ArticleLiterature Review

The effect of high-polyphenol extra virgin olive oil on cardiovascular risk factors: A systematic review and meta-analysis

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Abstract

The polyphenol fraction of extra-virgin olive oil may be partly responsible for its cardioprotective effects. The aim of this systematic review and meta-analysis was to evaluate the effect of high versus low polyphenol olive oil on cardiovascular disease (CVD) risk factors in clinical trials. In accordance with PRISMA guidelines, CINAHL, PubMed, Embase and Cochrane databases were systematically searched for relevant studies. Randomized controlled trials that investigated markers of CVD risk (e.g. outcomes related to cholesterol, inflammation, oxidative stress) were included. Risk of bias was assessed using the Jadad scale. A meta-analysis was conducted using clinical trial data with available CVD risk outcomes. Twenty-six studies were included. Compared to low polyphenol olive oil, high polyphenol olive oil significantly improved measures of malondialdehyde (MD: -0.07µmol/L [95%CI: -0.12, -0.02µmol/L]; I2: 88%; p = 0.004), oxidized LDL (SMD: -0.44 [95%CI: -0.78, -0.10µmol/L]; I2: 41%; P = 0.01), total cholesterol (MD 4.5mg/dL [95%CI: -6.54, -2.39mg/dL]; p<0.0001) and HDL cholesterol (MD 2.37mg/dL [95%CI: 0.41, 5.04mg/dL]; p = 0.02). Subgroup analyses and individual studies reported additional improvements in inflammatory markers and blood pressure. Most studies were rated as having low-to-moderate risk of bias. High polyphenol oils confer some CVD-risk reduction benefits; however, further studies with longer duration and in non-Mediterranean populations are required.

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... Olive oil (OO) polyphenols have been demonstrated to mediate the prevention and management of CVD and associated risk factors (e.g., dyslipidemia) through various mechanistic pathways (17) . In particular, EVOO polyphenols have shown to improve levels of serum HDL-c (18) as well as the functionality of HDL by reducing HDL oxidative modifications and improving its physiochemical properties (19)(20)(21) . They also activate ABCA1 expression which is a key protein involved in cholesterol efflux (19) . ...
... Study participants were instructed to consume a daily dose of 60 mL of either HPOO or LPOO, over two intervention periods of 3 weeks each, added in their usual diet in its raw form. A 3-week study duration was chosen based on previous literature, where most studies were relatively short in duration with most intervention phases lasting on average, 3 weeks (18) . Furthermore, the researchers considered potential compliance issues, namely that the study was conducted in a non-Mediterranean population where EVOO is less habitually consumed and accepted. ...
... A 2-week washout period was chosen on the basis that this was sufficient to eliminate the carry-over effect of OO polyphenols between interventions, considering the short half-life of OO's phenolic compounds (30) . Furthermore, a daily dose of 60 mL OO was chosen in the current study, since this reflects the habitual amount consumed in Mediterranean populations, where the cardioprotective benefits of virgin OO (VOO) have previously been reported (17,18,31) . ...
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Olive oil (OO) polyphenols have been shown to improve high density lipoprotein (HDL) anti-atherogenic function, thus demonstrating beneficial effects against cardiovascular risk factors. The aim of the present study was to investigate the effect of extra-virgin high polyphenol olive oil (HPOO) vs. low polyphenol olive oil (LPOO) on the capacity of HDL to promote cholesterol efflux in healthy adults. In a double blind, randomized cross-over trial, 50 participants (aged 38.5±13.9 years, 66% females) were supplemented with a daily dose (60 mL) of HPOO (320 mg/kg polyphenols) or LPOO (86 mg/kg polyphenols) for 3-weeks. Following a 2-week wash-out period, participants crossed-over to the alternate treatment. Serum HDL cholesterol efflux capacity, circulating lipids (i.e., total cholesterol (TC), triglycerides (TG), HDL, low density lipoprotein (LDL)) and anthropometrics were measured at baseline and follow-up. No significant between-group differences were observed. Furthermore, no significant changes in HDL cholesterol efflux were found within either the LPOO and HPOO treatment arms; mean changes were 0.54% (95% CI -0.29 to 1.37) and 0.10% (95% CI -0.74 to 0.94), respectively. Serum HDL increased significantly after LPOO and HPOO intake, by 0.13 mmol/L (95% CI 0.04 to 0.22) and 0.10 mmol/L (95% CI 0.02 to 0.19), respectively. A small but significant increase in LDL of 0.14 mmol/L (95% CI 0.001 to 0.28) was observed following the HPOO intervention. Our results suggest that additional research is warranted to further understand the effect of OO with different phenolic content on mechanisms of cholesterol efflux via different pathways in multi-ethnic populations with diverse diets.
