In a recent study published in Nutrients, researchers conducted a systematic review to consolidate current evidence on the preventive benefits of extra virgin olive oil (EVOO) on disease risk factors.
Mediterranean diets are plant-based diets enriched with vegetables, fruits, nuts, legumes, whole grains, and moderate amounts of fermented dairy products and fish, and are essential for the prevention of chronic diseases.
EVOO, a common ingredient in the Mediterranean diet, is associated with a lower risk of several chronic diseases , such as cardiovascular disease and type 2 diabetes, stroke, metabolic syndrome, impaired cognitive function, and colon and breast cancer.
EVOO intake may reduce the risk of obesity and improve overall mortality. However, there is limited research on the specific daily amount of EVOO that can improve risk factors for chronic diseases. Dietary recommendations place little emphasis on distinguishing healthy fats like EVOO from other fats and oils.
In this systematic review, researchers compared the effects of foods containing EVOO on clinically significant metabolic and cardiovascular risk factors for cardiovascular disease, type 2 diabetes, metabolic syndrome, and insulin resistance with diets without EVOO.
A systematic data search was conducted using the Cochrane Library databases, Embase, and PubMed for the period between January 2000 and December 2022. The team then conducted a narrative data synthesis.
The researchers included only randomized controlled trials (RCTs) with human participants published in peer-reviewed scientific journals in English that compared the cardiometabolic effects of EVOO consumption with diets without EVOO.
The team excluded in vitro or animal studies, those that were not randomized, those that used only postprandial blood glucose measurements, tests only of phenolic compounds in olive oil, and those that evaluated the effects of olive oil added to pills, olive oil with additional ingredients, the use of live oil without reference to the extra virgin variety, the exclusive use of pomace or refined olive oil, abstracts and presentations, and works that demonstrate a possible alteration in drugs that may not have an influence on the factors being studied.
Studies evaluating “virgin olive oil” with a specific phenol content were also considered. Reference lists of the articles identified through searches were also reviewed to include additional relevant publications. The Academy of Nutrition and Dietetics (ANDQCC) Quality Criteria Checklist was used to assess the quality of the included RCTs.
In total, 34 of the 281 retrieved articles met the eligibility criteria and were considered for the final analysis, all of which were rated “positive” according to the ANDQCC assessment. Several references were included, including subgroup analyses from the PREDIMED (Prevention with Med Diet) study.
EVOO outperformed alternative food-based fats and low-fat (LF) diets in managing clinical indicators such as low-density lipoprotein cholesterol (LDL-cholesterol), low-density lipoprotein cholesterol (LDL-c), and blood pressure (BP), thereby increasing protective high-density lipoprotein cholesterol (HDL-c) and improving glucose and weight control.
The polyphenol content of EVOO, rather than the amount of monounsaturated fat, is likely responsible for its beneficial effects. Compared to sunflower oil, EVOO lowers systolic blood pressure (SBP) in hypertensive patients and healthy individuals. Certain phenols may be crucial for lowering blood pressure. One study reported a reduction in SBP with 161.0 mg/kgPhenol in hypertensive patients, while two studies with >300.0 mg/kg phenol showed no such effects.
EVOO can lower low-density lipoprotein cholesterol from initial levels above 120.0 mg/dL and increase HDL-c levels with higher phenol content, and diets containing daily EVOO were successful in promoting weight loss despite higher calorie intake than LF diets. Furthermore, EVOO with ≥150.0 mg/kg phenol could reduce LDL oxidation. EVOO can lower LDL-c levels to baseline levels above 120.0 mg/dL and increase HDL-c levels with an increase in phenol content, and diets containing daily extra virgin olive oil can effectively reduce body weight despite higher calorie intake from LF meals. Furthermore, EVOO with ≥150.0 mg/kg phenol could reduce LDL oxidation.
Few studies have included patients with high fasting blood glucose (FBG) or type 2 diabetes mellitus; therefore, the effect of extra virgin olive oil on FBG compared to other dietary regimens is unclear. Daily EVOO, on the other hand, may improve insulin sensitivity, as assessed by the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) compared to LF diets.
The shortest period of improvement and the lowest daily amount of EVOO required to improve blood pressure, HDL-c, and LDL-c were 21 days and 25.0 ml (almost two tablespoons) per day, with LDL-c and diastolic blood pressure (DBP) possibly >1.5 times the recommended daily intake. 300.0 mg of phenol per kg are required for maximum benefit. EVOO’s ability to improve diagnostic biomarkers for congenital heart disease, i.e., blood pressure, HDL-c, and LDL-c, may be related to its ability to reduce the risk of coronary heart disease.
While diets enriched with vegetable seed oils may lower LDL more effectively than EVOO, a daily diet rich in EVOO will result in healthier LDL because its particles will grow and be less likely to oxidize. In addition, extra virgin olive oil has been shown to reduce apoprotein B-100, meaning fewer low-density lipoprotein particles. The ability of EVOO to reduce the risk of type 2 diabetes and metabolic syndrome is related to its effects on HOMA-IR, insulin, and FBG, which reportedly improve after EVOO consumption compared to diets containing oils rich in polyunsaturated fats (sunflower oil) or LF diets.
Overall, the results showed that incorporating EVOO into the Mediterranean diet can significantly reduce the risk of chronic diseases. Regular consumption of EVOO, starting with two tablespoons daily, can improve multiple risk factors in as little as three weeks. Furthermore, EVOO is a better option for reducing the risk of chronic diseases than other dietary fats or refined olive oil.
Cooking vegetables with EVOO in Mediterranean countries increases the absorption of fat-soluble carotenoids and boosts vegetable consumption. Future research should focus on EVOOs with known phenolic content, non-European participants with unhealthy risk factors, and larger sample sizes.
Important Note: aceitedelcampo.com promotes the consumption of extra virgin olive oil for its culinary qualities and health benefits. However, no medication or current treatment should be replaced without the guidance of a healthcare professional.
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