over its LDL cholesterol content and emphasize that its consumption raises high-density-lipoproteins (HDL) cholesterol, which has long been thought to protect against heart disease.

The evidence for this claim is far from conclusive. Clinical trials with HDL-raising drugs could not demonstrate a clear-cut link between higher rates of HDL cholesterol in the blood and lower instances of cardiovascular disease.

“It is unknown which, if any, foods or nutrients that raise HDL cholesterol do so in a way that reduces atherosclerosis and coronary events,” Sacks said.

Due to its high levels of saturated fats, coconut oil is also a calorie-rich food, supplying 117 kilo-calories per tablespoon, which is more than butter or lard.

Additionally, coconut oil contains no cholesterol or fiber, while only providing trace amounts of vitamins, minerals and plant sterols, which block the absorption of cholesterol in the body.

Coconut oil marketing myths

Slickly-produced YouTube videos and seemingly authoritative articles that propagate online with catchy clickbait headlines that do address the LDL cholesterol content of coconut oil will often argue that this does not matter because of coconut oil’s lauric acid content.

Coconut oil gurus argue that lauric acid is a short-chain saturated fatty acid. These short-chain fatty acids are more water-soluble than longer chain fatty acids. They do not stick to arterial walls and have a fairly negligible impact on LDL cholesterol production.

Comprising 47 percent lauric acid, coconut oil does indeed have a plurality of this saturated fatty acid. However, experts argue that calling lauric acid a short-chain fatty acid is a misnomer.

Composed of 12 carbon atoms, lauric acid would technically fit the definition of a medium-chain fatty acid, which is also fairly water-soluble and has a much more limited effect on LDL cholesterol creation.

However, lauric acid actually behaves more like a long-chain saturated fatty acid since it is packaged into chylomicrons in the blood, a mechanism that increases LDL cholesterol by circulates the fatty acid chain for much longer than shorter chain fatty acids.

A meta-analysis of 16 clinical trials found that coconut oil consumption increased both LDL and HDL cholesterol levels relative to other nontropical vegetable oils.

LDL cholesterol increased by 10 points, while HDL cholesterol increased by four points. Only palm oil consumption increased cholesterol more than coconut oil. The meta-analysis further concluded that coconut oil consumption has no significant effect on body weight or body fat percentage, compared to other vegetable oils.

Beware of suspect science

Interestingly, many of the health claims from coconut oil gurus that the product’s heart-healthy, cholesterol-lowering and energy-providing effects are based on one study.

However, what they often neglect to mention is these findings examined a specific formation of coconut oil made from 100-percent medium-chain triglycerides instead of lauric acid and the other primary saturated fatty acids – myristic acid (18 percent), palmitic acid (9 percent) and caprylic acid (7 percent).

The medium-chain triglycerides in this iteration of coconut oil meant most of the saturated fat was absorbed into the blood instead of being stored in chylomicrons. After digestion, the medium-chain triglycerides travel to the liver where they are used for energy.

This formulation of coconut oil is not sold commercially. In fact, most commercially available coconut oil comprises only four percent medium-chain triglycerides.

Different types of coconut oil

Just like olive oil – and unlike most other vegetable oils – there are a few ways to produce coconut oil.

Coconut oil can be made by pressing fresh coconut flesh or dry coconut flesh.

When it is made using fresh coconut flesh, the result is a mixture of coconut milk and oil. The milk is separated from the oil via fermentation, centrifugation or by the use of enzymes and the resulting product is virgin or extra virgin coconut oil.

Unlike olive oil, these terms are not regulated by any government or agencies and are synonymous.

Refined coconut oil is made from dry coconut flesh, also known as copra, which is pressed to release the oil. The oil is then refined in a similar manner to most other seed oils and deodorized before it can be safely consumed.

Additionally, either one of these coconut oils can be partially hydrogenated, a process in which hydrogen atoms are added to the unsaturated fats in the oil. This process increases the shelf-life of the product

Consume coconut oil in moderation as part of a healthy diet

While coconut oil is far from a superfood, there is no problem enjoying it in moderate amounts as part of a healthy diet.

Coconut oil serves as an excellent substitute for butter when baking vegan goods. Using small amounts of virgin coconut oil also adds a subtle coconut flavor to sauteéd vegetables, sauces and curries.

Coconut oil is also an effective moisturizer for skin and hair. Massage small amounts directly onto the skin or hair and leave it in place for the desired amount of time before washing it out.

• Circulation
• Harvard T.H. Chan School of Public Health
• New York Times

The study, which was conducted by four researchers from the University of Naples Federico II and published in Cardiovascular Research, looked at the correlation between individual food groups and heart disease.

The researchers hope their meta-analysis provides a new context for the public to view what they eat and how they make their dietary choices.

