By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
As an Italian cardiologist who loves to cook, I find olive oil to be an almost perfect food. Not only does it smell and taste great, but it’s heart healthy—with two capital “H’s.”
Olive oil is the primary source of fat in the Mediterranean diet (one half of my Pan Asian Modified Mediterranean diet), and it’s often singled out as one reason why people in that region of the world suffer from significantly less cardiovascular disease. Increasingly, this health benefit of olive oil—along with many others—is attributed to its high phenol content.
Phenols are antioxidant micronutrients found only in plant foods. They’re especially concentrated in olive oil and highly effective at protecting against disease. In addition to cardiovascular concerns, olive oil has been shown to influence the development of Alzheimer’s disease, depression, liver toxicity, osteoporosis, ulcerative colitis, and cancers of the skin and breast.
In this article, though, I’m focusing on its benefits for the heart…
5 Heart Health Benefits of Olive Oil
Here are five (among the many) reasons why olive oil is particularly close to my heart:
1. Lower Blood Pressure
The first study to look at olive oil’s ability to lower blood pressure was published way back in 2000. Not only did it find olive oil (the extra virgin variety) more effective than sunflower oil at reducing both systolic and diastolic blood pressure, but one third of the study participants belonging to the olive oil group were able to stop their prescription blood pressure medications after six months.
The daily amount of olive oil used in the 2000 study was about four tablespoons for men and about three for women. However, a report from the University of California–Davis, released just last year suggests that you also can get a blood pressure–lowering benefit with just two tablespoons daily—though it may not be enough to justify dropping drug therapy (which you’d never do without getting the prescribing physician’s blessing, anyway…).
2. More Efficient HDL, Less Oxidized LDL
There has been a lot of research into the health benefits of olive oil as they relate to blood lipids, but the two most important are olive oil’s ability to increase the effectiveness of protective HDL cholesterol, as well as to minimize the oxidation of LDL cholesterol.
The science is mixed about whether olive oil can actually increase HDL levels; some studies say it does, others say it doesn’t. One study of particular interest, however, showed that regardless of HDL level, two tablespoons of high-phenol olive oil taken daily can enhance the effectiveness of HDL cholesterol—increasing its size and shape to allow each HDL molecule to carry more unused LDL to the liver for either excretion or recycling. In clinical terms, this is called your “cholesterol efflux capacity,” and it’s inversely related to your risk for developing heart disease.
Combined with the natural antioxidant power of phenols, this increased activity of HDL may play a role in another health benefit of olive oil: it reduces the oxidation of LDL. A separate report from the University of California-Davis states that consuming two tablespoons of olive oil a day (phenol content >400 mg/kg), may begin reducing your level of LDL oxidation in as little as four days. The same amount of olive oil with phenol content of 150 mg/kg can decrease LDL oxidation in less than four weeks.
3. Turns Down Inflammation-Related Genes
Because the phenols in olive oil are potent antioxidants, they are great for controlling inflammation. But that isn’t the only inflammation-fighting health benefit of olive oil.
A study out of Cordoba, Spain, shows that eating olive oil high in phenols also helps reduce the expression of pro-inflammatory genes. For the six-week trial, researchers recruited 20 men and women with metabolic syndrome, standardized their diets, and then had them eat an olive oil–based breakfast that was either high in phenols or low in phenols. After each meal, blood samples were taken and analyzed.
In total, 98 genes were identified as being affected by the amount of phenols the participants consumed. Most importantly, though, the genes associated with inflammatory mediators such as NF kappa-B, were suppressed. This is tremendous news, given that inflammation is the true cause of heart disease.
4. Protects the Endothelium
What’s the endothelium, you ask? It’s a thin layer of cells that lines the inner surface of your arteries and regulates their function, including the vessels’ ability to expand and contract as needed. Unfortunately, the endothelium is easily damaged, and repeated injury can lead to the development of atherosclerosis and vascular disease.
