The Health Benefits of Extra Virgin Olive Oil
The Gift of the Olive Tree
By Dr Artemis Morris
What is the best oil to use for health benefits and taste? The answer is found in the gift of the olive tree.
For decades, Americans have received conflicting advice about dietary fats and oils, from low fat to no fat, margarine to seed oils. Let’s explore the nutritional science behind the keystone ingredient of the Mediterranean diet: an oil that has risen above the rest for both its health benefits and its taste, extra virgin olive oil (EVOO).
How did we become so confused about dietary fat?
To understand the science, it helps to take a walk down memory lane into the kitchens of homemakers circa 1970. Following epidemiological research by Dr. Ancel Keys, ironically the same physician whose work identified the benefits of the Mediterranean diet, homemakers were encouraged to avoid cholesterol and saturated fats found in lard and butter and replace them with low fat products, refined vegetable and seed oils, margarine, and white, tasteless shortening for cooking and frying.
Even my Greek mother was not immune to the nutritional advice of the time. Hydrogenated shortening such as Crisco came laden with health claims: “heart healthy,” “more digestible,” and a “cholesterol free alternative” to other fats. It also promised crispier fries and pies and seemed never to go bad.
Many decades later, hydrogenated fats, also known as trans fats, found in shortening and some margarines were shown to raise harmful cholesterol, promote inflammation and atherosclerosis, and increase cardiovascular risk. The review “The Negative Effects of Hydrogenated Trans Fats and What to Do About Them” details how industrial trans fats contribute to coronary disease and why eliminating them became a public health priority.[1]
Since then, nutritional science has finally caught up with centuries of traditional wisdom. Highly processed “low fat” foods, hydrogenated shortenings, and highly refined seed oils are not health foods. Many highly processed foods can be laden with refined starches, added sugars, and additives that make them shelf stable and tasteless.
The 25 year Seven Countries Study analysis found that populations consuming more saturated and trans fats had substantially higher coronary heart disease death rates.[2] This was one of many hard lessons about trusting health claims, even well intentioned ones, especially around food.
Yet confusion remains about which fats and oils are healthiest.
Let’s break through the confusion and marketing mania surrounding which oil is best and how to use it.
It is not simply how much fat we eat that matters. It is the type and quality of the fat, how it is used, and what it replaces in the diet that make all the difference for health and longevity.
The accumulated evidence has moved nutrition science beyond the idea that all fats are interchangeable, or that eating as little fat as possible is the key to health. Hydrogenated trans fats are clearly harmful. Excess saturated fat can raise LDL cholesterol, particularly when it is not replaced with unsaturated fat.
Polyunsaturated fats (PUFAs) and monounsaturated fats (MUFAs) can both be valuable replacements. Extra virgin olive oil stands out because it supplies not only monounsaturated fat but also a complex mixture of beneficial phenolic compounds that protect the olive fruit and may help protect the humans who consume it against chronic disease.
Lesson #1: Lower saturated fat in relation to monounsaturated fat from foods such as olive oil
The Seven Countries Study led by Dr. Ancel Keys gave rise to our understanding of the health benefits of the Mediterranean diet and followed participants for up to 60 years. It was the first major study to show that dietary patterns lower in saturated fat and richer in monounsaturated fat, as found in the traditional Mediterranean diet that uses olive oil as its principal fat, were associated with markedly lower coronary heart disease and all cause mortality.
The 2025 historical and scientific review of Ancel Keys, the Mediterranean diet, and the Seven Countries Study places those long term findings in context and explains how the quality and food sources of fat became central to cardiovascular nutrition.[3]
A modern nutritional quality model based on international dietary recommendations ranked virgin olive oil first among 32 edible oils. The study “Virgin Olive Oil Ranks First in a New Nutritional Quality Score Due to Its Compositional Profile” gave virgin olive oil 100 points because of its favorable fatty acid profile and naturally retained plant antioxidants.[4]
While olive oil, avocado oil, and some other seed and vegetable oils are rich in monounsaturated fatty acids, EVOO stands apart because it is minimally processed and retains a high concentration and diversity of health promoting olive phenols.
