High Polyphenol Olive Oil and Heart Health: The Evidence

High polyphenol olive oil and heart health are linked in human trials through the polyphenol concentration, not the fat. In randomised controlled trials, olive oils identical in every respect except phenolic content produce different cardiovascular results, and the effect scales with the concentration.

The findings that replicate: high-polyphenol olive oil lowers oxidised LDL and markers of lipid peroxidation, raises HDL cholesterol, improves the ability of HDL to clear cholesterol from arterial walls, and reduces platelet aggregation in proportion to its oleocanthal content. In a 7,447-person randomised trial, a Mediterranean diet with extra virgin olive oil cut heart attack, stroke and cardiovascular death by 31% against a low-fat control.

One effect carries formal EU authorisation: olive oil polyphenols contribute to the protection of blood lipids from oxidative stress, provided the oil delivers at least 5 mg of hydroxytyrosol and its derivatives per 20 g consumed daily. Most retail olive oil does not reach that threshold.

What the trials show about high polyphenol olive oil and heart health

• Protection of blood lipids from oxidation. The one effect with EU regulatory authorisation. Consistent across 26 studies in meta-analysis.

• Lower oxidised LDL. The most reproducible biomarker finding in the literature.

• HDL that works better, not just HDL that is higher. Polyphenol-rich olive oil improved HDL cholesterol efflux capacity, the function that clears cholesterol from arterial walls.

• Platelet aggregation falls in proportion to oleocanthal. In type 2 diabetes patients, an oil at 500 mg/kg oleocanthal produced a platelet effect comparable to 400 mg of ibuprofen.

• Better endothelial function and lower blood pressure in people with raised blood pressure and metabolic risk.

• Fewer cardiovascular events in the largest randomised dietary trial ever run.

High polyphenol olive oil and heart health: the evidence at a glance

Endpoint	What the trials found	Certainty
Blood lipids protected from oxidation	Protective ¹	Authorised
Oxidised LDL	Reduced ²	Strong
Lipid peroxidation (MDA)	Reduced ³	Strong
HDL cholesterol	Increased, dose-dependently ⁴	Strong
Total cholesterol	Reduced ⁵	Strong
Cardiovascular events	Reduced ⁶	Strong
HDL efflux capacity	Improved ⁷	Substantial
LDL particle atherogenicity	Reduced ⁸	Substantial
Platelet aggregation	Reduced, in step with oleocanthal ⁹	Substantial
Endothelial function	Improved ¹⁰	Substantial
Systolic blood pressure	Reduced in raised-BP groups ¹¹	Substantial
Cholesterol-efflux genes	Upregulated ¹²	Substantial
Inflammatory markers	Reduced ¹³	Emerging

The numbers behind each row

1. Authorised under EU Regulation 432/2012, at 5 mg hydroxytyrosol and derivatives per 20 g daily. Covas 2006 (n=200); George 2019 meta-analysis (26 trials).

2. George 2019: SMD −0.44 (95% CI −0.78 to −0.10).

3. George 2019: −0.07 µmol/L (95% CI −0.12 to −0.02).

4. Covas 2006: rose linearly across 2.7, 164 and 366 mg/kg. George 2019: +2.37 mg/dL.

5. George 2019: −4.5 mg/dL.

6. PREDIMED (Estruch 2018): HR 0.69 (95% CI 0.53–0.91) for the Mediterranean diet with extra virgin olive oil against a low-fat control. Diet pattern, not phenolic fraction.

7. Hernáez 2014: +3.05% on polyphenol-rich oil vs −2.34% on polyphenol-poor oil, P=0.042.

8. Hernáez 2015, Journal of Nutrition.

9. Katsa 2024: ADP sensitivity down 50–100%, TRAP down 20–50%, dose-dependent. Agrawal 2017: the effect tracked oleocanthal, not total phenolics (R=0.56, P=0.002).

