Medically reviewed on May 16, 2018
Scientific Name(s): Olea europaea L. Family: Oleaceae
Common Name(s): Olive oil , sweet oil
Olive oil is a nutrient widely used as a salad oil and in cooking. It has also been used as a vehicle for oily suspensions for injections and topically as a demulcent and emollient. Historically, it has been used as a laxative. Olive oil is an element of the Mediterranean diet and is promoted as a beneficial source of dietary fat to improve the lipid profile and reduce cardiovascular morbidity. Clinical trials are limited and generally have been conducted as part of epidemiological studies to validate observed cardiovascular effects.
Trials investigating the effects of olive oil have typically used daily doses ranging from 25 to 40 mL and 8 to 70 g without reported adverse effects. It has been used topically to soften ear wax and incorporated into creams for topical application.
Contraindications have not been identified.
Generally recognized as safe (GRAS) when used as food. Avoid dosages above those found in food because safety and efficacy are unproven.
None well documented.
Ingestion of excessive amounts of olive oil has caused temporary mild diarrhea. Allergic reactions from topical use have been rare.
No toxicology has been reported.
The olive tree is an evergreen, growing to approximately 10 m in height. Native to Mediterranean regions, olive trees also are cultivated in similar climates in the Americas. The small, leathery leaves are gray-green on top with fine, white, scale-like hairs on the undersides. The ellipsoid olive drupe (fruit) measures 2 to 3 cm in length. 1
Records of the olive tree date back to the 17th century BC. It appears to be native to historical Palestine. Ramses II, Egyptian ruler from 1304 and 1237 BC, is said to have used olive oil for every ailment. 2 , 3 , 4
Olive oil is a fixed oil, expressed from ripe olive fruits. It is pale yellow and may have a greenish tint, depending on the ratio of chlorophyll to carotene. Olive oil is composed largely of esters of oleic acid (an n -9 mono-unsaturated fatty acid), forming approximately 80% of the total fatty acid content. Linoleic acid (a polyunsaturated fatty acid) and saturated palmitic acid form the balance of the fatty acid content.
In addition, approximately 200 other chemical compounds have been identified in the oil including tocopherols, beta-carotene, phytosterols, pigments, terpenic acids, flavonoids (luteolin, quercetin, squalene), and phenolic compounds (eg, oleuropein, tyrosol).
Composition of the oil depends on the cultivar, stage of drupe maturity, climate, and other factors. Olive oil is offered in several grades of purity, including virgin oil (initial unrefined oil from first fruit pressing) or pure (lower quality from subsequent pressings). Chemically, the difference between extra virgin and virgin oils pertains to the amount of free oleic acid permitted (4% free oleic acid in virgin; 1% in extra virgin).
Thin-layer chromatography and gas chromatography analyses are used to detect adulteration of the oil with foreign oils (eg, cottonseed, peanut, sesame). Limits are set for the amounts of saturated fatty acid chain lengths and number of sterols. 3 , 4 , 5 , 6 , 7 , 8
Uses and Pharmacology
Olive oil is a nutrient widely used as a salad oil and in cooking, and is a common element in the Mediterranean diet. 4 , 9 , 10 Studies have sought to establish outcomes related to differing phenolic (and other) content of the oil 11 and the detrimental effect of heating. 12 , 13 , 14 Most, but not all, studies have shown a concentration-dependent effect of phenolic content on activity of the oil; higher phenolic content is equated with greater benefit.Cardiovascular conditions
The relative safety of olive oil and the availability of randomized clinical trials in humans render data from animal trials mostly irrelevant.Clinical data
Interest in the potential of olive oil to reduce cardiovascular disease has derived from epidemiological studies correlating consumption of Mediterranean diets rich in olive oil with positive health outcomes, as well as the PREDIMED 5-year Mediterranean diet intervention study. 6 , 15 Few clinical studies exist with sound methodology which nonsurrogate markers of cardiovascular outcomes were utilized. Olive oil has been used as placebo in trials of omega-3 supplementation after coronary surgery. 16 , 17
Mechanisms proposed for olive oil's activity include its influence on the lipid profile; 13 , 18 , 19 , 20 , 21 , 22 markers of endothelial function, inflammation, and coagulation; 10 , 11 , 23 nitric oxide production; low-density lipoprotein (LDL) oxidation; plasma antioxidant capacity; 12 , 13 , 18 , 19 , 20 , 24 , 25 , 26 and serum insulin/glucose response. 21 , 22 , 27
In normotensive and hypertensive elderly patients, consumption of olive oil reduced systolic blood pressure but not necessarily diastolic pressure. 28 , 29 , 30 Olive oil consumption lowered systolic blood pressure in patients with stable coronary heart disease 31 but not in patients with chronic heart failure. 32
Markers of atherosclerosis have been studied in healthy volunteers, in hyperlipidemic and stable coronary heart disease patients, and in elderly patients, including subpopulations of the European Prospective Investigation into Cancer and Nutrition study (EUROLIVE) and Three-City study. 33 , 34 , 35 , 36 , 37 , 38 , 39 In most analyses, decreased inflammatory status was associated with the intake of phenolic-rich olive oil; however, some studies found only marginal benefits. 34 , 35 , 40 , 41