... Evidence from SLRs of RCTs suggested olive oil specific biophenols improved cardiovascular risk factors, particularly oxidized-LDL and blood pressure, with mixed effects on other outcomes (George et al. 2019;Hohmann et al. 2015;Sahebkar et al. 2017). Additional SLRs for RCTs of high-biophenol foods such as ginger, turmeric, green tea, and pomegranate skins suggest a beneficial effect of biophenols on blood pressure, triglycerides, and flow mediated dilation. ...
... The SLRs of RCTs which utilized supplements may not be directly applicable to the biophenol content in edible oils; however, are supported by cohort study evidence. Despite potential accuracy limitations for biophenol intake assessment within cohort studies, strong favorable evidence was found for high biophenol olive oil compared to low biophenol olive oil across three SLRs (George et al. 2019;Hohmann et al. 2015;Lukas Schwingshackl et al. 2019). Directly applicable to judging edible oils, 25 ml-75 ml per day of high biophenol olive oil or 3.4-31 mg biophenols from EVOO had clear benefits to cardiovascular health when compared to refined olive oil (George et al. 2019;Hohmann et al. 2015). ...
... Despite potential accuracy limitations for biophenol intake assessment within cohort studies, strong favorable evidence was found for high biophenol olive oil compared to low biophenol olive oil across three SLRs (George et al. 2019;Hohmann et al. 2015;Lukas Schwingshackl et al. 2019). Directly applicable to judging edible oils, 25 ml-75 ml per day of high biophenol olive oil or 3.4-31 mg biophenols from EVOO had clear benefits to cardiovascular health when compared to refined olive oil (George et al. 2019;Hohmann et al. 2015). ...
Article
Dietary guidelines for many Western countries base their edible oil and fat recommendations solely on saturated fatty acid content. This study aims to demonstrate which nutritional and bioactive components make up commonly consumed edible oils and fats; and explore the health effects and strength of evidence for key nutritional and bioactive components of edible oils. An umbrella review was conducted in several stages. Food composition databases of Australia and the United States of America, and studies were examined to profile nutrient and bioactive content of edible oils and fats. PUBMED and Cochrane databases were searched for umbrella reviews, systematic literature reviews of randomized controlled trials or cohort studies, individual randomized controlled trials, and individual cohort studies to examine the effect of the nutrient or bioactive on high-burden chronic diseases (cardiovascular disease, type 2 diabetes mellitus, obesity, cancer, mental illness, cognitive impairment). Substantial systematic literature review evidence was identified for fatty acid categories, tocopherols, biophenols, and phytosterols. Insufficient evidence was identified for squalene. The evidence supports high mono- and polyunsaturated fatty acid compositions, total biophenol content, phytosterols, and possibly high α-tocopherol content as having beneficial effects on high-burden health comes. Future dietary guidelines should use a more sophisticated approach to judge edible oils beyond saturated fatty acid content.
... The rise in EVOO use in Australian households has the potential to contribute to healthier dietary patterns and positively impact population health due to the myriad of health benefits associated with its high nutritional quality and its unique composition. In particular, oleic acid in addition with bioactive polyphenolic molecules (such as oleuropein, hydroxytyrosol, and tyrosol) are important constituents of EVOO which may help to explain its cardioprotective role including reductions in TC and LDL-C, blood pressure, proinflammatory markers, improved insulin sensitivity and endothelial function, and reductions in oxidative stress (41)(42)(43)(44)(45). Regular consumption of EVOO has also been associated with reductions in diabetes mellitus, inflammatory bowel disease, obesity and some cancers (46). ...
... Nevertheless, despite the perceived health benefits reported by participants in the present study, the majority reported using less than one tablespoon of olive oil per day, which is markedly less than reported in previously published clinical trials investigating cardiovascular benefits from the use of EVOO (13,41,48). Whether lower quantities of EVOO incorporated into an otherwise healthy dietary pattern will exert the same cardiovascular benefits remains largely unknown and is subject to ongoing research. ...
