Supplements · Metabolic & Cardiometabolic
olive oil decreases cardiovascular disease risk
In plain terms: Is olive oil good for your heart?
Strong support Supplements
Part of: • Olive oil
RefutedContestedStrong support
consensus score 0.60
Yes - this is one of the better-supported food-and-heart claims. Higher olive oil intake tracks with lower heart disease and stroke, and the PREDIMED trial found a Mediterranean diet rich in extra-virgin olive oil cut cardiovascular events by about 30%. Much of the trial evidence is for the whole Mediterranean pattern, of which olive oil is a central part.
📅 Last reviewed: 2026-07-15 ⓘ
Evidence ladder
How far up the ladder this claim has climbed. A high consensus on a low rung means "consistent so far," not "proven in people."
Top evidence so far: All trials, pooled (Meta-analysis)
MechanismIn-vitroAnimalObservationalRCTMeta-analysis
How the studies fall
7 support 0 contradict 0 tested null 2 mixed · 9 sources, 6 independent groups · 5 superseded — pooled inside a review, counted once
What the evidence shows
Olive oil is one of the best-supported foods for heart health. Multiple meta-analyses find higher intake associated with roughly 15% lower cardiovascular disease and notably lower stroke risk, and the landmark PREDIMED randomized trial found a Mediterranean diet enriched with extra-virgin olive oil cut major cardiovascular events by about 30% versus a control diet.
The evidence (14)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| Del Saz-Lara A et al. 2024 · Food Funct | meta-analysis | supports | moderate | Systematic review + random-effects meta-analysis, 'seven in the meta-analysis', searched to October 2024. The outcome measured is fatal CVD only, not incident cardiovascular events: 'cardiovascular mortality (HR: 0.84; 95% CI: 0.76-0.93)', summarised as 'Consumption of OO particularly reduces cardiovascular mortality (16%)'. Direction supports the claim, but fatal-CVD-only ascertainment on a seven-study pool with no heterogeneity or risk-of-bias figures visible (abstract-only, paywalled) puts this at moderate rather than high - the same tempering already applied to oo-buckland-2012 on this claim. |
| Ke Y et al. 2024 · Food Funct | meta-analysis | supports | high | Dose-response meta-analysis, 30 prospective-cohort articles / 2,710,351 participants (searched to March 2024): highest vs lowest olive oil intake gave CVD incidence RR 0.85 (95% CI 0.77-0.93), CHD incidence RR 0.85 (0.72-0.99), CVD mortality RR 0.77 (0.67-0.88); per 10 g/day, CVD incidence -7% and stroke incidence -5%. Benefit was nonlinear, confined to intakes of 0-18 g/day. |
| Xia M, Zhong Y, Peng Y, Qian C 2022 · Front Nutr | meta-analysis | supports | moderate | Random-effects meta-analysis of prospective cohorts (PubMed + Scopus to 31 Jul 2022): 'higher consumption of olive oil conferred a significantly reduced risk in CVD (RR: 0.85, 95% CI: 0.77-0.93, p < 0.001)', with 'the aggregated RR of CVD for each 5-g/days increment in olive oil consumption was 0.96 (95% CI: 0.93-0.99, p = 0.005)' and benefit attenuating beyond ~20 g/day. Supports the claim, but quality drops high->moderate on the full text: the CVD estimate is NOT from 13 cohorts as previously recorded — 'Eight cohorts from six studies were included in the meta-analysis of CVD risk, totaling 261,016 patricians [sic] and 14,033 CVD cases.' Figure 2 shows four of those eight point estimates are null, including the largest independent contributor (Donat-Vargas EPIC-Spain, RR 0.95, 0.84-1.08, 23.5% weight) and Sadeghi 2021 (0.95, 0.74-1.21, 11.4%), while 57% of the pooled weight comes from one investigator group (Guasch-Ferre NHS 26.1% + HPFS 23.4% + PREDIMED 7.7%). Heterogeneity is low (I2 = 41%) but publication bias was untestable for this endpoint at fewer than 10 studies, the search covered only 'PubMed and Scopus', there is no PROSPERO registration, and Table 2's follow-up subgroups total 10 cohorts for an 8-cohort pool. Funding is a small institutional grant with no industry COI. Pool is nested inside oo-ke-2024. ↩ SUPERSEDED — pooled in the review above, counted once |
| Rees K et al. 2019 · Cochrane Database Syst Rev | meta-analysis | mixed | high | Cochrane 30 RCTs: PREDIMED reduced stroke (HR 0.60); no significant effect on total CVD/mortality (whole-Med). |
| Buckland G et al. 2012 · Am J Clin Nutr | observational | supports | moderate | EPIC-Spain cohort (40,622 adults, 13.4 y). Outcome measured is CVD MORTALITY, not incident cardiovascular events, on 416 CVD deaths: 'In comparison with nonconsumers, the highest quartile of olive oil consumption was associated with ... a 44% (95% CI: 21%, 60%) reduction in CVD mortality', with a continuous estimate of 'a 13% (95% CI: 6%, 20%) decreased risk of CVD mortality' per 10 g · 2000 kcal⁻¹ · d⁻¹. Right direction and a large point estimate, but a wide interval on a modest event count and fatal-CVD-only ascertainment - quality moderate rather than high for an incidence claim. ↩ SUPERSEDED — pooled in the review above, counted once |
