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Tips for health professionals to encourage people to include Extra Virgin Olive Oil in their daily diet

Tips for health professionals to encourage people to include Extra Virgin Olive Oil in their daily diet

What volume of Extra Virgin Olive Oil (EVOO) should people consume each day? This is a common question that often elicits many different responses.

The Australian Dietary Guidelines do not have a specific volume recommendation for EVOO. However, on average, volumes of 25 – 50ml of EVOO per day seem to be most strongly associated with health benefits in healthy populations and those with risk factors including mild hypertension and overweight or obesity. 1-5 These studies have investigated EVOO as a food, rather than as part of a specific dietary intervention such as the Mediterranean diet.

A 2012 trial showed that 60ml of biophenol rich olive oil reduced blood pressure in those with normal to high blood pressure or stage 1 hypertension, whereas an olive oil that did not contain biophenols did not.5 It is worth noting that EVOO is naturally high in biophenols, whereas refined olive oil is not.

Research coming out of Australia Mediterranean diet interventions are recommending volumes of 3 – 4 tablespoons (60 – 80ml) of EVOO per day, with good effect for pre-existing health conditions including Coronary Heart Disease, Type 2 Diabetes and Fatty Liver Disease.6,8 It is important to note that these studies include EVOO as part of a Mediterranean diet intervention.

For example, a 2010 Randomised Cross-Over study of twenty-seven participants living with Type 2 Diabetes in Melbourne, Australia, compared usual diet to a Mediterranean diet with 75ml (~ 4 tablespoons) of EVOO per day.8 The study found that compared with the usual diet, the Mediterranean diet reduced HbA1c from 7.1% to 6.8% and diet quality improved significantly, with no weight gain despite 40% of energy coming from fat.

The key to recommendations is to include EVOO in the diet with food, not as a medicine. This was recognized as facilitating the consumption of large quantities of vegetables and legumes – an important dietary recommendation for general health and for health conditions such as diabetes and heart disease.

This is an important point given current vegetable consumption in Australia is low. According to the Australia’s Health 2018 report, only 7% of adults and 5% of children ate enough serves of vegetables9. Other western countries also fall significantly short of recommended vegetable consumption. In the US, only one in ten adults meets recommended fruit and vegetable consumption.10

 

 

What about weight gain?

Several systematic literature reviews show that the Mediterranean diet, of which EVOO is the main culinary fat, results in similar weight loss compared to diets including low-fat and low-carbohydrate diets in overweight or obese individuals, and can significantly reduce measures of central obesity such as waist circumference and visceral fat.11,12

A 2014 study on 191 participants from the landmark PREDIMED study found that a Mediterranean diet supplemented with virgin olive oil (45ml per day) reduced total body weight to the same extent as the usually recommended low-fat diet.3

The type of fat found in food may also behave differently due to how different types of fats are metabolized. Monounsaturated fat in olive oil seems to burn more readily than saturated fat in cream. 14

A 2017 randomized control trial showed that EVOO consumption reduced body fat and improved blood pressure compared to the same amount of soybean oil in  an energy restricted normal-fat diet in obese adult women with excess body fat.15 Fat loss was 80% higher with EVOO consumption compared to the control group.

 

 

Practical ways to encourage people to include Extra Virgin Olive Oil in the daily diet

Below are ten top tips to encourage people to include EVOO in their daily diet.

To ensure these tips are relevant to people living in non-Mediterranean countries such as Australia, lead Australian research dietitians Dr Hannah Mayr and Dr Elena George were interviewed for their advice. Hannah and Elena are Australian-based researchers who specialize in applying the Mediterranean diet to an Australian population, and are expert contributors at The Olive Wellness Institute. They both work with patients who may have been following a low-fat diet in the past and assist them transition to a diet with higher levels of healthy fats.

 

 

Tips from the experts:

  1. Elena recommends that people cook or dress their favourite vegetables with EVOO. She says patients are receptive to the information that their vegetables will taste delicious and they will also increase the amount of nutrients they are getting by cooking in EVOO.

 

  1. Pull on recent studies to back this up with the evidence. People are often happy to hear that cooking vegetables in EVOO will add more nutrients to their food and help absorb fat soluble vitamins, and food components such as glucosinolates (found in broccoli and kale) and carotenoids (found in carrots).

 

  1. Elena also encourages people to try baking or stir frying (green beans, broccoli, cauliflower, carrots, zucchini, potato, etc) coated in EVOO (infused varieties for extra flavour), or add the EVOO to steamed veggies after cooking. The best part is that it’s a quick and delicious way to prepare a healthy side to any meal.

 

  1. Hannah recommends that instead of having a normal sandwich, deconstruct it to include salad with bread on the side and then use EVOO to dress the salad and for dipping the bread rather than butter or margarine.

 

  1. Hannah also recommends that people use EVOO as a dressing on salads and not just in their dinner meals. Whether people make their own lunch or buy a salad at work, having a bottle of EVOO at their office to dress their salad rather than using a commercial dressing is a way to include more EVOO in the diet. She also educates people on the point that eating salad with EVOO will help them feel fuller for longer.

