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Olive oil? Healthy or not?!

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I am wondering about the case made that, quoting above,

"PREDIMED is consistent with the notion that EVOO is at least more effective at preventing stroke than CHD per se  [...] the same was true for nuts: [ image here in thread above] ... but more protective (indeed, evidently exclusively protective) against (drumroll) total mortality."


How is this reconciled with Figure 1 in the PREDIMED study referenced below that shows adjusted hazard ratios of total mortality in the MedDiet+nuts being roughly half that of in the MedDiet+EVOO group?


Reference: https://www.ncbi.nlm.nih.gov/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Click%20on%20image%20to%20zoom&p=PMC3&id=3738153_1741-7015-11-164-1.jpg


Frequency of nut consumption and mortality risk in the PREDIMED nutrition intervention trial


First: how did you get that image to link?


Second: it would've been helpful to have linked the paper itself, and not just this Figure. "You can't get there from here."


Third: see the section of my post where I discuss this paper ;)xyz  , beginning "in the substudy they're referring to,(6)".

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Full paper is here:



As far as I understand, if you are a high nut eater at the beginning of the study and assigned to MED+Nuts group you get 0.37 risk, which means all time nut eaters have the lowest mortality. On the other hand, if you are a high nut eater and assigned to MED+EVOO group, you cut back on nuts and use more EVOO since it's free. Does that mean replacing EVOO with nuts is not a good idea? Nuts > EVOO?


Table 2 is more interesting. If you eat just 3 servings of Walnuts a week, you get almost half the mortality. How is that possible, even after adjusting for tons of things? Walnuts >>> EVOO?

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Mech, you seem to be misunderstanding the study still. Again, this was not a study of the clinical trial treatment effect of EVOO or nuts: it was an nested epidemiological study of how baseline, pre-trial dietary habits impacted future health outcomes for the groups subsequently enrolled into the trial. It's not telling you anything about the benefit or lack of it of EVOO or a low-fat diet: it's telling you something about the benefits nut consumption, and how that interfaced with dietary assignment.

As you can see, there were at least nominal reductions in risk for high-nut consumers in all three groups, but people who were assigned to EVOO got less benefit from prior high nut intake, and people assigned to the low-fat control got less benefit still. The authors note that dietary assignment changed everyone's nut intake during the course of the trial:


"Changes in total nut consumption were +15.95 ± 21.10 g/day (mean ± SD) in the MedDiet supplemented with nuts, -0.80 ± 16.31 g/day in the MedDiet supplemented with extra virgin olive oil and −3.12 ± 13.85 g/day in the control group."


So people who ate a lot of nuts at baseline consumed substantially more nuts over the course of the trial when assigned to eat more nuts (and given free nuts to eat), and unsurprisingly got the greatest benefit from nuts. But people who ate a lot of nuts at baseline got less benefit from nuts if assigned to the EVOO and low-fat diets, because they either stayed the same or even ate slightly fewer nuts.


The lesson here is about eating more nuts: it's not itself about eating more or less EVOO.


And remember: we have the trial itself to answer that question, along with a ton of prior epidemiology and short-term trials. The answer is to eat nuts and EVOO.

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  • 1 month later...

Olive oil is not healthier for hearts.Yes, foods rich in monounsaturated fats like olive oil may be better than foods full of saturated and trans fats, but just because something is “better” does not mean it is good for you.

Better cigarettes (those with less nicotine and toxic chemicals like benzo(a)pyrenes) still promote lung cancer. Better monounsaturated fats like olive oil may still lead to diseased arteries. 

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Olive oil is not healthier for hearts.


Healthier than what? There are many threads, including the ones by MR here on these boards, which suggest EVOO is healthier than most fats for the heart, the CV system and all-cause mortality. The assertion that EVOO is not healthier would be more credible there was cited evidence.  


Yes, foods rich in monounsaturated fats like olive oil may be better than foods full of saturated and trans fats[...]