That combination, not monounsaturated fat alone, is one reason EVOO has become the best studied culinary oil within a healthy Mediterranean dietary pattern.
Lesson #2: Choose extra virgin olive oil for the greatest potential benefit
In the CORDIOPREV randomized clinical trial, 1,002 adults with established coronary heart disease were assigned to a Mediterranean diet rich in EVOO or a low fat diet for seven years. Major cardiovascular events occurred in 87 people in the Mediterranean diet group and 111 in the low fat group, approximately 26% fewer events with the Mediterranean pattern.[5]
The health value of olive oil depends partly on how it is produced, stored, and used. EVOO retains more phenolic compounds because it has not been chemically refined.
Protect it from H-A-L-T: heat, air, light, and time.
Enjoy it with food. Cook, marinate, fry, and bake with it. EVOO not only adds flavor but also helps the body absorb fat soluble nutrients in vegetables and helps protect nutrients in food.
What exactly is extra virgin olive oil?
Olive oil is the fresh pressed juice of the olive fruit. For thousands of years, Mediterranean cultures have used it as food, medicine, for topical skin care, and as part of religious and spiritual life.
According to the International Olive Council’s olive oil standards, extra virgin olive oil is produced from olives by mechanical or physical means, is suitable to consume as it is, and has free acidity of no more than 0.8 grams per 100 grams.[6]
It must also pass chemical and sensory standards. Certified tasters look for fruitiness and the absence of defects.
“Virgin,” “olive oil,” “light olive oil,” and “olive pomace oil” are not interchangeable with EVOO. Refined grades still contain oleic acid, but refining removes much of the aroma, flavor, and important phenols and bioactive compounds that contribute to its antioxidant, anti-inflammatory, antimicrobial, and other health related properties.
What is in a tablespoon of EVOO?
EVOO is nutrient dense rather than vitamin dense. According to USDA FoodData Central, one tablespoon, about 14 grams, supplies approximately 119 calories and 13.5 grams of fat: about 10 grams monounsaturated, 1.9 grams saturated, and 1.4 grams polyunsaturated fat, with no carbohydrate, protein, cholesterol, or sodium of nutritional significance.[7]
It also provides approximately 1.9 mg of vitamin E and 8 mcg of vitamin K, although values vary by cultivar, climate, harvest, processing, and storage.
The real nutritional personality of EVOO comes from two complementary fractions.
The major fraction: Triglycerides, dominated by oleic acid, a monounsaturated omega-9 fatty acid that generally makes up about 55% to 83% of the oil.
The minor fraction: Phenolic compounds, tocopherols, squalene, phytosterols, pigments, and volatile compounds. These represent only a small part of the oil, but they contribute disproportionately to flavor, stability, and biological activity.
Important compounds in EVOO include oleocanthal, hydroxytyrosol, tyrosol, oleuropein derivatives, squalene, vitamin E, chlorophylls, and carotenoids.
Oleocanthal, responsible for part of the peppery throat sting, affects the same COX inflammatory enzymes targeted by ibuprofen in laboratory testing. The review “Oleocanthal, a Phenolic Derived from Virgin Olive Oil” summarizes its effects on inflammatory and disease related pathways.[8]
Hydroxytyrosol and tyrosol are antioxidant phenols that help protect lipids from oxidation.
Oleuropein derivatives contribute bitterness and are being studied for vascular and metabolic effects.
Squalene is a naturally occurring lipid especially abundant in olive oil and involved in skin physiology and cholesterol synthesis.
Alpha tocopherol, or vitamin E, is a fat soluble antioxidant that helps protect cell membranes.
Chlorophylls and carotenoids contribute color and antioxidant activity, although their levels vary widely.
Phenol content is only listed on high quality extra virgin olive oils, and its content can vary based on agricultural and processing methods. Freshness, olive variety, ripeness at harvest, milling, filtration, packaging, and storage all matter.
A bold, fruity, bitter, peppery extra virgin olive oil is one of the best sensory indicators of oleocanthal and many bitter tasting phenols.
The most important health benefits of extra virgin olive oil
Here is where the evidence becomes exciting, but also where context matters. Some studies test EVOO itself, while others study total olive oil intake or an entire Mediterranean diet in which EVOO is the main added fat.
