Daily consumption of extra-virgin olive oil (EVOO) — especially varieties rich in antioxidants — can improve cholesterol levels and support heart health, according to a peer-reviewed study in Nutrients, an international open-access nutrition science journal, and reported by Eating Well magazine.
While heart disease is the No. 1 killer of Americans, experts stress it is preventable. The American Heart Association promotes its “Life’s Essential 8,” which outlines four health behaviors — eating a heart-healthy diet, engaging in regular physical activity, quitting tobacco, and getting adequate sleep — and four measurable health factors: managing weight, cholesterol, blood sugar and blood pressure.
“Clinical, epidemiological, and experimental evidence shows that the Mediterranean diet, including extra virgin olive oil, reduces the risk of diseases linked to oxidative stress, chronic inflammation, and immune system issues like cancer, atherosclerosis and cardiovascular disease (CVD), helps to improve chronic liver diseases, like Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and liver fibrosis, reducing the likelihood of liver cancer,” according to the Nutrients study: “Exploring the Benefits of Extra Virgin Olive Oil on Cardiovascular Health Enhancement and Disease Prevention: A Systematic Review.”
Olive oil’s heart benefits are well documented, due mainly to its monounsaturated fats. But polyphenols — potent plant-based antioxidants found in EVOO — may also play a significant role. To examine this, scientists in Greece compared the effects of two EVOOs with different polyphenol levels.
The study recruited 50 participants with hyperlipidemia (high blood lipids, including LDL cholesterol) and 20 without. Participants with hyperlipidemia were split into two groups: one consumed high-polyphenol EVOO, the other low-polyphenol EVOO at a higher dose to equalize total daily polyphenol intake. The healthy group was matched by gender and given the same EVOO types and dosages. All participants took the olive oil on an empty stomach for four weeks while maintaining their usual diets and lifestyles.
Results showed that those with hyperlipidemia experienced greater improvements in blood lipids than the healthy group. HDL, the “good” cholesterol, increased, and lipoprotein (a) — similar to LDL cholesterol — decreased slightly in the high-risk group. Importantly, the high-polyphenol EVOO group saw significant improvements in total cholesterol compared to the low-polyphenol group, despite equal polyphenol intake overall.
Researchers caution that the small sample size, short study period and the specific type of Greek olive used may limit broader applicability. Diet information was not collected to prevent other polyphenol-rich foods from influencing outcomes.
These findings are particularly relevant for African Americans, who, according to the American Heart Association, face a 30% higher risk of dying from heart disease than White Americans. While African Americans generally have slightly lower total cholesterol levels, Black men often have higher LDL levels, and disparities in healthcare access mean they are less likely to be diagnosed with or treated for heart disease.
Health experts suggest that incorporating EVOO into daily meals — such as in salads and dips or drizzled over vegetables — can be a simple, heart-healthy step.
The National Institutes of Health (NIH) adds that pairing dietary changes with regular exercise, weight management, and routine cholesterol checks is essential.
“It’s important to take charge of your cardiovascular health,” the NIH notes, “and that means making sustainable changes to both diet and lifestyle to lower cholesterol and protect the heart.”