“Most dietary recommendations look specifically at nutrients and not at foods. The evidence on which they are based is evidence related to nutrients,” Gabriele Riccardi, the study’s lead author, told Olive Oil Times.

“Since people are eating foods and not nutrients, you have to translate this information into foods,” he added. “We wanted to look right at the foods and see what is the evidence in all the available literature worldwide on these large databases to look at the relationship between specific food consumption and cardiovascular disease.”

What Riccardi and the rest of his team found was hardly surprising. However, it gave them a more nuanced approach to recommending how people may change their eating habits to follow a more heart-healthy diet.

“The evidence is highly concordant in showing that, for the healthy adult population, low consumption of salt and foods of animal origin, and increased intake of plant-based foods – whole grains, fruits, vegetables, legumes and nuts – are linked with reduced atherosclerosis risk,” the researchers wrote in the study. “The same applies for the replacement of butter and other animal and tropical fats with olive oil and other unsaturated-fat-rich oil.”

Indeed, the researchers found that processed red meat and unprocessed red meat were highly correlated with increased incidence of and mortality from coronary heart disease and cardiovascular disease.

Two out of three of the studies looked at by the researchers pointed to a daily serving of 50 grams of processed red meat being associated with a 27 percent to 44 percent increase in coronary heart disease incidence.

Three separate studies showed that daily consumption of 100 grams of unprocessed red meat was also associated with excess cardiovascular disease mortality.

The researchers also found, rather unsurprisingly, that the consumption of nuts, fruits, vegetables and whole-grain cereals were all highly correlated with lower risks of coronary heart disease and cardiovascular disease occurrence.

Five out of six studies that the researchers looked at showed an inverse relationship between fruit and vegetable consumption and coronary heart disease and cardiovascular disease. Green leafy vegetables showed the highest levels of reducing risk for the two diseases.

The same was largely true of olive oil, which was highly correlated to a lower risk of cardiovascular disease.

The researchers found that in a dose-response evaluation, a five-gram increase of olive oil consumption was associated with a seven-percent decrease in coronary heart disease incidence, a four-percent decrease in cardiovascular disease incidence and an eight-percent decrease in cardiovascular disease mortality.

The consumption of vegetable oils high in linoleic acids, such as safflower, sunflower, corn and soybean oils, was also highly correlated with reduced cardiovascular disease incidence and mortality.

The results of their study led the researchers to draft a new food consumption guide. It looks very similar to the United States Food and Drug Administration’s food guide pyramid, but with a few major differences.

“If we want to reduce the risk of cardiovascular disease worldwide, it is much more appropriate, feasible and cost-effective if we ask people to concentrate on foods items to promote rather than food items to reduce,” Riccardi said.

“It’s much more effective in reducing cardiovascular disease to tell people to increase your consumption of fruit, vegetables, whole grains, legumes and utilize olive oil for salads,” he added.

For Riccardi, the decades-old conversation about avoiding certain foods and macronutrients, such as fat, has not worked. Neither has the more recent one about shunning some fats in favor of others, a concept too abstract to apply on a daily basis.

“It is nonsense to say to people that you have to prefer unsaturated fat to saturated fat because most people don’t know what saturated fat or unsaturated fats are,” he said.

“Instead, it is much easier and direct to tell the consumers, in relation to cooking fat, olive oils should be the preferred source of monounsaturated fats and should replace butter and other animal fats or tropical oils whenever possible,” Riccardi added.

He hopes that governments and the food industry pay attention to this study, but acknowledged that getting people to change how they eat has been widely unsuccessful, even in the face of the individual findings of the dozens of studies his team analyzed.

“We know that diet is able to reduce cardiovascular disease events by as much as 50 percent,” he said. “That’s a lot. The problem is, what can we do to make people change.”

Part of the issue is the piecemeal nature of scientific studies, many of which have a very narrow focus and are difficult for members of the public to put into a broader context. Part of Riccardi’s idea was to provide some of that context in this type of study.

“We know how people should change, but we don’t know how to convince people to make the right choices,” Riccardi said. “I hope that basing our study on solid evidence and giving emphasis to positive change rather than negative change can make a difference in relation to what has been done in the past.”

He added that his research team plans to do the same thing with type 2 diabetes, identifying the specific relationships of food and food groups with the chronic disease. The goal of this study will also be to help people identify which foods to eat more of and which foods to cut back on.

“The healthy diet is not a punishment for people,” Riccardi said. “Instead, it is a resource of gastronomic appeal and pleasure at the table.”

“We know that it is possible for people to eat well, to eat with pleasure and that’s one of the messages of the Mediterranean diet,” he concluded. “You can have a very nice diet, very appealing with foods that you love and at the same time to have this type of diet can have a beneficial impact on your health, particularly on cardiovascular disease risk.”

• Cardiovascular Research
• Washington Post