Is Extra-Virgin Olive Oil Really a Health Food?

Extra-virgin olive oil has long held a reputation as a health-promoting food.

With its supposed heart health benefits and anti-inflammatory properties, it’s frequently recommended as a nutritious diet staple. 

In fact, extra-virgin olive oil is a key part of the Mediterranean diet, which the US News & World Report has ranked as the healthiest diet for years (1, 2). 

However, is extra-virgin olive oil truly as beneficial for health as believed? Let’s explore.

Background on EVOO and Health

Extra-virgin olive oil is a main fat source in the Mediterranean diet. Olive trees have long provided an important source of food and nutrients in this region (3).  

Today, olive oil continues to provide helpful plant compounds and daily calories to people practicing this diet pattern, which is rich in fruits, vegetables, whole grains, legumes, nuts with moderate consumption of fish, poultry, and dairy. (4).  

This oil is a rich source of monounsaturated fatty acids (MUFAs). These fats may improve heart health by improving cholesterol and lowering inflammation (5, 23).  

It also contains plant sterols (6). These may help block cholesterol absorption in the gut and lower LDL (the “bad” cholesterol) (7). MUFAs and sterols make up most of this oil. But, smaller parts, like antioxidant polyphenols, might actually be more responsible for its health benefits (1).

Polyphenols may play a role in preventing high blood pressure, strokes, and heart attacks (8). They may also affect how genes are expressed, impacting inflammation and oxidative stress—key factors in cardiovascular diseases (8). 

So, consuming extra-virgin olive oil regularly, especially as part of a Mediterranean-style diet (1), has been associated with: 

• Heart Health: It may support heart health by improving blood vessel functions, raising good cholesterol, lowering bad cholesterol, and reducing inflammation. It may also help prevent blood clots by stopping platelets from sticking together.
• Lower Blood Pressure: Polyphenols in extra virgin olive oil may lower blood pressure. They might do so by relaxing blood vessels and affecting blood pressure genes.
• Reduced Inflammation: This oil lowers inflammation. It does this by decreasing the proteins and chemicals that cause it.
• Metabolic Health: It’s polyphenols may improve carb metabolism. This may reduce the risk of type 2 diabetes and help with weight and cholesterol levels.
• Brain Health: Polyphenols in extra virgin olive oil may lower Alzheimer’s risk by reducing oxidative stress and supporting brain function.
• Gut Health: Polyphenols in extra virgin olive oil may improve gut health. They may change the gut microbiota, boost intestinal immunity, and increase good bacteria. Its compounds also have antimicrobial properties that may help fight harmful bacteria and viruses.
• Cancer Prevention: Extra virgin olive oil may reduce cancer risk. Its polyphenols may affect cancer-related genes, providing protective effects.

What the Research Says

Cardiovascular health benefits

Extra virgin olive oil may help prevent and manage various conditions. However, a lot of research has focused on its potential heart health benefits.

A key study, the 2018 PREDIMED trial, tested over 7,000 people at high risk for heart problems (9). 

It saw that a Mediterranean diet with extra virgin olive oil or nuts led to fewer heart issues, like heart attacks and strokes, than a low-fat diet (9).  

Surprisingly, in the PREDIMED trial, extra virgin olive oil appeared to have little to no effect on LDL levels (9). “Though certain specific studies may conflict, I generally feel that there is good research to support LDL-reducing benefits of olive oil,” says MyFitnessPal dietitian Katherine Basbaum (17).   

But, importantly, it may help prevent LDL from undergoing a bad chemical process called oxidation (10).

LDL oxidation is a key contributor to plaque buildup in the arteries (atherosclerosis), a major factor in cardiovascular health (10). 

A 2022 review further highlighted extra virgin olive oil’s key role in the Mediterranean diet and heart health. Its healthy fats and polyphenol antioxidants may help meet daily essential fatty acid and antioxidant needs (1). These are important for cardiovascular well-being (1).