And right off the bat we have a problem here that renders the rest of your post meaningless. You state "foods rich in monosaturated fats like olive oil" - as if all monosaturated fats were equal, and olive oil was of equal status to those wrt. health effect. That is a serious misconception which destroys the credibility of anyone making such an assertion. OO is a universe removed from monosaturated fat that occurs in for example red meat. And EVOO as a food apart from the monosaturated FA also has other compounds in it that don't occur in OO, so that too needs to be taken into account when speaking of "foods" as you do.


but just because something is “better” does not mean it is good for you.

Better cigarettes (those with less nicotine and toxic chemicals like benzo(a)pyrenes) still promote lung cancer.


This doesn't have any bearing on the topic and represents no evidence as to the healthfulness or not of FA - it is a rhetorical point.


Better monounsaturated fats like olive oil may still lead to diseased arteries. 


And here we are back to the compounded problems as seen above - collapsing all monosaturated fats as if representative of OO, and lack of evidence that OO leads to diseased arteries.


Bottom line, there is not much value in your assertions and observations, beyond positing of negative possibilities with a complete absence of any evidence for the actual existence of such a possibility.

Edited by TomBAvoider
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Olive oil is not healthier for hearts.Yes, foods rich in monounsaturated fats like olive oil may be better than foods full of saturated and trans fats, but just because something is “better” does not mean it is good for you.

Better cigarettes (those with less nicotine and toxic chemicals like benzo(a)pyrenes) still promote lung cancer. Better monounsaturated fats like olive oil may still lead to diseased arteries. 



As Tom has already helpfully noted, this is all nonsense, seemingly derived from the low-fat vegan echo chamber (Jeff Novick, MacDougall, Rosane Oliveira, et al). Please see my mega-post on EVOO health benefits.

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MIchael, do you know if there is any transdermal absorption of polyphenols when olive oil is applied topically?  I notice some slight stimulating effects when I apply a moderately high polyphenol oil to my face and skin, although this might be more the result of the sensory qualities of a more pungent olive oil.

Edited by tea
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Wow what another fantastic thread. Thanks for the extensive reading and opinions.


Firstly I think it prudent to mention that the Japanese have rather extended lives and their diet tends to consist mostly of the following;


White rice, stewed vegetables, pickled vegetables and smaller relatively high oil fish such as Sardine and Pacific Saury. Most of this being enhanced with soy sauce. There is not a drop of olive oil anywhere on their tables, and trust me as a 3rd generation Italian American living on the pacific coast of Japan it tends to frustrate me as I am often handed a bottle of "salad oil" which is anything but made of olives. "Pfft what is this crap ?" I think to myself before demurring to the hostess.


In general the salt intake for the Japanese people is quite high, although I am not going to bother searching for a study that backs up my position as I have lived in the country for more than a decade and feel I am experienced enough to know the amounts of sodium they consume. Your standard old school breakfast is going to be a small bowl of white rice, a piece of grilled fish and a bowl of miso soup. Many a table also includes a fried egg and perhaps some pickles or related seaweed dish such as Hijiki. If you don't know what Hijiki is, do yourself a favor and take a closer look at it because its wonderful. There is also a distinct possibility that Natto will also be consumed at breakfast. If you can overcome the smell, the taste is not so terrible actually. Green tea is also popular but coffee seems to be the preferred choice of late.


Miso, Natto and Green tea are very healthy and I hope everyone here at least considers eating them on a semi regular basis.


Recently in their relative wealth and lifestyle adjustments the Japanese have switched to a Western diet. Lots of processed food, sweets and snack foods. The resulting number of obese people and those in relative ill health called "Metabo" here is profoundly disturbing. I could go on about the diet they consume traditionally but its not that relevant to the thread focusing on olive oil, suffice to say that longer life with essentially NO olive oil is possible as evidenced by the people of the Japanese archipelago. The endocrinology clinics are full of people on insulin and missing limbs because they fail to heed the doctors advice.


Relating to Olive Oil, I think it also pertinent to mention that many Italian distributors and wholesalers often blend their oils. Its somewhat frowned upon by purists but its an all too common occurrence. Indeed the wife and I were in Italy on a trip a few years ago and while sampling some local oils were told to buy it in the shop because they don't blend like the fancy folks in town. This was in a small shop in Frosinone although my relatives suggested http://www.attiliosfinefoods.com/to me for online shopping. I warn you that its not cheap and I tend to buy perhaps once a year and make due with the Italian brands at the local import shop that I am relatively convinced are blended. Spending money on a good quality olive oil is all well and good but perhaps its best to find the source of it if you are going to really get the "true" stuff.


