Rx Nutrition Resource Center

Rx Nutrition Resource Center

Perspective from Jamy D. Ard, MD
Disclosures: Guasch-Ferré and Larsson report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
January 10, 2022
3 min read

Olive oil consumption may cut risk for CV, all-cause death

Perspective from Jamy D. Ard, MD
Disclosures: Guasch-Ferré and Larsson report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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A diet that includes approximately half a tablespoon of olive oil daily may cut risk for CV death and all-cause death by 19%, according to research published in the Journal of the American College of Cardiology.

In an analysis of two large U.S. cohorts, researchers also found that replacement of margarine, butter, mayonnaise and dairy fat with olive oil was similarly associated with lower risk for total and cause-specific mortality.

Graphical depiction of data presented in article
Data were derived from Guasch-Ferré M, et al. J Am Coll Cardiol. 2022;doi:10.1016/j.jacc.2021.10.041.

“Clinicians should be counseling patients to replace certain fats, such as margarine and butter, with olive oil to improve their health,” Marta Guasch-Ferré, PhD, a senior research scientist and instructor in medicine at the Harvard T.H. Chan School of Public Health, told Healio. “Our study helps clinicians make specific recommendations that will be easy for patients to understand and hopefully implement into their diets.”

Assessing olive oil intake

Guasch-Ferré and colleagues analyzed olive oil intake from two prospective cohorts of healthy U.S. adults: the Nurses’ Health Study (1990-2018; n = 60,582 women) and the Health Professionals Follow-up Study (1990-2018; n = 31,801 men). Participants completed a semiquantitative food frequency questionnaire every 4 years. Olive oil consumption was categorized by frequency: never or less than once per month (reference); up to 4.5 g per day (< 1 teaspoon); 4.5 g to 7 g per day (1 teaspoon to 0.5 tablespoons); and at least 7 g per day ( 0.5 tablespoons). Researchers used Cox proportional-hazards models to estimate HRs for total and cause-specific mortality.

Across both cohorts, 36,856 participants died during 28 years of follow-up. Mean olive oil consumption increased from 1.6 g per day in 1990 to about 4 g per day in 2010; margarine consumption fell from a mean of 12 g per day in 1990 to 4 g per day in 2010.

Compared with participants who rarely or never consumed olive oil, the adjusted pooled HR for all-cause mortality among participants reporting the highest consumption of olive oil was 0.81 (95% CI, 0.78-0.84), with results persisting after adjustments for demographic and lifestyle factors.

Higher olive oil intake was associated with 19% lower risk for CVD mortality (HR = 0.81; 95% CI, 0.75-0.87), a 17% lower risk for cancer mortality (HR = 0.83; 95% CI, 0.78-0.89), a 29% lower risk for neurodegenerative disease mortality (HR = 0.71; 95% CI, 0.64-0.78) and an 18% lower risk for respiratory disease mortality (HR = 0.82; 95% CI, 0.72-0.93).

In substitution analyses, replacing 10 g per day of margarine, butter, mayonnaise and dairy fat with the equivalent amount of olive oil was associated with 8% to 34% lower risk for total and cause-specific mortality.

Researchers observed no associations when olive oil was compared with other vegetable oils combined. Guasch-Ferré said researchers were not able to assess the effect of different olive oil varieties on mortality risk.

Marta Guasch-Ferré

“It is known that extra-virgin and virgin olive oil varieties have higher amounts of polyphenols that have been associated with better lipid profiles and less inflammation,” Guasch-Ferré told Healio. “It would be interesting to assess the differences among types of olive oil and the health effects of other vegetable oils on health outcomes as well as disentangle the mechanisms of this associations such as identifying metabolomic markers of olive oil intake. Further research is needed to investigate the mechanisms underlying the associations between olive oil consumption and health and which population groups are most likely to benefit.”

Benefit by olive oil type

Susanna C. Larsson

In a related editorial, Susanna C. Larsson, PhD, senior researcher and associate professor of cardiovascular and nutritional epidemiology at Karolinska Institutet in Stockholm, wrote that the inability to distinguish between olive oil varieties is important, as refined olive oil has lower levels of phenolic compounds compared with extra-virgin olive oil “and may therefore have fewer health benefits.”

“Several questions remain,” Larsson wrote. “Are the associations causal or spurious? Is olive oil consumption protective for certain CVDs only or also for other major diseases and causes of death? What is the amount of olive oil required for a protective effect? Is the potential effect ... confined to polyphenol-rich extra-virgin olive oil or are refined olive oil and other vegetable oils as beneficial? More research is needed to address these questions.”

Previous observational studies have shown a beneficial CV effect when diets are enriched with olive oil. As Healio previously reported, in an analysis of the PREDIMED trial, a traditional Mediterranean diet enriched with virgin olive oil enhanced the function of HDL compared with a Mediterranean diet enriched with nuts or a low-fat control diet. However, Larsson noted that olive oil consumption in the PREDIMED trial “differed remarkably” from U.S. consumption.


For more information:

Marta Guasch-Ferré, PhD, can be reached at mgausch@hsph.harvard.edu; Twitter: @martaguasch1.