The strongest conclusion is that regularly replacing less healthful fats with fresh EVOO within a plant forward Mediterranean diet and lifestyle is a remarkably practical way to support long term health.
Research on extra virgin olive oil and Mediterranean dietary patterns has examined their relationship with chronic disease, heart and cardiovascular health, cholesterol, blood pressure, inflammation, oxidative stress, type 2 diabetes, metabolic syndrome, liver disease, body weight, healthy aging, cancer, dementia, cognitive decline, Alzheimer’s disease, rheumatoid arthritis, fibromyalgia, digestive health, mood, skin health, wound healing, and women’s health, including breast health, fertility, PMOS, bone health, menstrual disorders, and menopause.
This is a list of benefits still in progress. New research continues to emerge on olive oil, especially EVOO and its bioactive compounds, and their role in health and wellbeing.
The benefits appear to be especially meaningful when EVOO is incorporated into a Mediterranean style diet and lifestyle.
1. A longer life and lower risk of chronic disease
The JACC study “Consumption of Olive Oil and Risk of Total and Cause-Specific Mortality Among U.S. Adults” followed 92,383 adults for 28 years. Consuming more than 7 grams, just over half a tablespoon, daily was associated with a 19% lower risk of death from any cause than rarely or never consuming olive oil.
Replacing 10 grams per day of butter, margarine, mayonnaise, or dairy fat with olive oil was associated with 8% to 34% lower cause specific mortality.[9]
Because this was observational, it shows association rather than proof of cause and effect. However, its size, duration, substitution analyses, and consistency with clinical trials make the finding meaningful.
An umbrella review of 17 meta-analyses found that higher olive oil consumption consistently tracked with lower risks of cardiovascular disease, type 2 diabetes, several cancers, and all cause mortality.[10]
In plain language: the benefits are broadest when EVOO becomes a daily replacement, not merely an extra spoonful added on top of a highly processed diet.
2. Heart and cardiovascular protection
The landmark PREDIMED randomized trial assigned 7,447 adults at high cardiovascular risk to a Mediterranean diet supplemented with EVOO, a Mediterranean diet supplemented with nuts, or advice to follow a lower fat diet.
Over a median of 4.8 years, the EVOO group experienced about 31% fewer heart attacks, strokes, or cardiovascular deaths than the control group. Participants assigned EVOO received approximately one liter per week for their household.[11]
EVOO supports the cardiovascular system through several overlapping pathways. It can improve blood pressure regulation and endothelial function, reduce inflammatory signaling, support healthier HDL function, and make LDL less vulnerable to oxidation.
This last point matters. LDL concentration remains an established cardiovascular risk marker, but LDL must also undergo damaging modifications, including oxidation, to become especially inflammatory and readily taken up by macrophages in the arterial wall.
In the EUROLIVE randomized crossover trial, 200 healthy men consumed 25 mL daily of low, medium, and high polyphenol olive oils for three weeks each. HDL rose in a dose dependent manner as phenol content increased, while oxidized LDL fell most with the high polyphenol oil.[12]
This is why, in my medical practice at Artemis Wellness Center, I look beyond a standard lipid panel when clinically appropriate. Advanced cardiovascular assessment may include ApoB, lipoprotein(a), insulin resistance, inflammation, and oxidized LDL, not because cholesterol is irrelevant, but because cardiovascular disease is more complex than a single number.
Oxidized LDL was also one of the markers we examined in a pilot study conducted with the Yale School of Public Health and presented at the Yale Olive Oil Symposium in 2025.
3. Blood sugar, insulin resistance, and type 2 diabetes
The PREDIMED diabetes prevention analysis included 3,541 adults at high cardiovascular risk who did not have diabetes. Over 4.1 years, the Mediterranean diet supplemented with EVOO reduced new type 2 diabetes diagnoses by about 40% compared with lower fat advice, without calorie restriction or a prescribed exercise program.[13]
A systematic review and meta-analysis of olive oil and type 2 diabetes found a 16% lower diabetes risk among people with the highest versus lowest olive oil intake. Intervention trials also showed modest improvements in fasting glucose and HbA1c.[14]
EVOO may help by replacing saturated or refined fats, reducing post meal oxidative stress, supporting endothelial function, and improving the food matrix of meals.