Continuing on I would also like to point out that we should NEVER be eating oil or anything else from clear plastic bottles as they are treated with BPA or Bisphenol A. A very nasty chemical that produces a clear yet potent plastic perfect for the packing needs of 21st century distribution. BPA is not healthy and if you spend a little time researching it you will find that its a frequent additive in all kinds of processes. Please do not eat Olive oil from plastic bottles. The Mayo clinic has a blurb which does little justice to the issue http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/bpa/faq-20058331


BPA is nasty for young children especially boys, which is why we have seen a BPA movement in pacifiers and other infant related products. But they spray BPA inside cans as well. I try to buy beans from the bin the old fashioned way here in our town, but the grandmothers who still have it available are retiring in ever greater numbers.

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  • 9 months later...

What is the difference in results between the corrected version and the original?

There is some relevant material on the interwebz, some from authoritative sources (Harvard University). Apparently, nothing significant changed.

PREDIMED Study Retraction and Republication


What Changed, What Didn’t, and the Big Picture

On June 13, 2018, the New England Journal of Medicine (NEJM) retracted the 2013 study, “Primary Prevention of Cardiovascular Diseases with a Mediterranean Diet,” [1] as a result of error in randomization procedures affecting a portion of participants in the PREDIMED (Prevención con Dieta Mediterránea) trial. Concurrently, NEJM published a corrected version of the study with reanalyzed data, “Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts.” [2]

What Changed?

  • The number of participants included in the analysis:
    • The original study included 7447 participants at high cardiovascular risk to one of three diets: a Mediterranean diet supplemented with extra-virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet (advice to reduce dietary fat). [1]
    • The republished study disclosed several issues related to the randomization process: enrollment of household members without randomization; allocation of several clinics instead of individual patients at 1 of 11 study sites; and apparent inconsistent use of randomization tables at another study site.
    • The authors re-ran the analyses by statistically correcting for correlations within families or clinics. They also re-ran the analyses omitting 1588 participants whose trial-group assignments were known or suspected to have departed from proper randomization protocol. [2]

What Didn’t Change?

  • Despite these revelations, there was no significant change in the results of the trial when researchers reanalyzed the data:
    • In both the original and republished study, the incidence of cardiovascular disease in the Mediterranean diet groups was lowered by approximately 30% when compared to the control diet. [1,2]
    • The overall conclusion remains largely unchanged: “In this study involving persons at high cardiovascular risk, the incidence of major cardiovascular events was lower among those assigned to a Mediterranean diet supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet.” [2]
  • To date, PREDIMED remains the largest dietary intervention trial to assess the effects of the Mediterranean diet on cardiovascular disease prevention.


Edited by mccoy
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The PREDIMED study has been cited by Michael Rae in some of his posts here and by Valter Longo in his book as an evidence of the benefits of EVOO.

AFAIK, it's a benchmark study on the evidence of the benefits of EVOO and nuts. I'm pretty happy the results didn't change substantially.

I confess that even if they had changed, I would have gone on eating EVOO and nuts just the same. Old habits are hard to break, especially when there are so many other sources extolling the virtues of such foods .

Edited by mccoy
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On 2/23/2017 at 7:35 PM, Michael R said:

I say again: the benefits of consuming EVOO are backed by seven decades of scientific research culminating in a massive, randomized, multi-year controlled trial with hard outcomes. There is no other food in the world with that level of scientific support. If you aren't including 2 T of it in your diet a day, you're either ignorant sensu stricto, desperately poor, or a Damned Fool.

 Nice reminder. I'm digging this from Amphora:


Chilean Coratina

"Harvest Date: May 2018

Biophenols: 645 FFA: .19  Perox: 6.3 Oleic: 79.5

A wonderfully fruity Chilean Oil! This Coratina has classic notes of green banana and apple peel. Viscous with a jolt of pungency on the back end. An excellent choice for folks looking for a high phenol oil with a kick!"

