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The importance of including extra virgin olive oil in a healthy diet

Mary Flynn
3-10-2026
The importance of including extra virgin olive oil in a healthy diet

What is extra virgin olive oil? Extra virgin olive oil is made by crushing the olive fruit using only water and no chemical solvents. Thus, EVOO is essentially the juice of the olive fruit, so it is part of a plant-based diet. Compared with other dietary fats and low-fat diets, daily consumption of EVOO starting at two tablespoons a day is superior in the improving risk factors for chronic diseases that can be measured at your annual medical appointment. These include lowering blood pressure and blood levels of LDL, increasing blood levels of HDL, improving blood levels of blood glucose, and for weight management.1 EVOO will improves HDL function,2 meaning HDL will work better; extra virgin olive oil can improve what is called “insulin sensitivity”3 or how well the insulin you make in your pancreas will work. EVOO decreases oxidation throughout your body,4 including decreasing the oxidation of LDL.5 Excess oxidation increases aging of tissue and the risk of heart disease and cancers. EVOO will decrease inflammation 67 and inflammation is a central component in prostate cancer development, progression, and metastasis. 8 EVOO also improves endothelial function. 789

What makes olive oil healthy? The health benefits of EVOO were originally attributed to the monounsaturated fat content of the oil. This led to the development of the Med diet score, which is the MFA: SFA content of the diet, to assess the health benefits of the Mediterranean diet. If the population being studied is from a Mediterranean country where the MFA diet content would largely include EVOO, the benefits are typically seen 1011; however, there are usually no health benefits with use of the score to assess the diet in populations outside Mediterranean countries 1213, where other foods such as beef and vegetable seed oils 15, would contribute to the MFA content. In contrast, when EVOO is used to determine the Med diet score, benefit is found, 814151617 providing clear evidence that EVOO is vital to realizing the health benefits of a Mediterranean diet.

The health benefits of EVOO are clearly due to the phenol content of olive oil as studies assessing the benefits for ranges of total phenols show linear benefit with phenol content (ap-proximately greater than 200 mg/kg) meaning the higher the phenol content of the oil, the greater the health benefits, and no benefit with low (< 50 mg/kg) phenol content, a level that would not qualify as extra virgin. 57 If the health benefits were due to the fat content of the oil, one would see the same health benefits whether the oil contained phenols or not. But this is not the case. The health benefits are only seen with EVOO that contains phenols The phenol content of the oil is determined by the olive used to make the oil, the growing of the olives, harvesting of the olives, and the making of the EVOO. The speed at which the olives are turned into the oil is very important and the faster the oil is extracted from the olives, the greater the level of phenols that are retained. Olive oil that is made when the olives are left for too long means poor quality oil. The best EVOO is made within eight hours at most from when the olives being picked. Look at the company website for the olive oil to see if it pro-vides information on how long it is from the olives being picked to the oil being made. The longer the time until the oil is made, the more phenols that are lost as the olives will oxidize.

Summary:

  • Two tablespoons of extra virgin olive oi per day will improve a wide range of risk factors for chronic diseases.
  • Using the Med diet score to define a Mediterranean diet may not give accurate results for a study.
  • The health benefits of extra virgin olive oil are due to the phenol content of the oil.

Footnotes

  1. Flynn MM, Tierney A, Itsiopoulos C. Is Extra Virgin Olive Oil the Critical Ingredient Driving the Health Benefits of a Mediterranean Diet? A Narrative Review. Nutrients 2023;15(13). DOI: 10.3390/nu15132916. ↩

  2. . Hernaez A, Castaner O, Elosua R, et al. Mediterranean Diet Improves High-Density Lipoprotein Function in High-Cardiovascular-Risk Individuals: A Randomized Controlled Trial. Circulation 2017;135(7):633-643. DOI: 10.1161/CIRCULATIONAHA.116.023712. ↩

  3. Ryan M, McInerney D, Owens D, Collins P, Johnson A, Tomkin GH. Diabetes and the Mediterranean diet: a beneficial effect of oleic acid on insulin sensitivity, adipocyte glucose transport and endothelium-dependent vasoreactivity. Qjm 2000;93(2):85-91. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10700478). ↩