Drizzle it over beans, lentils, greens, and vegetables, and it makes the very foods that support glucose control more delicious.
4. Healthy body weight and fatty liver support
EVOO is calorie dense, so it does not cause weight loss by magic. Yet a Mediterranean diet rich in EVOO does not appear to promote weight gain when it replaces other fats.
In the five year PREDIMED body weight analysis, 7,447 adults following non calorie restricted Mediterranean diets did not gain more weight than the lower fat control group. The EVOO group ended with slightly lower weight and waist circumference.[15]
EVOO also makes vegetables, legumes, and whole foods satisfying, which may improve adherence and satiety.
For metabolic dysfunction associated steatotic liver disease, or MASLD, formerly NAFLD, small trials and observational studies suggest benefit, but the evidence is less definitive than it is for heart disease or diabetes.
The PREDIMED analysis of a Mediterranean diet rich in EVOO and fatty liver found lower fatty liver prevalence with stronger adherence to the EVOO rich pattern among older adults at high cardiovascular risk.[16]
I view EVOO here as part of a larger prescription: fewer refined carbohydrates and ultra processed foods, more plants and fiber, regular movement, and appropriate weight and glucose management.
A 2025 study in the American Journal of Clinical Nutrition found that across 121,119 U.S. adults, each additional 7 grams, about half a tablespoon, of olive oil daily over a four year period was linked to 0.09 kg less weight gain. Replacing butter, margarine, or other oils with olive oil also predicted slightly less long term weight gain.[18]
EVOO also works similarly to the GLP-1 promoting drugs that are so popular today for weight loss but has lasting effects when consumed as part of a healthy Mediterranean style diet and lifestyle. Seasons has explored this topic further in its article, “Is Extra Virgin Olive Oil Nature’s GLP-1?”
5. Brain health, memory, and dementia risk
The 2024 JAMA Network Open study “Consumption of Olive Oil and Diet Quality and Risk of Dementia-Related Death” followed 92,383 U.S. adults for 28 years and documented 4,751 dementia related deaths.
More than 7 grams of olive oil daily was associated with a 28% lower risk of dementia related death, regardless of overall diet quality. Replacing 5 grams daily of margarine or mayonnaise with olive oil was associated with an additional 8% to 14% reduction.[17]
Clinical evidence is smaller but encouraging. In the PREDIMED cognitive randomized trial, 447 cognitively healthy older adults were followed for a median of 4.1 years. Those assigned to the EVOO rich Mediterranean diet performed better on composite measures of memory and overall cognition than the lower fat control group.[19]
EVOO may support the brain indirectly through healthier blood vessels and glucose regulation and directly through lower oxidative stress and inflammation.
It is a promising food for dementia prevention.
6. Cancer risk, with particularly intriguing evidence for breast health
Cancer is a complex and rising problem in our increasingly toxic environment. EVOO can play an important role in prevention as part of a healthy Mediterranean dietary pattern and lifestyle.
A 2022 systematic review and meta-analysis of 45 studies found that the highest olive oil intake was associated with a 31% lower overall cancer risk than the lowest intake, including lower risks of breast, gastrointestinal, and urinary tract cancers.[20]
The most compelling trial result comes from the PREDIMED breast cancer analysis. Among 4,282 women followed for a median of 4.8 years, those assigned to a Mediterranean diet supplemented with EVOO had 68% fewer invasive breast cancer diagnoses than women receiving lower fat advice.[21]
The total number of breast cancers was small, so this dramatic result needs replication, but it is one of the most important clinical signals in nutrition and breast cancer prevention.
EVOO belongs at the table alongside screening, exercise, weight management, limited alcohol, adequate sleep, and individualized holistic medical care.
7. Inflammation, arthritis, and pain
Chronic inflammation is involved in cardiovascular disease, metabolic disease, autoimmune conditions, and pain.
EVOO’s oleic acid and phenols, especially oleocanthal, hydroxytyrosol, and oleuropein derivatives, can influence NF-κB, COX enzymes, antioxidant defenses, and inflammatory cytokines. Human effects are generally modest and depend on dose, phenol content, dietary context, and the condition being studied.