10. Moreno-Luna 2012; Njike 2021.

11. Moreno-Luna 2012; Schwingshackl 2019 network meta-analysis.

12. Farràs 2013, Journal of Nutritional Biochemistry. ABCA1 and related transporters.

13. Patti 2020; Ruiz-García 2023 (APRIL study).

The authorised claim, and the number attached to it

The European Union permits one health claim on olive oil polyphenols. Under Commission Regulation (EU) 432/2012:

Olive oil polyphenols contribute to the protection of blood lipids from oxidative stress.

The condition of use is specific. The oil must deliver at least 5 mg of hydroxytyrosol and its derivatives, which the regulation defines to include the oleuropein complex and tyrosol, per 20 g of olive oil, taken daily. Five milligrams in twenty grams is 250 mg/kg.

Almost no olive oil on a supermarket shelf reaches it. The oil that satisfies this claim is not an ordinary oil.

Our 2025/2026 harvest was analysed by LC-MS/MS at the IOC-accredited laboratory of the Universidad de Córdoba, under the ARISTOIL Interreg Mediterranean programme:

	mg/kg
Hydroxytyrosol and derivatives	947
Tyrosol and derivatives	1,284
Claim-relevant phenols (EU 432/2012)	2,231
Oleocanthal	1,248
Total phenolic compounds	2,236

A 20 g daily intake of this oil delivers 44.6 mg of hydroxytyrosol, tyrosol and their derivatives, against a regulatory minimum of 5 mg. 8.9 times the threshold.

Everything below this line describes what researchers have found in named trials, in named journals. It is science, reported as science.

1. The polyphenol number is the variable, not the olive oil

The study that anchors this field is deceptively simple in design.

In 2006, Covas and colleagues published the EUROLIVE trial in the Annals of Internal Medicine. Two hundred healthy men, six research centres, five European countries. Each man consumed 25 mL of olive oil per day for three weeks, then crossed over to a different oil, then a third.

The three oils were the same oil. Same variety, same fatty acid profile, same monounsaturated fat, same dose. One thing changed: the polyphenol concentration. 2.7 mg/kg, 164 mg/kg, 366 mg/kg.

HDL cholesterol rose in a straight line with the phenolic content. The total cholesterol to HDL ratio fell in a straight line. Oxidative damage to lipids fell in a straight line. The oil at 366 mg/kg outperformed the oil at 164 mg/kg, which outperformed the oil at 2.7 mg/kg.

That is a dose-response relationship, and dose-response is the strongest signal a nutrition trial can produce. It is why the high-phenolic category exists at all. It also carries a conclusion the industry rarely states out loud: if the effect scales with concentration, an oil at 50 mg/kg is not a weaker version of an oil at 2,000 mg/kg. It is closer to the placebo arm.

I hold the record for the highest polyphenol concentration ever measured in an olive oil, 4,943 mg/kg, from the 2018 harvest. That is worth mentioning here for one reason, which is that chasing the number taught me what this graph implies. If the biological effect is linear in concentration, then concentration is an agronomic and processing target, not a marketing adjective. Everything about how we farm, when we pick and how we mill follows from it.

2. Olive oil polyphenols and cholesterol: protecting blood lipids from oxidation

Oxidised LDL is not a cosmetic marker. LDL particles chemically damaged by free radicals are the ones macrophages engulf to become foam cells, and foam cells are the raw material of atherosclerotic plaque. Native, undamaged LDL does not do this nearly as readily. Oxidation is where the trouble starts.

This is the effect the European Union authorised, and the authorisation rests on unusually consistent evidence.

