Extra Virgin Olive Oil

let food be thy medicine …

Mary M. Flynn, PhD, RD, LDNThe Miriam Hospital and Brown University, Providence,

RIOctober 2015

Epidemiology

Lower rate of heart disease and cancers in countries consuming a traditional Mediterranean diet

plant-based (vegetables, fruits, grains) extra virgin olive oil red wine

Seven Country Study Meddiet Score – using ratio MFA:SFA in the diet

[Flynn: not useful]

Extra virgin olive oil – key component of the Mediterranean diet

Risk factors for chronic diseases that diet can change

excessive oxidation lipids (cholesterol, triglycerides) and lipoproteins

(HDL, LDL) blood pressure blood levels of glucose and insulin inflammation cancer: initiation, promotion, progression (to

tumor)

Plant products

Phytonutrients

all plants have them (variety)

protect plant from the environment

health properties in humans → related to decreasing risk factors for chronic diseases

Extra virgin olive oil

Juice of the olivephenol content – responsible for health benefitsexpressed as: mg/kg. [Flynn guidelines]

refined: < 20 mg/kglow: up to + 190 mg/kgmedium: 200-400 mg/kghigh: > 400 mg/dl

Depends on: olive, growing/ harvesting conditionsMany of these phenols are exclusive to olives

Oxidation

Excess oxidation:initiates and promotes cancer (DNA, membranes)makes an LDL particle that contributes to atherosclerosis

Oxidation is promoted with polyunsaturated fatsfound in: vegetable seed oils, red meat, fish oils

Olive oil: primarily monounsaturated fat highest content of alpha tocopherol (vitamin E) high phenolic content decreases LDL, DNA oxidation

Blood lipids/ lipoproteins

LDL: level is not as important as oxidation Compared to vegetable seed oil (high in

polyunsaturated fats): extra virgin olive oil may or may not decrease

Phenolic content: some evidence higher phenolic may lower LDL

Linear increase in HDL with increasing phenolic content

Blood pressure

Compared to sunflower oil:

2 to 3 tablespoons/day of EVoo for 6 months:significant decrease in systolic and diastolic

4 tablespoons of EVoo /day 4 weeks (84 yrs): decrease in systolic BP

Blood pressure

Phenolic content:

men (161 mg/kg v refined) at 3 tablespoons/day of EVoo for 3 weeks:

lowered systolic BP

Women (564 mg/kg v refined) at 4 tablespoons/day of EVoo for 8 weeks

lowered systolic and diastolic

Blood levels of insulin and glucose

Higher (but within normal range) levels related to:increase risk of heart disease and cancers (breast,

prostate, colon, leukemia)

3 tablespoons/ day EVoo for 2 weeks v sunflower oil:significant decrease in fasting glucose and insulin

Olive oil enriched diet v vegetable oils for 8 weeks:improved insulin sensitivity (need less insulin)

Pasta and eggplant fried in olive oil 2 tablespoons lead to lower blood glucose and insulin v just adding olive oil

Inflammation

Response to disease, level of disease

Oleocanthal – inhibits COX 2 enzyme COX2 leads to inflammatory pathway

same action as ibuprofen (NSAID)

Olive oil and cancer protection

Squalene – found in all olive oil tumor inhibitor

decreases cancer risk

Most of squalene to the skin → UV protection

Oleuropein (in test tube) inhibited cancer cell invasion and regressed tumors

Vegetables and olive oil

Carotenoids – give pigment to vegetablespowerful cancer fighting properties in the body** need dietary fat to absorb ** cooking in fat increases absorption

Glucosinolates – cruciferous family (cauliflower, cabbage, broccoli, Brussel sprouts, kale)cancer protective, especially breast and prostate** water soluble, preserved with fat

Makes vegetables taste better, increases intake

Body weight

Inverse relationship Mediterranean diet adherence and body mass index (BMI) in Spain and Greece

SUN Study (Spain): higher baseline consumption of olive oil reported, lower likelihood of gaining weight (not significant, but a trend)

Related to smaller waist circumference

Plant-based, olive oil diet (PBOO)

Per day:> 3 tablespoons extra virgin olive oil (high quality)unlimited vegetables and Salad (minimum of 4 servings)

1 serving = ½ cup of vegetables or 1 cup of greens (salad)

3- 4 servings of fruit1 serving = ½ cup or ½ piece of fruit

6 to 8 servings of starch (emphasis on whole grains)1 serving = 1 oz. dry weight

eggs and dairy included limited poultry or seafood; no red meat

Cost of olive oil

Consider at price per tablespoon

Should be an “every day food”

Benefits start at 2 tablespoons / day

Flynn: 1 tablespoon EVoo per cup of vegetables

Can use to cook

Flynn research with EVoo

Women with invasive breast cancercompared to a lower fat diet, plant-based EVoo diet:

better weight loss and acceptability lower triglycerides and higher HDL

Men with recurrent prostate cancer and metabolic syndrome:

8 weeks of diet led to mean weight loss of 6%(BMI: 32.5 to 30.5; p<0.05)decrease in glucose and insulin

Flynn research with Evoo, cont.

6 week cooking program for food pantry clientsgoal of 2 to 3 main meals a week using EVoo recipes

Significant decreases in: purchases of meat, carbonated beverages, desserts,

snacks and total groceries ($68 to $37/week) Food Insecurity – less hunger Body mass index (BMI) and waist size

Significant increases in: total number and variety of fruits and vegetables

McAuley House – “Healing Food Project”6-week cooking program for type 2 diabetics10 completed: 15% decrease in blood glucose trend towards weight loss, diet improvement

“Food is Medicine” – to educate current and future health professionals how food can be used as medicine. cooking program for type 2 DM6 months of food from food pantry

Conclusions:

Consistent use of 2 tablespoons per day of extra virgin olive oil will:

improve health by lowering oxidation, inflammation, blood pressure, and blood glucose and insulinimprove health and level of blood lipids (LDL, HDL) lowering body weight and decrease risk of weight gainlower food costs and improve diet (likely increase vegetable intake)