In women with fibromyalgia, the preliminary trial “Extra Virgin Olive Oil Improves Oxidative Stress, Functional Capacity, and Health-Related Psychological Status” found that EVOO improved selected oxidative stress, physical function, and psychological measures more than refined olive oil.[22]
Evidence for rheumatoid arthritis is also suggestive of benefits for this inflammatory disease.
EVOO is best understood as one anti-inflammatory component of a Mediterranean dietary pattern.
8. Immune function and the gut–immune connection
Our immune system needs to be able to respond appropriately to defend and protect us, but not so aggressively that chronic inflammation damages our own tissues.
EVOO can support this balance through several pathways. Its vitamin E and phenols help protect cell membranes from oxidative stress. Its phenols can influence immune cell signaling and inflammatory cytokines, and compounds that reach the colon interact with the gut microbiome and intestinal barrier, where much of immune regulation takes place.
The review “Dietary EVOO Polyphenols and Gut Microbiota Interaction” reports that EVOO phenols can influence the activity of lymphocytes and monocytes while also shaping microbial metabolites and intestinal inflammatory signaling.[23]
The review “Extra-Virgin Olive Oil and the Gut–Brain Axis” connects EVOO’s effects on the microbiota, mucosal immunity, metabolic health, and neuroinflammation.[24]
The most responsible takeaway is that EVOO supports an immune resilient dietary pattern, especially when it replaces pro-inflammatory fats and helps us eat more vegetables, herbs, legumes, and other polyphenol rich foods.
9. Digestive health and the microbiome
Extra virgin olive oil has traditionally been used to make plant foods both delicious and digestible.
Research now suggests that its phenolic metabolites reach the intestine, influence oxidative and inflammatory signaling, and interact with gut microbes to support the gut microbiome and function as a prebiotic.
In a randomized trial comparing EVOO with canola oil in ulcerative colitis, EVOO reduced selected inflammatory markers and improved several gastrointestinal symptoms.[25]
This was a condition specific trial and supports the idea that the type and phenol content of dietary fat can matter to the intestinal environment.
10. Women’s health across the lifespan
EVOO has earned a permanent seat at the table for women’s health. Within a Mediterranean pattern, it supports the cardiovascular, metabolic, bone, breast, and cognitive concerns that become especially important through perimenopause and menopause.
The 25 year Women’s Health Study analysis followed 25,315 initially healthy women and recorded 3,879 deaths. Women with the highest Mediterranean diet adherence had a 23% lower risk of death than those with the lowest adherence.
Inflammation, insulin resistance, triglyceride rich lipoproteins, and metabolic health explained more of the association than standard LDL cholesterol alone.[26]
This means the benefits of a Mediterranean diet reach much farther than a standard cholesterol panel.
For women, EVOO is a delicious daily tool for improving the overall pattern: vegetables taste better, beans become satisfying, herbs bloom, and meals become something to share rather than endure.
11. Mood and healthy aging
Mediterranean diet adherence is associated with fewer depressive symptoms in many observational studies, but it is difficult to isolate the effect of olive oil from fish, plants, social connection, activity, and the rest of the lifestyle.
In the 2024 NutBrain study, older women with the highest Mediterranean diet adherence had 62% lower odds of depressive symptoms, while a higher monounsaturated to saturated fat ratio was associated with 42% lower odds.[27]
EVOO is part of a dietary and lifestyle pattern that nourishes the brain, blood vessels, microbiome, and pleasure of eating, all relevant to emotional health.
12. Skin health and wound healing
EVOO supplies vitamin E, squalene, and phenolic compounds that have antioxidant and anti-inflammatory activity.
Laboratory research suggests hydroxytyrosol, tyrosol, and oleocanthal can influence fibroblast migration and proteins involved in tissue repair.
However, laboratory findings are not the same as proof that applying kitchen olive oil heals wounds.
The human fibroblast study on olive phenols and skin health provides a useful mechanism for future research, not a substitute for evidence based wound care.[28]
How much EVOO should you use?
For most adults, at least 1½ to 2 tablespoons daily is a realistic, evidence informed goal, especially when it replaces butter, shortening, creamy dressings, or refined fats.