Studies in healthy volunteers and in hyperlipidemic adults and children have generally shown improved lipid profile with consumption of virgin olive oil. 19 , 22 , 41 , 42 , 43 , 44 , 45 Increases in phenolic and oleic acid content of the LDL were measured in EUROLIVE study participants and probably contributed to decreased LDL-oxidation. 26 , 43 , 46 , 47
In the PREDIMED clinical trial, high adherence to the Mediterranean diet was associated with decreases in the occurrence of metabolic syndrome and type 2 diabetes. 15 , 48 , 49 In patients with metabolic syndrome, consumption of olive oil 8 g/day over a 2-year period reduced insulin resistance, mean body weight, and cardiovascular risk. 50Cancer
Olive oil and cancer prevention have been inversely correlated in experimental models with animals. In rats, olive oil had no colon tumor-enhancing effects compared with other fatty-type diets. 51 Olive oil may influence carcinogenic processes via signaling pathways, reduced oxidative stress (due to antioxidant oleic acid, vitamin E, and polyphenol content), and reduced DNA damage. Oleic acid may also regulate receptors, such as human epidermal growth factor 2. 23 , 52Clinical data
Despite concerns that monounsaturated oils, such as olive oil, are weak promoters of certain cancers (eg, breast, colon) compared with n -6 polyunsaturated oils, 53 reviews of epidemiological case-control datasets have found olive oil to be potentially protective against upper GI tract cancers (oral cavity, pharynx, esophagus, and larynx) but equivocal regarding colorectal cancers. 52 , 54 For high levels of olive oil consumption, a meta-analysis of the available data for breast and gynecological cancers is supportive of a risk reduction of 0.62 (95% confidence interval, 0.44 to 0.88). 52 Heterocyclic amines released during cooking have been shown to be mutagenic in bacterial and animal studies. A large, multicenter, case-control study evaluated the potential effect of fried foods on colorectal cancers (1,394 colon cancer, 886 rectal cancer, 4,765 controls). Use of olive oil in frying demonstrated a positive effect in colon cancer risk reduction but not in rectal cancer. 55Clinical nutrition
The relative safety of olive oil and the availability of randomized clinical trials in humans render data from animal trials mostly irrelevant.Clinical data
The use of olive oil as a nutritional source in intensive care and high-risk surgery patients and in neonates has been studied. Olive oil is well tolerated, and decreases in intensive care unit stay and infection rates have been demonstrated in surgical patients. 56 , 57 , 58 In preterm infants, olive oil has been compared with soybean oil or usual parenteral nutrition. Trials are generally small; however, olive oil supplementation appears to be safe and well tolerated and achieves the targeted essential fatty acid and lipid profiles. However, effects on LDL oxidation and immune status are equivocal. 59 , 60 , 61 , 62 , 63Other uses
It is used as a vehicle for oily suspensions for injection and is a drug solvent; it has also been used to soften ear wax. 3 , 64 In elderly patients, it has been used in cognitive function clinical trials, as well as in studies of rheumatoid arthritis as the comparator (placebo) oil. 65 , 66Antibacterial
The plaque-inhibitory action of an olive oil dentifrice has been demonstrated. Adhesion and growth of bacteria were inhibited with olive oil in comparison with conventional fluoride wash. 67 In other experiments, olive oil exhibited in vitro antimicrobial properties against gram-negative bacteria, fungi, and enterotoxin B production by Staphylococcus aureus . 68 , 69Dermatitis
Applied topically, olive oil acts as a demulcent and emollient. It is used in massage and to soften the skin in eczema and psoriasis, as well as to prevent stretch marks. Olive oil is used in the preparation of soaps, ointments, and liniments. 3 A clinical study of virgin olive oil and virgin coconut oil found both oils to be effective in reducing dermatitis symptoms. 70 In preterm infants, 4 weeks of daily olive oil-based cream was more effective than an emollient with regard to dermatitis. 71GI
Olive oil is a mild laxative and has been used as an intestinal lubricant. 64 , 72 There are claims that it is useful for gall bladder problems, including cholecystitis and cholelithiasis; however, the effectiveness of olive oil for such conditions is not well documented. 73Rheumatoid arthritis
Olive oil has been used as a placebo in many trials studying oils. In a placebo-controlled trial of fish oils in patients with rheumatoid arthritis, improvement in the disease process was noted in both groups, despite methodological limitations of the study. 74
Trials investigating the effects of olive oil have typically used daily doses ranging from 25 18 to 40 mL 25 and 8 50 to 70 g 24 without reported adverse reactions. It has also been used topically to soften ear wax and incorporated into creams for topical application. 71 , 73
GRAS status when used as food. Avoid dosages above those found in food because safety and efficacy are unproven. A clinical study used daily olive oil (4 g) as a comparator oil in pregnant women at 30 weeks gestation and followed them through to delivery. Olive oil was assumed to be inert and no adverse events were reported at this dose. 75
None well documented.
Information is lacking.
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