Another heart health benefit of olive oil is its ability to slow down this process.
When the endothelium is injured, it releases microparticles that begin the body’s inflammatory response. Additionally, cells are created to replace those that are damaged. Researchers measuring both of these responses have found that people who follow a Mediterranean diet rich in olive oil produce fewer inflammatory microparticles and more restorative cells.
5. Helps Prevent Heart Attack and Stroke
When you add together all of the individual ways olive oil soothes and protects the arteries, there’s not a lot of mystery as to why it’s also touted as a great food for preventing heart attack and stroke. Still, research supports this clear conclusion.
The PrediMed (Estruch R, et al) trial assigned more than 7,000 participants—all of whom were thought to be at “high risk” for a future cardiovascular event—to three groups. One group followed the Mediterranean diet and supplemented with consumed additional extra virgin olive oil weekly. Another followed the Mediterranean diet and ate additional mixed nuts daily. The third group were advised to eat a low-fat diet, but given no specific advice.
After an average follow up time of nearly five years, investigators found that both the olive oil and mixed nuts group had a 28 to 30 percent reduction in risk for major cardiovascular events, including heart attacks and strokes.
How to Buy the Best Olive Oil
One last, but very important note: Virtually all of the research cited above used olive oil with high phenol content. In shopping terms, that means you must buy and use extra virgin olive oil if you want to realize these great heart health benefits.
Cold-pressed extra virgin oil is highest in phenols because it’s the least processed of all olive oils. It also tends to be the most expensive, but if you’re like me, you can’t really put a price on good health.
Learn more about my criteria for how to choose the best olive oil.
- Batra S. EVOO Effective in Lowering High Blood Pressure. Olive Oil Times. 29 Dec 2015. Accessed August 16, 2016.
- Batra S. Olive Oil Improves Blood Lipid Profile, Reduces Risk of Heart Disease. Olive Oil Times. 31 Mar 2015. Accessed August 16, 2016.
- Carmargo A, et al. Gene expression changes in mononuclear cells in patients with metabolic syndrome after acute intake of phenol-rich virgin olive oil. BMC Genomics. 2010;11:253.
- Estruch R, et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. N Engl J Med, 2013; 368:1279-1290. Full article online at http://www.nejm.org/doi/full/10.1056/NEJMoa1200303#t=article; (Retracted and republished June 2018 at https://pubmed.ncbi.nlm.nih.gov/29897866/).
- Ferrara LA, et al. Olive oil and reduced need for antihypertensive medications. Arch Intern Med. 2000 Mar 27;160(6):837-42.
- Fitó M, et al. Antioxidant effect of virgin olive oil in patients with stable coronary heart disease: a randomized, crossover, controlled, clinical trial. Atherosclerosis. 2005 Jul;181(1):149–58.
- Flynn M and Wang S. Olive Oil as Medicine: The Effect on Blood Lipids and Lipoproteins. Mar 2015. UC– Davis Olive Center.
- Flynn M and Wang S. Olive Oil as Medicine: The Effect on Blood Pressure. Dec 2015. UC–Davis Olive Center.
- Hernáez Á, et al. Olive oil polyphenols enhance high-density lipoprotein function in humans: a randomized controlled trial. Arterioscler Thromb Vasc Biol. 2014 Sep;34(9):2115-9.
- Martin C. Mediterranean diet reduces endothelial damage and improves the regenerative capacity of endothelium. Am J Clin Nutr. 2011 93:267-274.
- Paravantes E. Olive Oil Keeps the Heart Young. Olive Oil Times. 7 Apr 2011. Accessed August 16, 2016.
- Ruano J, et al. Intake of phenol-rich virgin olive oil improves the postprandial prothrombotic profile in hypercholesterolemic patients. Am J Clin Nutr. 2007 Aug;86(2):341–6.
© Stephen Sinatra, MD. All rights reserved.