George and colleagues, in Critical Reviews in Food Science and Nutrition (2019), pooled 26 clinical trials comparing high-polyphenol against low-polyphenol olive oil. Against the low-polyphenol comparator, the high-polyphenol oils produced:

• Oxidised LDL: standardised mean difference −0.44 (95% CI −0.78 to −0.10)

• Malondialdehyde, a marker of lipid peroxidation: −0.07 µmol/L (95% CI −0.12 to −0.02)

• Total cholesterol: −4.5 mg/dL

• HDL cholesterol: +2.37 mg/dL

Twenty-six trials pointing the same way. Castañer and colleagues at IMIM Barcelona, writing in the American Journal of Clinical Nutrition in 2012, sharpened the picture: polyphenol-rich olive oil not only protected LDL from oxidation but downregulated CD40-ligand and its downstream products in the same subjects, linking the antioxidant effect directly to pro-atherogenic inflammatory signalling.

The mechanism is not mysterious. Hydroxytyrosol and its derivatives are incorporated into the LDL particle itself. They travel with it. They are present at the site where oxidation would otherwise happen.

3. HDL that works, not HDL that is merely high

For thirty years HDL was treated as a number to be raised. That view aged badly. Drugs that raised HDL cholesterol substantially failed to reduce cardiovascular events, and the field moved to a better question: not how much HDL, but how well it works.

The function that matters is cholesterol efflux capacity, HDL's ability to pull cholesterol out of macrophages sitting in an arterial wall and carry it to the liver. Efflux capacity predicts cardiovascular events independently of HDL cholesterol level.

Hernáez and colleagues tested exactly that in Arteriosclerosis, Thrombosis, and Vascular Biology (2014). A randomised crossover, 25 mL per day, olive oil at either 2.7 mg/kg or 366 mg/kg of polyphenols.

Cholesterol efflux capacity improved by 3.05% on the polyphenol-rich oil and fell by 2.34% on the polyphenol-poor oil (P=0.042). The particles themselves changed: the HDL core became triglyceride-poor, the membrane more fluid, and small dense HDL3 fell.

One level down, the reason becomes visible. Farràs and colleagues, in the Journal of Nutritional Biochemistry (2013), showed that olive oil polyphenols upregulated cholesterol-efflux gene expression in living human subjects, including ABCA1, the transporter that physically moves cholesterol out of the macrophage and onto the HDL particle.

Polyphenols do not simply move a number on a lipid panel. They change what the particle is able to do.

4. Oleocanthal, heart health, and the platelet

This part of the story has nothing to do with cholesterol.

In 2005, Beauchamp and colleagues published a short paper in Nature. The peppery, throat-catching sting of a fresh bitter olive oil comes from a single molecule, and that molecule inhibits cyclooxygenase in the manner of ibuprofen. They named it oleocanthal.

Two decades on, the cardiovascular consequence has been tested in people.

Agrawal and colleagues, 2017, Journal of Functional Foods. Nine healthy men, 40 mL of extra virgin olive oil, randomised crossover. The critical design choice: the oils were matched for total phenolic content and differed only in phenolic profile. Some rich in oleocanthal, one dominated by tyrosol. Collagen-stimulated maximum platelet aggregation fell, and the size of the fall correlated with oleocanthal intake specifically (R=0.56, P=0.002), not with total polyphenols.

That detail matters more than anything else on this page. Total polyphenol content did not predict the platelet effect. Oleocanthal did. An oil can carry an impressive total phenolic number, be poor in oleocanthal, and on this endpoint behave like a weak oil.

This is not a theoretical concern. I read a lot of other people's laboratory reports, and the pattern is consistent enough to be predictable: a producer leads with an impressive total phenolic figure, and the oleocanthal line, if it appears at all, is a small fraction of it. Oleuropein aglycone and its isomers can carry a total number a long way on their own. The reason is in the mill, and I will come back to it below.

Katsa and colleagues, 2024, International Journal of Molecular Sciences. Ten patients with type 2 diabetes, randomised crossover, five isocaloric meals of white bread combined with one of: butter; butter plus 400 mg ibuprofen; olive oil below 10 mg/kg phenolics; olive oil at 250 mg/kg oleocanthal; olive oil at 500 mg/kg oleocanthal.