  4. Visioli F, Caruso D, Grande S, et al. Virgin Olive Oil Study (VOLOS): vasoprotective potenial of extra virgin olive oil in mildly dyslipidemic patients. Eur J Nutr 2005;44(2):121-7. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15309433 ). ↩

  5. Covas MI, Nyyssonen K, Poulsen HE, et al. The effect of polyphenols in olive oil on heart disease risk factors: a randomized trial. Ann Intern Med 2006;145(5):333-41. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16954359 ). ↩ ↩2

  6. Barcelo F, Perona JS, Prades J, et al. Mediterranean-style diet effect on the structural properties of the erythrocyte cell membrane of hypertensive patients: the Prevencion con Dieta Mediterranea Study. Hypertension 2009;54(5):1143-50. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19805640 ). ↩

  7. Moreno-Luna R, Munoz-Hernandez R, Miranda ML, et al. Olive oil polyphenols decrease blood pressure and improve endothelial function in young women with mild hypertension. Am J Hypertens 2012;25(12):1299-304. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22914255 ). ↩ ↩2 ↩3

  8. Esposito K, Marfella R, Ciotola M, et al. Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. Jama 2004;292(12):1440-6. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15383514 ). ↩ ↩2

  9. Kourek C, Makaris E, Benetou V, et al. Extra Virgin Olive Oil (EVOO) Improves Vascular Endothelial Function and Hemodynamic Parameters in Patients with Hyperlipidemia: A Post Hoc Analysis of a Randomized Controlled Trial. Nutrients 2025;17(23). DOI: 10.3390/nu17233650. ↩

  10. Benetou V, Trichopoulou A, Orfanos P, et al. Conformity to traditional Mediterranean diet and cancer incidence: the Greek EPIC cohort. Br J Cancer 2008;99(1):191-5. DOI: 10.1038/sj.bjc.6604418. ↩

  11. Dominguez LJ, Bes-Rastrollo M, de la Fuente-Arrillaga C, et al. Similar prediction of total mortality, diabetes incidence and cardiovascular events using relative- and absolute-component Mediterranean diet score: the SUN cohort. Nutr Metab Cardiovasc Dis 2013;23(5):451-8. DOI: 10.1016/j.numecd.2011.10.009. ↩

  12. Kesse-Guyot E, Andreeva VA, Lassale C, et al. Mediterranean diet and cognitive function: a French study. Am J Clin Nutr 2013;97(2):369-76. DOI: 10.3945/ajcn.112.047993. ↩

  13. Mirmiran P, Moslehi N, Mahmoudof H, Sadeghi M, Azizi F. A Longitudinal Study of Adherence to the Mediterranean Dietary Pattern and Metabolic Syndrome in a Non-Mediterranean Population. Int J Endocrinol Metab 2015;13(3):e26128. DOI: 10.5812/ijem.26128v2. ↩

  14. Davis CR, Hodgson JM, Woodman R, Bryan J, Wilson C, Murphy KJ. A Mediterranean diet lowers blood pressure and improves endothelial function: results from the MedLey randomized intervention trial. Am J Clin Nutr 2017;105(6):1305-1313. DOI: 10.3945/ajcn.116.146803. ↩

  15. Hernaez A, Castaner O, Goday A, et al. The Mediterranean Diet decreases LDL atherogenicity in high cardiovascular risk individuals: a randomized controlled trial. Mol Nutr Food Res 2017;61(9). DOI: 10.1002/mnfr.201601015. ↩

  16. Salas-Salvado J, Bullo M, Babio N, et al. Reduction in the incidence of type 2 diabetes with the Mediterranean diet: results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes Care 2011;34(1):14-9. DOI: 10.2337/dc10-1288. ↩

  17. Toledo E, Salas-Salvado J, Donat-Vargas C, et al. Mediterranean Diet and Invasive Breast Cancer Risk Among Women at High Cardiovascular Risk in the PREDIMED Trial: A Randomized Clinical Trial. JAMA Intern Med 2015;175(11):1752-1760. DOI: 10.1001/jamainternmed.2015.4838. ↩