However, some research suggests that consuming more extra virgin olive oil isn’t always better. 

In 2024, a trial in the Journal of the American Heart Association tested high (4 tablespoons/day) versus low extra virgin olive oil intake (1 tablespoon/day) in a whole-food, plant-based diet. It examined the diet’s heart health effects (11).

Both diets improved heart health compared to what people usually ate. However, the diet with less olive oil seemed better at lowering bad cholesterol (LDL), even though the difference was minor (11).

Based on their findings, the researchers said the benefits of a Mediterranean diet might not come from olive oil. (11). But the study has limitations, so more research is needed.

In the low olive oil diet, most fats came from whole foods. These included avocados, nuts, seeds, and olives. This meant the diet had more fiber and unprocessed plant chemicals (11).

These “intact” nutrients from whole foods might help lower LDL cholesterol more effectively, but olive oil still appears to support heart health (11).

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EVOO’s Role in a Balanced Diet

Understanding how extra virgin olive oil fits into your diet is essential for maximizing its potential health benefits. 

Look for “extra-virgin” olive oil, which is less processed and contains more antioxidants than regular olive oil (12). 

For benefits, people typically add 1 to 4 tablespoons of uncooked extra virgin olive oil to their food daily. It’s considered safe, effective, and well-tolerated by most adults (1).

But olive oil is high in calories. Eating more calories than your body needs daily can contribute to unwanted weight gain.

So, most people may want to limit their intake to 1 to 2 tablespoons a day, unless a health professional advises otherwise.

Also, while it likely helps, extra virgin olive oil isn’t the only reason for the Mediterranean diet’s health benefits. As mentioned, whole foods provide dietary fiber and other nutrients not found in olive oil.

So, it’s important to consider your overall diet quality and balance when adding extra virgin olive oil to your daily routine.  

Swap ultra-processed fats for healthy fats

A common recommendation is to limit saturated fat in your diet, swapping out for healthy fat sources like extra virgin olive oil.

Health organizations still say to limit saturated fat in your diet. But research is beginning to show a more nuanced view, and official guidelines may soon change (13, 18). The effect of saturated fat on heart health might depend more on your diet quality and the specific sources of these fats. (13).

The point is that not all sources of saturated fat are inherently unhealthy. For example, eggs and unrefined coconut oil are minimally processed sources of saturated fat that are rich in nutrients and may offer health benefits (14, 15). 

Saturated fat from processed foods may be worse than that from whole foods because it is refined and often comes with unhealthy ingredients (19). These include high amounts of added sugar, salt, and other food additives (19, 20).

On the other hand, unsaturated fats are generally believed to be healthier. But, processing and heating can damage them, creating harmful compounds (21, 22). Refined seed and vegetable oils, often found in processed and fried foods, are prime examples of this (21, 22). 

So, instead of focusing solely on reducing saturated fat intake, replacing fats from processed and fried foods with those from whole foods might be more beneficial  (13).

It is also important not to replace saturated fats in your diet with refined carbs, like foods made with flour, as this may be worse for heart health  (13).

Ultimately, though the debate on saturated fat continues, whole food fats likely pose different health risks than fats in ultra-processed and fried foods (16), such as:

• Processed meats
• chicken nuggets and french fries
• Store-bought chips, crackers, and pastries

So, consider replacing them with high-quality sources of fats, including cold-pressed, minimally processed oils and whole foods like:

• Extra virgin olive oil
• Nuts
• Seeds
• Avocados
• Fatty fish

The Bottom Line

Extra virgin olive oil is rich in healthy fats and antioxidants.

It benefits health, especially when it’s part of a balanced diet and replaces unhealthy fats, like those in ultra-processed foods.

But, moderation remains important. Eating a lot of olive oil does not seem to offer extra benefits and could contribute to excess calorie intake.

More research is needed, especially on specific health outcomes. But, consuming extra virgin olive oil as part of a plant-rich diet, like the Mediterranean diet, is a wise choice for health and disease prevention.  

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