Platelet sensitivity to ADP fell by 50 to 100%, and to TRAP by 20 to 50%, sustained from 90 to 240 minutes after the meal. The effect was dose-dependent between the 250 and 500 mg/kg arms.

The oil containing 500 mg/kg of oleocanthal produced a platelet effect comparable to the meal containing 400 mg of ibuprofen.

Glucose and triglyceride responses were identical across all five meals. The platelet effect was not a knock-on from a better metabolic response. It was the oil.

Now set a number beside it. The strongest arm of the Katsa trial used an oil at 500 mg/kg oleocanthal. Our 2025/2026 harvest measures 1,248 mg/kg oleocanthal by LC-MS/MS at the Universidad de Córdoba.

Those are two separate facts: a published trial, and a laboratory measurement. What connects them is worth knowing. Oleocanthal is the one polyphenol in olive oil whose concentration is almost never published. The trials that found the platelet effect specified it in mg/kg. And a total polyphenol figure on a label tells you nothing whatsoever about it.

5. Olive oil polyphenols, blood pressure and endothelial function

The endothelium is the single cell layer lining every blood vessel. It decides, moment to moment, whether the vessel dilates or constricts. Endothelial dysfunction is one of the earliest detectable steps toward cardiovascular disease, arriving long before any plaque is visible on a scan.

Moreno-Luna and colleagues, 2012, American Journal of Hypertension. Twenty-four young women with high-normal blood pressure or stage 1 hypertension, double-blind randomised crossover. Two diets, identical except for the olive oil: one polyphenol-rich at roughly 30 mg per day, one polyphenol-free. Blood pressure fell and endothelial function improved on the polyphenol-rich oil.

Njike, Katz and colleagues, 2021, International Journal of Cardiology. Twenty adults with prediabetes or metabolic syndrome. A single 50 mL dose of high-polyphenolic extra virgin olive oil against refined olive oil containing no polyphenols. Endothelial function improved measurably within hours of one dose.

Schwingshackl's network meta-analysis in Nutrition, Metabolism and Cardiovascular Diseases compared refined, low-phenolic and high-phenolic oils head to head across the trial literature, and ranked high-phenolic extra virgin olive oil highest on systolic blood pressure and on oxidised LDL. (The European Food Safety Authority reviewed a proposed disease-risk-reduction claim on these endpoints in May 2025 and considered the evidence short of the bar it applies to that specific class of claim, which is deliberately severe and distinct from what the trials above report.)

6. Does high polyphenol olive oil and heart health translate into fewer heart attacks?

One trial has tested it at scale.

PREDIMED randomised 7,447 people at high cardiovascular risk in Spain to one of three diets: a Mediterranean diet supplemented with roughly 50 mL per day of extra virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet advising reduced fat. Median follow-up, 4.8 years. Primary endpoint: myocardial infarction, stroke, or cardiovascular death.

Extra virgin olive oil arm: hazard ratio 0.69 (95% CI 0.53 to 0.91). A 31% relative reduction in major cardiovascular events. The trial was republished in the New England Journal of Medicine in 2018 following a reanalysis with more conservative methods, and the result held.

Read it precisely. PREDIMED tested a dietary pattern including extra virgin olive oil against a low-fat diet. It did not randomise high-phenolic against low-phenolic oil, so it cannot alone prove the polyphenol fraction caused the reduction.

What it does supply is a dose-response signal pointing the same direction as everything above. Guasch-Ferré and colleagues, analysing olive oil intake within the PREDIMED cohort in BMC Medicine, found participants in the highest tertile of extra virgin olive oil consumption had a 39% lower risk of cardiovascular disease (HR 0.61, 95% CI 0.44 to 0.85), and that every additional 10 g per day of extra virgin olive oil was associated with a 10% lower cardiovascular risk.

More oil, less disease. More polyphenols, better biomarkers. Two independent lines of evidence converging on the same conclusion.

