Reviewing the cardiovascular and other health effects of olive oil: Limitations and future directions of current supplement formulations.

We reviewed the literature to date for high-level evidence on the cardiovascular and other health effects of olive oil with a focus on the amount, frequency of use and type of olive oil consumed in prior studies. A total of twelve prospective cohort studies with sample sizes of at least 4000 individuals and one meta-analysis were identified. The majority of cohorts followed individuals aged ≥55 years old, free of cardiovascular disease (CVD) at baseline but at high risk, over periods of 4–10 years and with daily consumption amounts of 10–35 g/day. With the exception of the PREDIMED cohort that employed extra virgin olive oil, most remaining studies did not differentiate between different types of olive oil. Taken together, the data suggests an association between greater olive oil consumption and a lower CVD incidence/mortality and stroke risk. We use this information to evaluate the use of commercially available, capsule-based olive oil dietary supplements and suggest future directions. Notably, achieving minimum total daily doses described in the aforementioned studies would be challenging with current market formulations of olive oil supplements dosed at 1–1.25 g/capsule. Outside of mechanistic studies, little progress has been made in determining the olive oil component(s) underlying the observed health effects given the lack of compositional reporting and consistency across large scale human studies. We propose the use of supplements of varying composition, such as varying total phenolic content, in pragmatic trial designs focused on low-cost methodologies to address this question. • Olive oil consumption is associated with decreased cardiovascular disease incidence and mortality. • Limited clinical data exists in support of consuming extra virgin olive oil with a high phenolic content. • More research is required to ascertain the exact olive oil nutritional composition accounting for observed health benefits. • Olive oil dietary supplement formulations released to date fall short of minimum daily dosing requirements. • We propose their use in clinical trials to determine which olive oil components have a cardioprotective effect. [ABSTRACT FROM AUTHOR]