Edited by Sthira
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AmphoraNueva also has a high phenol Chetoui (850+ polyphenols), but the crush date is back in November, so it's probably equal or slightly lesser potency than the new harvest Coratina.

On page 1 of this thread, Michael classifies Chetoui as a low phenol cultivar, but after some research, I would definitely think it falls under the high phenolic category.


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  • 4 months later...

All: in a post in another thread, I noted:


MUFA comes out neutral, or only very slightly beneficial [on CVD risk vs. carbs or SaFA], or even slightly harmful in well-done meta-analyses, presumably because of unavoidable confounding of MUFA with SaFA and its deleterious confounders in the Western diet:


the major sources of monounsaturated fatty acids in the United States and Scandinavia were dairy, meat, and partially hydrogenated oils.  A high intake of fat from these foods typifies an unhealthy lifestyle. Correction for confounders such as smoking, body mass index, and activity cuts the excess risk associated with high monounsaturated fatty acid intake in half, and therefore monounsaturated fatty acids may have acted as a surrogate for other risk factors. In countries in which olive oil is the main source, a high monounsaturated fatty acid intake is associated with lower rates of coronary heart disease.
Katan MB. Omega-6 polyunsaturated fatty acids and coronary heart disease. Am J Clin Nutr. 2009 May;89(5):1283-4. Epub 2009 Mar 25. PubMed PMID: 19321556.

 Certainly, both the epidemiological evidence within Mediterranean countries where olive oil is used in meaningful quantities, as well as now large-scale clinical trials, demonstrate that plant-based MUFA, and especially real extra-virgin olive oil (or, though less celebrated, canola) reduces cardiovascular events and mortality, likely total mortality, and mortality from some cancers.

A recent report supports this specifically for CVD risk, without even narrowly specifying olive oil (let alone high-phenolic EVOO):


We investigated the associations of cis MUFA intake from plant (MUFA-P) and animal (MUFA-A) sources with CHD risk separately among 63,442 women from the Nurses' Health Study (1990-2012) and 29,942 men from the Health Professionals Follow-Up Study (1990-2012).


Intakes of MUFA-Ps and MUFA-As were calculated by using validated food-frequency questionnaires collected every 4 y. Incident nonfatal myocardial infarction and fatal CHD cases (n = 4419) were confirmed by medical record review.


During follow-up, MUFA-Ps and MUFA-As contributed 5.8-7.9% and 4.2-5.4% of energy on average, respectively. When MUFA-Ps were modeled to isocalorically replace other macronutrients, HRs (95% CIs) of CHD were 0.83 (0.68, 1.00) for saturated fatty acids (SFAs; 5% of energy), 0.86 (0.76, 0.97) for refined carbohydrates (5% of energy), and 0.80 (0.70, 0.91) for trans fats (2% of energy) (P = 0.05, 0.01, and 0.001, respectively). For MUFA-As, corresponding HRs (95% CIs) for the same isocaloric substitutions were 1.04 (0.79, 1.38) for SFAs, 1.11 (0.91, 1.35) for refined carbohydrates, and 0.88 (0.77, 1.01) for trans fats (P = 0.76, 0.31, and 0.08, respectively). Given the common food sources of SFAs and MUFA-As (Spearman correlation coefficients of 0.81-0.83 between these groups of fatty acids), we further estimated CHD risk when the sum of MUFA-As and SFAs (5% of energy) was replaced by MUFA-Ps, and found that the HR was 0.81 (95% CI: 0.73, 0.90; P < 0.001) for this replacement.

PMID: 29566185
PMCID: PMC5875103 [Available on 2019-03-01]
DOI: 10.1093/ajcn/nqx004


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  • 3 weeks later...
 Just heard Dean Ornish speak and he still insists oils are bad in general for anyone with existing heart disease, his new book Undo It is soon to be released. As for those without heart disease he certainly favors whole food sources like nuts and olives. Interestingly the case against olive oil is supported by UC DAVIS see citation and they too suggest olives as a healthier choice.
Edited by mikeccolella
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To be honest, I'm still a bit skeptical about the value of EVOO but many have built what seems like a pretty solid case for it.  There are a lot of points in your above linked article that seem "bogus" and also kind of a straw man for this thread, the link talks about "oils" mostly, not specifically EVOO which seems to be taken in small almost daily doses by some people here.