7. The number on the label is not the number in the bottle

Every trial on this page dosed a measured concentration. Covas dosed 366 mg/kg. Katsa dosed 500 mg/kg of oleocanthal. The results are dose-dependent, which means the concentration at the moment of swallowing is the concentration that matters.

Polyphenols are antioxidants. That is the point of them, and it is also their weakness. An antioxidant works by being oxidised in place of something else. Every day a bottle of olive oil sits in contact with oxygen, warmth and light, its polyphenol concentration falls. Oleocanthal and oleacein, the two most bioactive secoiridoids and the two responsible for the peppery bite, are among the least stable of all.

I have watched this happen to my own oil. Send the same batch to the same laboratory six months apart, stored the way retail oil is normally stored, and the second report does not look like the first. The total phenolic figure falls. The oleocanthal figure falls faster.

An oil harvested at 2,000 mg/kg, decanted into a clear bottle, shipped through an unrefrigerated warehouse and left half-empty on a kitchen counter for four months is not a 2,000 mg/kg oil by the time it reaches the mouth. The number on the label is a historical fact about a laboratory. It is not a fact about your spoon.

This is why the harvest date is a more useful piece of information than almost anything else printed on a bottle, and it is why we stopped selling oil in bottles at all. Each dose is a 5 mL monodose, filled under nitrogen, sealed away from oxygen and held in cold chain from the mill to customer dispatch. The dose taken is the dose that was measured.

It is also why the mill matters more than the grove. Oleocanthal is not sitting inside the olive waiting to be pressed out. It is formed during malaxation, when β-glucosidase and the OeEAME1/OeEAME2 methylesterase pathway act on ligstroside aglycone in the crushed paste. Get the fruit maturity, the malaxation temperature or the malaxation time wrong and the oleocanthal is simply never created.

This is why so many high-polyphenol oils publish a large total phenolic number alongside a small oleocanthal number, and why most never publish the oleocanthal figure at all. The total is agronomy. The oleocanthal is process control.

What high polyphenol olive oil and heart health actually comes down to

The literature is consistent on a narrow point, and it is the point most olive oil marketing gets backwards.

The cardiovascular effects in these trials do not come from olive oil. They come from molecules that olive oil can carry, at concentrations the ordinary retail market does not reach. The trial that isolated the platelet effect found it tracked one compound, oleocanthal, that almost nobody measures and almost nobody reports.

So ask for the number. Ask for the method: LC-MS/MS, or HPLC under COI/T.20/Doc. No 29, are the accredited standards. Ask for the harvest date. Ask what happened to the oil between the mill and your hand.

I have spent many years reading these reports, and the thing that still surprises people is how little the words on a label correlate with the numbers on the page. Two oils can both be certified extra virgin, both organic, both single-estate, and one can carry forty times the polyphenol content of the other.

An oil that cannot answer those questions is a condiment. There is nothing wrong with a condiment. It is simply not what any of these trials were studying.

Nicolas Netien is Co-founder and Chief Scientific Officer of Oleaphen. He holds the world record for the highest polyphenol concentration ever measured in olive oil (4,943 mg/kg, 2018 harvest) and is a Knight of the Order of Agricultural Merit of the French Republic.

4. FAQ

Frequently asked questions

Is high polyphenol olive oil and heart health actually supported by human trials, or only by laboratory work?

By human trials. The EUROLIVE study (Covas et al., Annals of Internal Medicine, 2006) randomised 200 men across five European countries to olive oils differing only in polyphenol concentration, and found HDL cholesterol, the total cholesterol to HDL ratio and lipid oxidative damage all improved in proportion to the phenolic content. A 2019 meta-analysis in Critical Reviews in Food Science and Nutrition pooled 26 clinical trials and found high-polyphenol olive oil reduced oxidised LDL, malondialdehyde and total cholesterol, and raised HDL cholesterol, against low-polyphenol olive oil.

How many polyphenols does olive oil need for the EU health claim?