Article
Dietary oils and fats contain different fatty acid compositions which are associated with cardiometabolic disease risk. Despite their influence on disease outcomes, the types of dietary oils and fats predominately used in Australian households remain unknown. The aim of this study was to investigate the use of dietary oils and fats in cooking and food preparation in Australia. Adults living in Australia completed a cross-sectional online survey outlining their current household oil and fat use from July to December 2021. The survey was disseminated via social media platforms and included questions about the types of dietary oils and fats used for different cooking methods and the perceived motivators for choosing the main household oil. A total of 1248 participants responded to the survey. Participants were mostly female (91.6%) aged between 25 to 44 years (56.7%). The majority of participants (84.5%) reported using some form of olive oil as their main source of oil for cooking and food preparation. Almost two-thirds of the sample (65.4%) reported using extra virgin olive oil (EVOO), mainly in raw food preparation (71.5%) or savoury baking and roasting (58%). Fewer households reported using rice bran oil (4.6%), canola oil (4.3%), and vegetable oil (1.8%). Almost half of all participants (49.6%) identified perceived health benefits as the primary motivating factor for their main choice of oil, followed by sensory preference (46.7%), versatility (10.2%), and convenience (8.8%). Australian adults frequently use olive oil, specifically EVOO, as the main oil for cooking and food preparation in the household.
... This is supported by underlying biological and mechanistic data, which suggest a diet rich in vegetable and fruit matter, including extra virgin olive oil rich in bioactive compounds including polyphenols, is cardioprotective. Both in vitro and in vivo laboratory studies have demonstrated potential mechanisms by which these compounds can moderate the inflammatory effects of fatty liver [44,45]. A systematic review of randomised controlled trials highlighted the importance of polyphenol-rich food products and cardiovascular outcomes [45]. ...
... Both in vitro and in vivo laboratory studies have demonstrated potential mechanisms by which these compounds can moderate the inflammatory effects of fatty liver [44,45]. A systematic review of randomised controlled trials highlighted the importance of polyphenol-rich food products and cardiovascular outcomes [45]. Adherence to Mediterranean diet has also been associated with other cardiovascular risk factors such as lower central obesity, MetS and low-grade inflammation, consistent with the results demonstrated in this analysis [46]. ...
Article
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Background: Non-alcoholic fatty liver disease (NAFLD) is the leading cause of liver disease, affecting ~30% of the population and increasing CVD. This study aimed to explore the direct, indirect and combined effects of Mediterranean diet, NAFLD and inflammation on the 10-year CVD risk in a healthy adult population. Methods: Using baseline and 10-year follow-up data from the ATTICA study, adherence to Mediterranean diet was measured using MedDietScore, and presence of NAFLD at baseline was assessed using the fatty liver index (FLI). Participants' 10-year CVD outcomes were recorded and C-reactive protein (CRP) was used as a surrogate marker for inflammation. The direct and indirect roles of these factors were explored using logistic regression models and the pathways between them were analysed using a structural equation model (SEM). Results: NAFLD prevalence was 22.9% and its presence was 17% less likely for every unit increase in MedDietScore. NAFLD presence at baseline was associated with increased 10-year CVD incidence (39.4% vs. 14.5%, p = 0.002), but when adjusted for MedDietScore, NAFLD was not an independent predictor of 10-year CVD risk. MedDietScore was an independent protective factor of 10-year CVD risk (OR = 0.989, 95% CI: 0.847, 0.935), when adjusted for NAFLD at baseline, age, gender, sedentary lifestyle and other confounders. Further exploration using SEM showed that MedDietScore was associated with CVD risk directly even when inflammation as CRP was introduced as a potential mediator. Conclusion: FLI as a proxy measure of NAFLD is a strong predictor of 10-year CVD risk, and this prognostic relationship seems to be moderated by the level of adherence to Mediterranean diet. Adherence to Mediterranean diet remained an independent and direct CVD risk factor irrespective of NAFLD status and CRP.
... 5 Some polyphenols contained in OO contribute to the cardioprotective effects. 6 In addition, the minor components present in OO also correlate with taste and nutritional value, physicochemical characteristics of the product, and important markers for OO quality, purity, and authenticity. 7 the authenticity of edible fats and oils is typically investigated by identifying some differences between authentic and adulterated oils in terms of the contents of chemicals contained in the evaluated oils. ...
