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Do Olive Oil and the Mediterranean Diet Offer Protective Benefits Against Cardiovascular Disease and Mortality? (2021)

Do Olive Oil and the Mediterranean Diet Offer Protective Benefits Against Cardiovascular Disease and Mortality? (2021)

Several diets claim to improve heart health by promoting the consumption of “healthy fats.” Though a critical component of a healthy diet, other factors, like sustainability and nutritional balance, must also be considered. One diet that’s stood the test of time is the Mediterranean diet. Recommended by the American Heart Association (AHA) and the American College of Cardiology, the Mediterranean diet focuses on the consumption of monounsaturated fatty acids, which prominently comes from extra virgin olive oil (EVOO). Adherence to the Mediterranean diet has been associated with a decreased mortality rate –– and both time and research have supported it –– Italians and Greeks from the Mediterranean Sea have the highest life expectancy and the lowest rates for all-causes of mortality (1). Unfortunately, quality of life and life expectancy here in America doesn’t follow suit. That’s likely because the Standard American Diet and lifestyle are drastically different. The result –– higher rates of mortality, often caused by heart disease.

Heart disease is one of the top 10 leading causes of death in the United States. But this doesn’t have to remain our truth forever. Preventative measures, like diet and lifestyle choices, can drastically reduce heart disease risk and other life-threatening conditions. Let’s discuss how the Mediterranean Diet and olive oil can reduce your risk of developing cardiovascular diseases.

Olive Oil vs. Extra Virgin Olive Oil –– What’s the Difference?

First, let’s unpack the difference between olive oils. There are so many options, and it’s important to know what’s best for you and your family. Extra virgin olive oil is produced from cold pressing the best quality of olives. This production method allows the oil to retain various bioactive and antioxidant components like polyphenols, phytosterols, and vitamin E. Meanwhile, standard olive oil is a mixture of refined and virgin oil –– with, on average, 80% being refined (2). This is not ideal, as refined oil losses phytochemicals, antioxidants, and anti-inflammatory components during processing. As a result, standard olive oil and EVOO provide different health benefits. When you can go with high quality EVOO so you can retain all the benefits the oil has to offer.

Olive Oil and Cardiovascular Disease

Olive oil a key component in the Mediterranean diet that can reduce the incidence of heart diseases. EVOO is rich in antioxidants that act as a protector for red blood cells. Damaged red blood cells can eventually result in cardiovascular diseases — like heart attack, heart disease, and stroke. Not to mention, EVOO can also lower your blood pressure, which is vital to living a long and healthy life.

What Research Says:

A study was conducted on 7,216 male and female participants with high cardiovascular disease risk to determine the association of common olive oil and extra virgin olive oil with the risk of cardiovascular disease and mortality. Participants in the study were randomly divided into interventions or control groups –– either a Mediterranean diet supplemented with extra virgin olive oil or nuts or a low-fat diet. Researchers found, “for each 10 g/d increase in extra-virgin olive oil consumption, cardiovascular disease, and mortality risk decreased by 10% and 7%, respectively” (2). The research findings indicate a significant reduction in cardiovascular disease and mortality when participants consumed higher amounts of EVOO every day. In contrast, participants who consumed standard olive oil did not significantly reduce cardiovascular disease and mortality. This is because standard olive oil or refined olive oil decreases the amount of bioactive and antioxidants available.

Many researchers use the same Mediterranean diet interventions to determine the association between the Mediterranean diet and cardiovascular disease prevention. Estruch et al. (2013) divided 9,000 participants into 3 different intervention groups: the Mediterranean diet supplemented with either EVOO or nuts or a controlled diet. The study required participants to be free of cardiovascular disease at enrollment. Participants also had to have 3 cardiovascular disease risk factors –– hypertension, smoking, elevated low-density lipoprotein cholesterol levels, low high-density lipoprotein cholesterol levels, overweight, obesity, or have a family history with coronary heart disease. The researchers found that the two Mediterranean diets supplemented with either extra virgin olive oil or nuts can reduce the risk of cardiovascular disease in approximately 30% of high-risk participants (3). This suggests that consuming higher amounts of EVOO may provide a protective effect against cardiovascular disease.

For reference, the Mediterranean diet participants supplemented with extra virgin olive oil consumed 30-50 grams of EVOO per day, and participants in the Mediterranean diet supplemented with nuts consumed 0.9-6 servings of nuts per week. You can make dietary changes by including EVOO and nuts in your meals!

Omega-3 Fatty Acids

Along with EVOO, fatty fish is a primary fat source in the Mediterranean diet. It’s often studied as it’s rich in omega-3 fatty acids. Omega-3 fatty acids are essential fatty acids that must be obtained through your diet because your body cannot produce them. According to the AHA, two servings of fatty fish are recommended each week (4). One serving of fatty fish is 3.5 ounces. Some examples of fatty fish are salmon, mackerel, and sardines.

Additionally, the Mediterranean diet and fatty fish can reduce inflammation! Reducing inflammation is essential because chronic inflammation can damage your blood vessels and eventually lead to cardiovascular disease. Consume an adequate amount of omega-3 fatty acids by having two servings of fatty fish a week to reduce inflammation and fight off cardiovascular disease!

Key Takeaway:

Extra virgin olive oil and the Mediterranean diet can reduce the risk of cardiovascular diseases such as heart disease, heart attack, and stroke. Research findings indicated that adherence to the Mediterranean diet supplemented with EVOO and nuts provides protective benefits for people at high risk for cardiovascular disease. The Mediterranean diet supplemented with EVOO (30-50 grams per day) and nuts (0.9-6 servings per week) may be used as secondary prevention to reduce the incidence of cardiovascular disease and mortality. Even a small amount of EVOO, like 10 grams per day, can provide protective benefits towards cardiovascular disease! Lastly, two servings a week of fatty fish rich in omega-3 fatty acids are recommended by the AHA.

Written by Joanna Chen

Reviewed by Kelly Powers, MA, RDN, a Registered Dietitian Nutritionist who takes a holistic approach to nutrition and health. Kelly is a recipe developer with a food blog highlighting whole foods, simple recipes, and her life in San Francisco. She’s the creator of 52 Weeks, a weekly meal plan program that helps users get back in the kitchen and feed themselves well. Kelly is also a co-founder of Olivaio.

Image Credits: Abayev;; Elijas; Tentis; Lewis

Frequently Asked Questions:

Q: What are the main sources of fat in the Mediterranean diet?
A: EVOO! Additionally, fatty fish like salmon, sardines, and mackerel are a primary source of fat in the Mediterranean diet. Nuts are a great source of healthy fats as well!

Q: Which type of oil provides the most health benefits?
A: Extra virgin olive oil retains various bioactive and antioxidant content such as polyphenols, phytosterols, and vitamin E. Many of these bioactive and antioxidant components are lost in refined olive oil and virgin olive oil during processing. To obtain the benefits from olive oil, it’s best to choose EVOO!

Q: How can you increase your consumption of olive oil?
A: Make food swaps such as substituting mayonnaise, butter, or margarine with extra virgin olive oil. Increasing your intake of EVOO can decrease your risk for cardiovascular disease.

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