At least 5 mg of hydroxytyrosol and its derivatives, which Commission Regulation (EU) 432/2012 defines to include the oleuropein complex and tyrosol, per 20 g of olive oil consumed daily. That works out to 250 mg/kg. Most retail extra virgin olive oil does not reach it. Our 2025/2026 harvest measures 2,231 mg/kg of claim-relevant phenols, delivering 44.6 mg in a 20 g daily intake, 8.9 times the regulatory minimum.

What is oleocanthal, and why is it measured separately?

Oleocanthal is the compound responsible for the peppery sting at the back of the throat in a fresh, bitter olive oil. It was identified in 2005 by Beauchamp and colleagues in Nature, who found it inhibits cyclooxygenase in the manner of ibuprofen. It is measured separately because total polyphenol content does not predict it. In the 2017 trial by Agrawal and colleagues in the Journal of Functional Foods, oils were deliberately matched for total phenolic content and differed only in profile, and the reduction in platelet aggregation tracked oleocanthal specifically, not the total.

Can high polyphenol olive oil replace a statin or an aspirin?

No. Nothing on this page should be read as a substitute for prescribed medication, and no one should alter a prescription without speaking to their doctor. The trials described here measured biomarkers and vascular function in defined populations. They did not test olive oil as a replacement for any medicine.

How much high polyphenol olive oil per day did the trials use?

The doses cluster tightly. Covas used 25 mL per day. Hernáez used 25 mL per day. Agrawal and Katsa used a single 40 mL dose. Njike used a single 50 mL dose. PREDIMED supplied roughly 50 mL per day. The EU authorised claim is written around 20 g, which is a little over 20 mL.

Why does olive oil lose its polyphenols, and how fast?

Polyphenols are antioxidants, and an antioxidant works by being consumed in place of something else. Exposure to oxygen, heat and light degrades them continuously from the moment the oil leaves the mill. Oleocanthal and oleacein, the two most bioactive secoiridoids, are among the least stable. An oil bottled at a high concentration and stored on a warm shelf for months is not delivering that concentration by the time it is eaten, which is why our oil is sold in nitrogen-flushed 5 mL monodoses held in cold chain rather than in bottles.

Does high polyphenol olive oil lower blood pressure?

Several randomised trials have reported improvements. Moreno-Luna and colleagues (American Journal of Hypertension, 2012) found that in young women with high-normal blood pressure or stage 1 hypertension, a polyphenol-rich olive oil diet lowered blood pressure and improved endothelial function against an identical diet with polyphenol-free oil. A network meta-analysis by Schwingshackl and colleagues ranked high-phenolic extra virgin olive oil highest among olive oil types on systolic blood pressure. Blood pressure is not an EU-authorised claim for olive oil polyphenols, so these are reported as research findings.

How do I know an olive oil really contains the polyphenols it claims?

Ask for the method and the laboratory. LC-MS/MS and HPLC under COI/T.20/Doc. No 29 are the accredited analytical standards recognised by the International Olive Council. Ask for the harvest date, because concentration falls with time. And ask specifically for the oleocanthal figure, not just the total, because the total will not tell you what you need to know. CITATIONS

1. Covas MI, Nyyssönen 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):333-341. doi:10.7326/0003-4819-145-5-200609050-00006

2. Hernáez Á, Fernández-Castillejo S, Farràs M, et al. Olive oil polyphenols enhance high-density lipoprotein function in humans: a randomized controlled trial. Arterioscler Thromb Vasc Biol. 2014;34(9):2115-2119. doi:10.1161/ATVBAHA.114.303374

3. Hernáez Á, Remaley AT, Farràs M, et al. Olive oil polyphenols decrease LDL concentrations and LDL atherogenicity in men in a randomized controlled trial. J Nutr. 2015;145(8):1692-1697.