Traditional Mediterranean diets and intervention diets such as PREDIMED may provide 2 to 4 tablespoons or more each day. Needs vary with total calorie requirements, health goals, medications, digestive tolerance, and the rest of the diet.
My Cretan family may use considerably more. In the Seven Countries Study, the cohort with the best health outcomes, which outlived the other participants in the study, consumed approximately 31 liters per person per year. That translates to about six tablespoons per day.
Start with two tablespoons of good quality EVOO and use it in your food.
I prefer prescribing olive oil in food rather than by the shot glass because it enhances the health benefits of food, especially vegetables. Drizzle it over greens and vegetables, fold it into bean dishes, whisk it into sauces, use it to marinate fish or poultry, use it for frying, and cook it with garlic, onions, and herbs.
This creates both nutritional synergy and pleasure.
My great-aunt, who lived to 107 and liked to shave a few years off her age, did take a little shot glass of olive oil every day.
But she also ate a traditional Mediterranean diet, walked regularly until she broke her hip, remained active in her church, and lived surrounded by a loving multigenerational family.
Her longevity reflected not only a Mediterranean diet rich in EVOO, but the lifestyle surrounding it.
How to choose a high quality EVOO
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Look for “extra virgin.” This is the highest grade and the best starting point for flavor and retained phenols.
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Find a harvest date. A harvest date is more informative than a distant “best by” date. Buy the freshest current harvest available.
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Choose protective packaging. Dark glass or an opaque tin protects the extra virgin olive oil from light. Avoid clear bottles that have sat in a bright window or under hot store lights.
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Know the producer and origin. A reputable producer, traceable lot, and clear origin are more meaningful than romantic label language. Single origin can be excellent, but it is not automatically superior to a skillful, transparent blend.
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Buy a size you will finish. Once opened, oxygen begins to work. A beautiful three liter tin is not a bargain if it takes a year to use.
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Taste it. Fresh EVOO should smell and taste fruity. Bitterness and pepperiness are positive attributes and often accompany phenols. Rancid olive oil may smell like crayons, stale nuts, putty, or old lipstick.
How to store and use EVOO
Remember H-A-L-T: heat, air, light, and time.
Keep it protected. Store it tightly closed in a cool, dark cabinet away from the stove.
Use it fresh. Ideally, use EVOO within 12 to 18 months of harvest and within a few months of opening.
Use it generously with food. Drizzle it over salads, soups, beans, fish, eggs, whole grains, and cooked vegetables.
Pair it with acidity. Whisk it with lemon juice or vinegar. Acidity softens bitterness and pungency.
Cook with it. Use EVOO for sautéing, roasting, baking, and ordinary home cooking. EVOO is more heat stable than internet mythology suggests because oleic acid and natural antioxidants resist oxidation. Avoid repeatedly overheating or reusing any oil.
Let it replace less healthful fats. Use EVOO in place of butter and less healthful fats rather than merely adding extra calories.
The peppery sensation that makes you cough is not a defect. It may be oleocanthal greeting you at the back of the throat.
Different olive varieties offer flavors from grassy and artichoke like to tomato leaf, almond, apple, and herbs.
Experiment until you find an extra virgin olive oil you love enough to use every day.
The bottom line: Make EVOO a daily ritual.
It is hard to imagine another single food doing so much: carrying flavor, helping us eat more plants, improving the absorption of fat soluble nutrients, and contributing to a dietary pattern associated with healthier hearts, brains, metabolism, and longevity.
Yet the deepest lesson of the Mediterranean diet is not to worship one ingredient.
It is to create a life in which good food is used generously and wisely alongside vegetables, legumes, fruit, herbs, whole grains, nuts and seeds as tolerated, fish, movement, rest, purpose, and people we love.
Choose fresh extra virgin olive oil. Protect it from heat, air, light, and time. Use it in place of less healthful fats. Taste it. Cook with it. Share it.
That is how the gift of the olive tree becomes food as medicine.
Medical note: This article is educational and is not a substitute for individualized medical care. EVOO can be part of a health supportive diet, but it does not diagnose, prevent, or treat disease on its own.
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