... the united States Food and drug administration (Fda) allows the claim relating to the capability of daily consumption of 23 g of OO to reduce the risk of coronary heart disease. 6 Some health benefit effects of dietary OO on human health have been reported. an OO-rich diet is reported to prevent cardiovascular diseases, reduce plasma triacylglycerol, increase high-density lipoprotein (hdl) cholesterol levels, improve the postprandial lipoprotein metabolism, and reduce blood pressure and the risk of hypertension, as demonstrated through epidemiological studies. ...
... 7,8 In healthy adults, EVOO has been shown to improve CVD risk factors including blood pressure, low grade inflammation and lipid profile. 9 The cardioprotective properties of EVOO have been primarily attributed to the high monounsaturated fat content; however, EVOO contains an array of unique polyphenols, also referred to as 'biophenols'. 10 These polyphenols have shown improvements in measures of glucose metabolism, lipid peroxidation and cholesterol markers in clinical trials. ...
... Other studies, even those which compare oils with varying polyphenol content, do not report the composition of the polyphenols contained within. 9 Finally, this study will report HDL efflux, oxidised LDL and other biomarkers of CVD that have not been extensively studied in previous dietary intervention studies. If shown to be beneficial, the present study will provide evidence for a widely accessible, low cost dietary intervention to reduce CVD risk and will significantly contribute to the existing literature on the clinical importance of polyphenol intake. ...
Article
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PurposeOlive oil polyphenols have been associated with cardiovascular health benefits. This study examined the antioxidant and anti-inflammatory effect of extra-virgin high polyphenol olive oil (HPOO) vs. low polyphenol olive oil (LPOO) in healthy Australian adults.Methods In a double-blind cross-over trial, 50 participants (aged 38.5 ± 13.9 years, 66% females) were randomized to consume 60 mL/day of HPOO (320 mg/kg polyphenols) or LPOO (86 mg/kg polyphenols) for three weeks. Following a 2-week wash-out period, participants crossed-over to the alternate treatment. Plasma oxidized low-density lipoprotein (ox-LDL), total antioxidant capacity (TAC), high-sensitivity C-reactive protein (hs-CRP) and anthropometrics were measured at baseline and follow-up.ResultsFourty-three participants completed the study. Although there were no significant differences between treatments in the total sample, plasma ox-LDL decreased by 6.5 mU/mL (95%CI − 12.4 to − 0.5) and TAC increased by 0.03 mM (95% CI 0.006–0.05) only in the HPOO arm. Stratified analyses were also performed by cardiovascular disease risk status defined by abdominal obesity (WC > 94 cm in males, > 80 cm in females) or inflammation (hs-CRP > 1 mg/L). In the subgroup with abdominal obesity, ox-LDL decreased by 13.5 mU/mL (95% CI − 23.5 to − 3.6) and TAC increased by 0.04 mM (95% CI 0.006–0.07) only after HPOO consumption. In the subgroup with inflammation, hs-CRP decreased by 1.9 mg/L (95% CI − 3.7 to −0.1) only in the HPOO arm.Conclusions Although there were no significant differences between treatments, the changes observed after HPOO consumption demonstrate the antioxidant and anti-inflammatory effect of this oil, which is more pronounced in adults with high cardiometabolic risk (Clinical Trial Registration: ACTRN12618000706279).
... 21 The benefits of biophenols have been suggested for the treatment of chronic conditions in humans, such as decreasing toxicity in hemodialysis, improving mental health and cognitive performance, managing nausea and vomiting in chemotherapy, or reducing cardiovascular disease risk. 19,[22][23][24][25][26][27] The beneficial effects of biophenols are due to a variety of mechanisms, including their antioxidant, antiglycation, and anti-inflammatory activities on glucose and lipid metabolism as well as cell proliferation and interactions with the gut microbiota. [28][29][30] More recently, there is a growing body of interventional research exploring the potential of biophenol-rich nutraceuticals on patient-centered outcomes in gastrointestinal conditions. ...
... Previous studies have shown the effect of biophenol-rich nutraceuticals on improving oxidative stress and inflammation in chronic disease states including liver disease, cardiovascular disease, and kidney disease. 19,27,69 Although only measured by few studies with a limited cumulative sample size and wide confidence intervals, decreasing certainty in the estimated effects, this finding may explain the mechanism by which GIS were improved. 70 Although inflammatory and oxidative stress markers are not consistent biomarkers for IBS, future studies should measure these outcomes to better explore how inflammation and oxidative stress may play a role within IBS subtypes and if these may be modified by biophenols. ...