| Guasch-Ferre M et al. 2020 · J Am Coll Cardiol | observational | supports | high | NHS/HPFS (92k): higher olive oil 14% lower CVD; substituting margarine/butter lowered risk. ↩ SUPERSEDED — pooled in the review above, counted once |
| Zekey FS et al 2026 · study_type: observational | observational | supports | low | Case-control, vascular disease (CVS) vs primary-care controls. Olive oil use OR=0.17 (95% CI 0.11-0.27) for case (vascular-disease) status vs control. |
| Al-Ghamdi S et al. 2018 · J Family Med Prim Care | meta-analysis | supports | low | Meta 4 RCTs (25k): MedDiet significant reduction in CV events (p=0.02) (whole-Med-diet). |
| Chiavarini M et al. 2024 · Nutrients | meta-analysis | supports | high | Umbrella of 31 meta-analyses: benefits in CVD/risk factors, cancer, mortality, diabetes. |
| Estruch R et al. 2018 · N Engl J Med | RCT | supports | high | PREDIMED RCT (7,447): MedDiet+EVOO vs control HR 0.69 for composite CVD events (whole-Med-diet w/ EVOO). |
| Martinez-Gonzalez MA et al. 2014 · Lipids Health Dis | meta-analysis | mixed | high | Meta: stroke RR 0.74/25g, combined CVD RR 0.82; CHD alone non-significant. |
| Guasch-Ferre M et al. 2014 · BMC Med | observational | supports | moderate | OBSERVATIONAL prospective cohort analysis within PREDIMED (n=7,216, 277 major cardiovascular events, median 4.8 y; exposure = baseline FFQ olive-oil tertiles taken 'before the individuals were randomized to the intervention group'). Top vs bottom tertile of total olive oil, fully adjusted including a MedDiet score with the olive-oil items removed: '35% lower risk (HR: 0.65; 95% CI: 0.47 to 0.89)', P for trend 0.01, with dose-response 'For each 10 g/d (one tablespoon) higher baseline total olive oil consumption there was a 13% (HR: 0.87; 95% CI: 0.81 to 0.94) decreased risk of major cardiovascular events.' Extra-virgin was stronger — 'Baseline EVOO consumption was inversely associated with major events after adjusting for potential confounders (39% lower risk (HR: 0.61; 95% CI: 0.44 to 0.85' , P for trend <0.01 — while common (refined + pomace) olive oil showed nothing: top tertile 1.11 (0.82 to 1.51), P for trend 0.40. TWO LIMITS ON WHAT THIS VOTE COVERS: the signal is carried entirely by the composite, since 'When we screened the risk of myocardial infarction and stroke according to the different categories and varieties of olive oil consumption it was observed that the inverse associations were non-statistically significant (data not shown)' — so it is no evidence for a stroke- or MI-specific claim; and by arm, the association held in both MedDiet groups (0.43, 0.25 to 0.75; and 0.45, 0.25 to 0.82) but 'the risk in the low fat control group was increased by 9% (HR: 1.09, 95% CI: 0.63 to 1.88' , though the homogeneity test was non-significant (P = 0.178) so the pooled estimate stands. Quality moderate: 277 adjudicator-blinded events and monotone dose-response, against FFQ exposure (validity r=0.60), residual confounding, an olive-oil-industry oil donation, and a habitual-consumer population whose LOWEST tertile already averaged 21.4 g/d. [Full PMC XML incl. Tables 1-4 read 2026-08-19.] ↩ SUPERSEDED — pooled in the review above, counted once |
| Martinez-Gonzalez MA et al. 2022 · Clin Nutr | meta-analysis | supports | moderate | Outcome-wide systematic review + random-effects meta-analysis of prospective cohorts (searched through January 2022); CVD pool 806,203 participants with 49,223 CVD events: 'A 16% reduced risk of CVD (relative risk [RR]: 0.84; 95% confidence interval [CI]: 0.76 to 0.94), standardized for every additional olive oil consumption of 25 g/d was found.' Supports the claim, but tempered to moderate: the CI's upper bound is 0.94, the paper states 'Only the results for T2D were homogeneous. Specific sources of heterogeneity for the other 3 outcomes were not always apparent', and the 27-study pool counts one RCT as three separate reports. Correction to the previous extract, which read 'olive oil associated with reduced CVD, cancer, T2D and mortality': the paper found NO cancer association — 'No significant association with cancer risk was observed (RR: 0.94; 95% CI: 0.86 to 1.03, per 25 g/d)' — so only CVD, T2D and mortality were positive. Abstract-grade (Elsevier paywall, not in PMC); cohorts nested inside the larger oo-ke-2024 pool. ↩ SUPERSEDED — pooled in the review above, counted once |
| Castro-Barquero S et al. 2020 · Nutrients | RCT | supports | low | PREDIMED substudy: EVOO-enriched MedDiet reduced antithrombotic-drug initiation and CV risk. |
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