Summary
Consuming extra virgin olive oil rich in polyphenols may offer more cardiovascular benefits than low-phenolic varieties, according to a study published in Nutrients. The study found that high-phenolic extra virgin olive oil led to improved lipid profiles in hyperlipidemic patients, with significant reductions in total cholesterol and increased levels of HDL cholesterol.
New research shows that consuming extra virgin olive oil rich in polyphenols may deliver more substantial cardiovascular benefits than low-phenolic varieties.
The study, published in Nutrients, investigated the impact of phenolic compound concentration in olive oil on blood lipids and other cardiovascular markers. Previous research on the Mediterranean diet or the health effects of olive oil often did not isolate this specific factor, the authors noted.
The data consistently support a moderate but meaningful association between daily extra virgin olive oil consumption and improved cardiovascular outcomes.- George Moschonis, La Trobe University, Australia
“Not all olive oils are created equal. Extra virgin olive oil retains high concentrations of polyphenols, and these compounds drive most of its cardiovascular benefits,” said George Moschonis, professor at the Department of Dietetics, Nutrition and Sport at La Trobe University in Australia, who was not involved in the study.
According to Moschonis, earlier evidence consistently shows that “high-phenolic extra virgin olive oil produces superior effects on endothelial function, HDL activity, and even small reductions in blood pressure compared with low-phenolic or refined varieties.”
High-density lipoprotein (HDL) activity — often called “good cholesterol” — reflects its protective role in removing harmful fats from the bloodstream and is a better indicator of heart health than HDL levels alone.
The new trial involved two extra virgin olive oils from the same variety, Koroneiki, differing significantly in phenolic concentration. The study followed 50 patients with hyperlipidemia — characterized by elevated cholesterol and blood lipids that increase the risk of cardiovascular disease and atherosclerosis — and 20 healthy control participants matched for age and gender.
Participants were randomly divided into two intervention groups. One consumed 20 grams per day of a lower-phenolic oil (414 mg/kg phenols), while the other consumed 8 grams per day of a higher-phenolic oil (1,021 mg/kg). Both groups received approximately 8.3 milligrams of polyphenols daily, allowing researchers to isolate the impact of phenolic concentration rather than total intake.
The olive oils were stored in dark glass bottles at controlled temperatures to preserve phenolic content throughout the four-week trial. Participants consumed the oil each morning on an empty stomach to ensure consistent absorption.
Participants maintained their usual diets and medications to minimize confounding factors and avoided other sources of polyphenols, such as supplements, teas, and foods rich in antioxidants.
Researchers measured changes in total cholesterol, triglycerides, and lipoprotein(a) — or Lp(a) — a fat-carrying particle linked to plaque buildup in arteries. They also tracked levels of ApoA1 and ApoB, proteins associated with HDL and LDL (“bad cholesterol”) activity.
Results showed that the consumption of extra virgin olive oil improved lipid profiles in hyperlipidemic patients compared to healthy controls. The group consuming high-phenolic olive oil experienced a significantly greater reduction in total cholesterol, averaging approximately 17 mg/dL lower, with a statistically significant time-by-group interaction (p = 0.045).
Levels of HDL cholesterol rose, while Lp(a) decreased, indicating improved cardiovascular protection. These benefits were more pronounced among participants with high cholesterol. Other measures, including ApoA1 and ApoB, showed a positive trend but did not reach statistical significance.
The study reported 100% adherence and no adverse effects, suggesting that extra virgin olive oil may be a practical and safe addition to the diet for cardiovascular support. The authors concluded that phenolic concentration — not simply the amount of oil consumed — appears central to olive oil’s heart-healthy properties.
“Based on current evidence, the data consistently support a moderate but meaningful association between daily extra virgin olive oil consumption and improved cardiovascular outcomes,” Moschonis said.
“Extra virgin olive oil can be considered a food that supports cardiovascular prevention, particularly when integrated into a healthy dietary pattern such as the Mediterranean diet,” he added. Even half a tablespoon per day, about eight grams, has been linked to a 14-percent lower risk of cardiovascular disease and an 18-percent lower risk of coronary heart disease.
According to Moschonis, extra virgin olive oil, exceptionally high in polyphenols, should be the default culinary fat, particularly as a replacement for saturated fats. “The broader goal should remain a balanced diet rich in unsaturated fats and plant foods,” he said.
Researchers emphasized that while much has been discovered about the benefits of extra virgin olive oil, many of its hundreds of polyphenolic compounds remain to be studied. These natural antioxidants and anti-inflammatory agents not only support health but also contribute to the distinctive taste and aroma of high-quality olive oils.
“Future research should identify and investigate the specific phenolic compounds that have the greatest health benefits,” Moschonis said. He also emphasized the importance of education in promoting olive oil culture, noting that in many regions outside the Mediterranean, it remains unfamiliar.
“We should explore ways to make extra virgin olive oil more accepted in non-Mediterranean diets, possibly through education and sensory adaptation,” he concluded.

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