Article
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Aim: Biophenol-rich nutraceuticals may be an adjuvant treatment for Crohn's disease (CD), ulcerative colitis (UC), symptomatic uncomplicated diverticular disease (SUDD), and irritable bowel syndrome (IBS). This systematic review and meta-analysis aimed to determine the efficacy and safety of biophenol-rich nutraceutical supplementation on CD, UC, SUDD, and IBS on gastrointestinal symptoms (GIS), quality of life (QoL), inflammatory and oxidative stress biomarkers, and adverse events compared to usual care or placebo. Methods: PubMed, Embase, CINAHL, and CENTRAL were searched for randomised controlled trials until 27 April 2020. Outcomes were GIS, inflammatory and oxidative stress markers, QoL, and adverse events. The Cochrane Risk of Bias tool and GRADE were used to appraise studies. Data were pooled using Revman. Results: Twenty-three trials in CD, UC, and IBS patients were included. Compared with placebo, biophenol-rich nutraceuticals improved GIS (SMD: 0.43 [95%CI: 0.22, 0.63]; GRADE: very low) in UC, CD, and IBS participants. In UC and CD participants, biophenol-rich nutraceuticals improved CRP by 1.6 mg/L [95%CI:0.08, 3.11; GRADE: low], malondialdehyde by 1 mmol/L [95%CI:0.55, 1.38; GRADE: low]; but only resveratrol improved QoL (SMD: -0.84 [95%CI: -1.24, -0.44; GRADE: high). Resveratrol (for UC and CD participants) and peppermint oil (for IBS participants) had greater certainty in the evidence for improving GIS and QoL (GRADE: moderate to high). There was no effect on adverse events (P > .05). Conclusions: Biophenol-rich nutraceuticals may be an effective and safe adjuvant treatment for the management of CD, UC, and IBS; with higher certainty of evidence for resveratrol for UC and CD and peppermint oil for IBS.
... The findings of this investigation also showed that ALA (C18:3, n-3) increased significantly in the camelina oil compared to the other groups. It seems that using other oils as a placebo could not be effective in finding between-group differences because rapeseed oil and olive oil have a cholesterol-lowering effect [32][33][34]. Rapeseed oil contains polyphenols and high amounts of unsaturated fatty acids, mainly monounsaturated fatty acids, that can effectively reduce cholesterol levels by enhancing the excretion of bile acid and reducing cholesterol absorption [32]. Moreover, olive oil contains approximately 55-83% oleic acid, 4-20% PUFA and other components, such as phenolic compounds [35]. ...
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Background This systematic review and dose–response meta-analysis of published randomized controlled trials (RCTs) was conducted to determine the effectiveness of camelina oil supplementation (COS) on lipid profiles and glycemic indices. Methods Relevant RCTs were selected by searching the ISI Web of Science, PubMed, and Scopus databases up to July 1, 2022. RTCs with an intervention duration of less than 2 weeks, without a placebo group, and those that used COS in combination with another supplement were excluded. Weighted mean differences and 95% confidence intervals were pooled by applying a random-effects model, while validated methods examined sensitivity analyses, heterogeneity, and publication bias. Results Seven eligible RCTs, including 428 individuals, were selected. The pooled analysis revealed that COS significantly improved total cholesterol in studies lasting more than 8 weeks and utilizing dosages lower than 30 g/d compared to the placebo group. The results of fractional polynomial modeling indicated that there were nonlinear dose–response relations between the dose of COS and absolute mean differences in low-density cholesterol, high-density cholesterol, and total cholesterol, but not triglycerides. It appears that the greatest effect of COS oil occurs at the dosage of 20 g/day. Conclusion The present meta-analysis indicates that COS may reduce cardiovascular disease risk by improving lipid profile markers. Based on the results of this study, COS at dosages lower than 30 g/d may be a beneficial nonpharmacological strategy for lipid control. Further RCTs with longer COS durations are warranted to expand on these results.