 

  1. One tablespoon of EVOO per cup of vegetables is a good rule of thumb according to Dr Mary Flynn, research dietitian and Associate Professor of Medicine at Brown University. Mary prescribes three tablespoons of EVOO per day to her patients, ideally with vegetables. This would ensure people are consuming at least three cups of vegetables per day – meeting their daily recommended five serves of vegetables per day.

 

Other tips:

  1. Swap butter for EVOO in baking – there are many varieties of EVOO available in Australia – from mild through to more robust flavors. Choose a mild flavor for baking. A useful conversion chart for swapping EVOO for butter in baking can be found here.

 

  1. Swap butter or margarine for EVOO on toast at breakfast.

 

  1. If people are nervous to include EVOO in their diet or swap for another type of oil – remind them that EVOO is not just a source of fat and they will get additional nutrients (such as biophenols and Vitamin E) from EVOO.

 

  1. For a healthy sweet treat that also helps achieve two serves of fruit per day, encourage people to try dressing fresh orange slices with a mild flavored EVOO and some cinnamon sugar. This common dish in Spain tastes similar to a sweet pastry.

View article references

  1. Hernaez A, Fernandez-Castillejo S, Ferries M et al. Olive oil biophenols enhance high-density lipoprotein function in humans: a randomized controlled trial. Arteriosclerosis, Thrombosis, and Vascular Biology Journal of the American Heart Association. 2014;34:2115–9.

 

  1. Hernaez A, Remaley AT, Farras M, Fernandez-Castillejo S, Subirana I, Schroder H, et al. Olive Oil Polyphenols Decrease LDL Concentrations and LDL Atherogenicity in Men in a Randomized Controlled Trial. J Nutr. 2015;145(8):1692-7.

 

  1. Castañer O, Fitó M, López-Sabater MC, et al. The effect of olive oil polyphenols on antibodies against oxidized LDL. A randomized clinical trial. Clinical nutrition 2011; 30: 490-493.

 

  1. Castañer O, Covas M-I, Khymenets O, et al. Protection of LDL from oxidation by olive oil polyphenols is associated with a downregulation of CD40-ligand expression and its downstream products in vivo in humans. The American journal of clinical nutrition 2012; 95: 1238-1244.

 

  1. Moreno-Luna R, Munoz-Hernandez R, Miranda ML, et al. Olive oil polyphenols decrease blood pressure and improve endothelial function in young women with mild hypertension. Am J Hypertens. 2012;25:1299–304.

 

  1. Mayr HL, Itsiopoulos C, Tierney AC, et al. Improvement in dietary inflammatory index score after 6-month dietary intervention is associated with reduction in interleukin-6 in patients with coronary heart disease: The AUSMED heart trial. Nutrition research (New York, NY) 2018 2018/05/29. DOI: 10.1016/j.nutres.2018.04.007.

 

  1. George E, Kucianski T, Mayr H, et al. A Mediterranean Diet Model in Australia: Strategies for Translating the Traditional Mediterranean Diet into a Multicultural Setting. Nutrients 2018; 10: 465.

 

  1. Itsiopoulos C, Brazionis L, Kaimakamis M, et al. Can the Mediterranean diet lower HbA1c in type 2 diabetes? Results from a randomized cross-over study. Nutrition, Metabolism and Cardiovascular Diseases 2011; 21: 740-747.

 

 

  1. Lee-Kwan S, Moore L, Blanck H, et al. Disparities in State-Specific Adult Fruit and Vegetable Consumption - United States 2015. MMWR Morb Mortl Wkly Rep. 2017;66:1241 – 1247. DOI: http://dx.doi.org/10.15585/mmwr.mm6645a1

 

  1. Bendall C, Mayr H, Opie R, et al. Central obesity and the Mediterranean diet: A systematic review of intervention trials. 2017, p.1-15.

 

  1. Mancini JG, Filion KB, Atallah R, et al. Systematic Review of the Mediterranean Diet for Long-Term Weight Loss. Am J Med 2016; 129: 407-415.e404. 2016/01/02. DOI: 10.1016/j.amjmed.2015.11.028.

 

  1. Lasa A, Miranda J, Bullo M, et al. Comparative effect of two Mediterranean diets versus a low-fat diet on glycaemic control in individuals with type 2 diabetes. European journal of clinical nutrition 2014; 68: 767.

 

  1. Piers L, Walker K, Stoney R, et al. The influence of the type of dietary fat on postprandial fat oxidation rates: monounsaturated (olive oil) vs saturated fat (cream). Int J Obesity. 2002;26:814-821

 

  1. Cândido FG, Valente FX, da Silva LE, et al. Consumption of extra virgin olive oil improves body composition and blood pressure in women with excess body fat: a randomized, double-blinded, placebo-controlled clinical trial. European Journal of Nutrition 2017: 1-11.