4. Farràs M, Valls RM, Fernández-Castillejo S, et al. Olive oil polyphenols enhance the expression of cholesterol efflux related genes in vivo in humans. J Nutr Biochem. 2013;24(7):1334-1339. doi:10.1016/j.jnutbio.2012.10.008

5. Castañer O, Covas MI, Khymenets O, et al. Protection of LDL from oxidation by olive oil polyphenols is associated with a downregulation of CD40-ligand expression and its downstream products in vivo in humans. Am J Clin Nutr. 2012;95(5):1238-1244.

6. Moreno-Luna R, Muñoz-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):1299-1304. doi:10.1038/ajh.2012.128

7. Njike VY, Ayettey R, Treu JA, Doughty KN, Katz DL. Post-prandial effects of high-polyphenolic extra virgin olive oil on endothelial function in adults at risk for type 2 diabetes: a randomized controlled crossover trial. Int J Cardiol. 2021. [volume and pages to confirm]

8. Agrawal K, Melliou E, Li X, et al. Oleocanthal-rich extra virgin olive oil demonstrates acute anti-platelet effects in healthy men in a randomized trial. J Funct Foods. 2017;36:84-93. doi:10.1016/j.jff.2017.06.046

9. Katsa ME, Ketselidi K, Kalliostra M, et al. Acute antiplatelet effects of an oleocanthal-rich olive oil in type II diabetic patients: a postprandial study. Int J Mol Sci. 2024;25(2):908. doi:10.3390/ijms25020908

10. Beauchamp GK, Keast RSJ, Morel D, et al. Phytochemistry: ibuprofen-like activity in extra-virgin olive oil. Nature. 2005;437(7055):45-46.

11. George ES, Marshall S, Mayr HL, et al. The effect of high-polyphenol extra virgin olive oil on cardiovascular risk factors: a systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2019;59(17):2772-2795. doi:10.1080/10408398.2018.1470491

12. Schwingshackl L, Krause M, Schmucker C, Hoffmann G, Rücker G, Meerpohl JJ. Impact of different types of olive oil on cardiovascular risk factors: a systematic review and network meta-analysis. Nutr Metab Cardiovasc Dis. 2019.

13. Hohmann CD, Cramer H, Michalsen A, et al. Effects of high phenolic olive oil on cardiovascular risk factors: a systematic review and meta-analysis. Phytomedicine. 2015;22(6):631-640.

14. Estruch R, Ros E, Salas-Salvadó J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. N Engl J Med. 2018;378(25):e34. doi:10.1056/NEJMoa1800389

15. Guasch-Ferré M, Hu FB, Martínez-González MA, et al. Olive oil intake and risk of cardiovascular disease and mortality in the PREDIMED study. BMC Med. 2014;12:78.

16. Patti AM, Carruba G, Cicero AFG, et al. Daily use of extra virgin olive oil with high oleocanthal concentration reduced body weight, waist circumference, alanine transaminase, inflammatory cytokines and hepatic steatosis in subjects with the metabolic syndrome: a 2-month intervention study. Metabolites. 2020;10(10):392.

17. Ruiz-García I, Ortíz-Flores R, Badía R, et al. Rich oleocanthal and oleacein extra virgin olive oil and inflammatory and antioxidant status in people with obesity and prediabetes. The APRIL study. Clin Nutr. 2023.

18. Farràs M, Castañer O, Martín-Peláez S, et al. Complementary phenol-enriched olive oil improves HDL characteristics in hypercholesterolemic subjects. The VOHF study. Mol Nutr Food Res. 2015;59(9):1758-1770.

19. Commission Regulation (EU) No 432/2012 of 16 May 2012 establishing a list of permitted health claims made on foods.

20. EFSA Panel on Nutrition, Novel Foods and Food Allergens. Phenolic compounds naturally present in olive oil and lowering of blood LDL-cholesterol and systolic blood pressure, therefore reducing the risk of coronary heart disease. EFSA Journal. 2025. doi:10.2903/j.efsa.2025.9470