... Previous reviews and meta-analyses of human trials have explored the evidence of the effects of dietary polyphenol intake on BP (George et al., 2019;Godos et al., 2019;Sweeney et al., 2022;Weaver et al., 2021). A systematic review and meta-analysis of dietary polyphenols and HTN involving 20 studies, comprising 200,256 individuals and 45,732 patients with HTN, noted that the polyphenol subclass, anthocyanins Abbreviations: ACE, Angiotensin converting enzyme; BP, Blood pressure; CENTRAL, Cochrane Central Register of Controlled Trials; CI, Confidence Interval; CVD, cardiovascular disease; DASH, Dietary Approaches to Stop Hypertension; DBP, Diastolic blood pressure; EMBASE, Excerpta Medica Database; FDSP, Freeze dried strawberry powder; HTN, Hypertension; ET, Ellagitannins; EA, Ellagic acid; MS, Metabolic syndrome; RCTs, Randomized controlled trials; ROB, Risk of bias; SBP, Systolic blood pressure; PROSPERO, International prospective register of systematic reviews; PRISMA, Preferred Reporting Items for Systematic Reviews and meta-Analysis. ...
Article
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Ellagitannin-rich food has been implicated to ameliorate cardiovascular risk, particularly blood pressure (BP). This systematic review and meta-analysis investigated the effect of ellagitannin-rich fruit consumption on BP. Five databases were screened and RCTs reporting the effect of ellagitannin-rich fruit consumption on BP and polyphenol content were included. Nineteen studies with 1,249 participants, showed a non-significant systolic blood pressure (SBP) and significant diastolic blood pressure (DBP) reduction, with ET-rich fruit consumption. Subgroup analysis revealed significant SBP reduction among hypertensives receiving 500–1000 mg polyphenol (-4.95 mmHg, 95 % CI: [-7.24, −2.66]) and among metabolic syndrome (MS) patients (-3.44 mmHg; 95 % CI: [-5.25, −1.63]). meta-regression revealed a positive association between polyphenol dosage and SBP changes. In conclusion, the consumption of ellagitannin-rich fruits may be considered an anti-hypertensive functional food/drink and recommended for patients who are at high risk for hypertension. Further well-designed trials are required to resolve the significant heterogeneities identified in the current literature.
... OO is not only the main culinary and dressing fat in Mediterranean countries, but also sets the MedDiet apart from other healthy dietary patterns. There is some observational evidence that OO may play a major role in explaining the associations of the MedDiet with a lower incidence of several chronic diseases [7][8][9], especially CVD [4,[10][11][12]. Virgin OO (the highest quality variety, obtained by mechanical processes and rich in phenolic compounds), has shown to have anti-inflammatory, antioxidant, and anti-atherosclerotic properties as well as beneficial effects on endothelial function and blood pressure control [8,[13][14][15][16]. ...
Article
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Background Evidence on the association between virgin olive oil (OO) and mortality is limited since no attempt has previously been made to discern about main OO varieties. Objective We examined the association between OO consumption (differentiating by common and virgin varieties) and total as well as cause-specific long-term mortality Methods 12,161 individuals, representative of the Spanish population ≥18 years old, were recruited between 2008 and 2010 and followed up through 2019. Habitual food consumption was collected at baseline with a validated computerized dietary history. The association between tertiles of OO main varieties and all-cause, cardiovascular and cancer mortality were analyzed using Cox models. Results After a mean follow-up of 10.7 years (129,272 person-years), 143 cardiovascular deaths, and 146 cancer deaths occurred. The hazard ratio (HR) (95% confidence interval) for all-cause mortality in the highest tertile of common and virgin OO consumption were 0.96 (0.75–1.23; P-trend 0.891) and 0.66 (0.49–0.90; P-trend 0.040). The HR for all-cause mortality per a 10 g/day increase in virgin OO was 0.91 (0.83–1.00). Virgin OO consumption was also inversely associated with cardiovascular mortality, with a HR of 0.43 (0.20–0.91; P-trend 0.017), but common OO was not, with a HR of 0.88 (0.49–1.60; P-trend 0.242). No variety of OO was associated with cancer mortality. Conclusion Daily moderate consumption of virgin OO (1 and 1/2 tablespoons) was associated with a one-third lower risk of all-cause as well as half the risk of cardiovascular mortality. These effects were not seen for common OO. These findings may be useful to reappraise dietary guidelines.
... Research has also investigated the role of the individual components of the MedDiet and the relationship between these components and CVD-related diseases and risk factors [23,24]. Red wine and olive oil have been to a greater extent investigated for their individual roles in reducing CVD-related morbidity and mortality [25][26][27][28]. However, the health benefits associated with the MedDiet are predominately due to the overall diet and how the collective dietary components can target multiple, different risk factors [29]. ...