"Oils are jam-packed with calories; as pure liquid fat, oil gets ALL their calories from FAT."

So a person should get almost all calories from carbs?  I'm not convinced, and they don't say why either... fats are beneficial for numerous reasons including to aid in the absorption of fat soluble nutrients.

"As a processed food, oil is virtually devoid of nutrients (except Vitamin E and Vitamin K)."

EVOO is a minimally processed food, basically just crushing the olives followed by straining out the solids, no solvents are used.  And it contains a lot of micronutrients which have even been shown to have cardiovascular system benefits and even blood pressure lowering effects.

"Oils slow blood flow, depress the immune system, stack up inside arteries, damage blood vessels and contribute to insulin resistance. ALL oils promote heart disease. A study in JAMA (Journal of the American Medical Association), all oils – saturated, monounsaturated (olive oil) and polyunsaturated (flax oil) – were associated with an increase in the plaque build up that clogs our arteries and leads to heart attacks."

Sounds like EVO is going to kill us (and they mention JAMA without bothering to cite the specific article?).  If you google olive oil and heart disease you'll see there is more than one side to this story (or read through this very thread).

or: https://www.bing.com/search?q=olive+oil+and+heart+disease    ?

"Oil also causes our red blood cells to clump up, which limits their ability to absorb and deliver oxygen to our cells and slows blood flow. Studies have shown that (blood) flow-mediated dilation decreases by over 30% for four hours after we eat a fatty meal. With such a decrease in flow-mediated dilation, is it any wonder that so many of us “crash” after a meal?"

Here's a webMD article that presents both sides of the debate: https://www.webmd.com/food-recipes/features/say-no-to-olive-oil

"Finally, according to the National Institutes of Health, oil suppresses our immune system, which makes us vulnerable to infections and impairs our bodies’ ability to stop the growth of cancer cells."

or: https://www.bing.com/search?q=olive+oil+and+the+immune+system    ?

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What does one do with such an article? A string of assertions with studies mentioned but not cited - a sensible argument is one where one can examine the grounds for the claims, but with no specific citations, there is no way to examine the studies and address the possible validity. Very frustrating.

Gordo's links have similar problems - in the webMD link, Vogel makes some mechanistic arguments based on a tiny sample, which is not super convincing, I guess in his world hormesis would not be a thing. 

EVOO is part of the diet/lifestyle nexus. It's a mistake to study its overall health effects in isolation from the matrix of foods it is consumed with and lifestyle factors such as exercise, sitting time, sleep patterns, drug/medication use etc. - I have no doubt one can engineer a scenario where isolated impact of EVOO may be negative, but it's like that old saw in philosophy "assuming a spherical cow" - this is not a real world result. 

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I personally think that many of us have a prejudice that olive oil is desirable -- I've never believed it.  IMO, OO is a high calorie, energy dense, nutrient poor over-valued prepared food.

I'm too lazy to find a lot of references agreeing with my prejudice -- but I caution, e.g. Gordo, to try to think objectively.

Another example:  whole grains (better than refined grains, but are they still any good?).  Luigi speaks in their favor; but the only evidence given is that they are a source of insoluble fiber.  Luigi claims that insoluble fiber is important for our gut microbiota -- but I've never seen any evidence that grains (whole or not) will do anything to improve the gut microbiota, for someone who eats primarily fruits and vegetables, like virtually all of us (not counting the carnivores).

  --  Saul

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It’s tricky especially because with epidemiology EVOO may look good for the average person because it just means they are eating the lesser of two evils, or they are more health conscious etc. etc. and please don’t show us rat studies geez.... IAC, I like the point that Whole Foods such as nuts and whole olives make more sense then processed oils. I think the logic there is very sound from what we see in nutritional science in general where more complex, less processed food is the way to go.

Also what about the point that Ornish and other reputable people have made that fats are harmful to the endothelial lining. High fat meals have been studied and yes they do decrease FMD.

here is a site with lots of research showing that even with improvements in blood lipids the oils, including OLIVE, damage endothelium and cause atherosclerosis in monkeys and blood flow diminished in humans.


Edited by mikeccolella
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