Article
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Atherosclerosis is the underlying cause of cardiovascular diseases (CVD) and is interrelated to stroke, heart attack, and heart failure. The Mediterranean Diet (MedDiet) has been closely associated with reduced CVD morbidity and mortality, but research is not well explored for this relationship in individuals with diabetes (who experience greater CVD morbidity and mortality than individuals without diabetes). The aim of this review was to explore the literature related to the MedDiet and atherosclerosis and associated risk factors in individuals with and without diabetes. In total, 570 articles were identified, and 36 articles were included. The articles were published between 2011 and 2021. Platforms used for the search were PubMed, Scopus, Cochrane Library, and ProQuest. Our literature search included clinical and observational studies. Clinical studies revealed the MedDiet was associated with improved biomarkers, plaque, and anthropometric measurements that are associated with atherosclerosis and CVD. Observational studies identified associations between the MedDiet and lower presence of atherosclerosis, improved vascular aging, and increased endothelial progenitor cells. However, most of the studies took place in Mediterranean countries. Further research is needed to better understand the long-term effects the MedDiet on atherosclerosis and its associated risk factors in diverse populations to include individuals with and without diabetes.
... Likewise, many randomized controlled clinical trials have evaluated the effect of olive oil consumption on CVD risk factors and markers of inflammation in humans (Carnevale et al., 2019;de la Torre et al., 2020;Fernández-Castillejo et al., 2017;Khaw et al., 2018;Morvaridi, Jafarirad, Seyedian, Alavinejad, & Cheraghian, 2020;Perrone et al., 2019;Rus et al., 2020;Sanchez-Rodriguez et al., 2018Sarapis et al., 2020;Valls et al., 2017). Significant evidence has been retrieved from systematic reviews and meta-analyses regarding the effect of EVOO or high-phenolic virgin olive oil on CVD risk factors such as decreased systolic blood pressure (George et al., 2019;Zamora-Zamora, Martínez-Galiano, Gaforio, & Delgado-Rodríguez, 2018), decreased low-density lipoprotein-cholesterol (LDL-C) (Schwingshackl et al., 2018) and oxidized LDL (Hohmann et al., 2015;Schwingshackl et al., 2018), risk reduction of all-cause mortality, cardiovascular (CV) mortality, and stroke (Schwingshackl & Hoffmann, 2014), and downregulation of inflammation and endothelial function markers (decreased C-reactive protein, interleukin-6, and tumor necrosis factor (TNF)-α.) (Fernandes et al., 2020;Schwingshackl, Christoph, & Hoffmann, 2015). These meta-analyses have also highlighted heterogeneous study designs and the lack of systematic studies as the main limitations of controlled clinical trials and cohorts that will need to be overcome to reach more robust conclusions in the future. ...
Chapter
Edible oils are essential energy providers in human diets. However, these oils are also a natural source of bioactive compounds and phytonutrients. This chapter will provide an overview of the bioactive lipids from olive, palm, and fish oils. The nutritional and health benefits of these oils are well documented and frequently associated with their minor lipids, which exhibit significant positive effects on human health. Each oil displays a unique set of lipid families, called lipidome, with bioactive lipids belonging to different classes and with diverse structures and functions. Bioactive lipids, such as polar lipids, prenol lipids, or polyunsaturated fatty acids, have been reported to have health benefits and to prevent the onset of several disorders. The knowledge of the bioactive compounds present in these edible oils is used to develop novel biotechnological applications that incorporate these lipids into functional foods, cosmetic or pharmaceutical innovations to improve human health and well-being.
... Fish and seafood is regarded as a source of high-quality protein and fat, particularly omega-3 fatty acids that were shown to reduce serum triglycerides and the risk of coronary heart disease [76]. Olive oil is highly valued because of its fatty acid and polyphenolic composition, which are key in risk reductions of CVD [77,78]. Based on the results of self-awareness towards complying with MedD patterns, the volunteers were quite accurate in their perception (2.96 ± 0.98 out of 5 (59%) vs. 7.6 ± 2.5 out of 14 (54%)), so we could conclude that they showed good general knowledge on how a MedD menu should be made. ...
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Non-communicable diseases (NCD) and lifestyle, particularly diet, have a close relationship. Based on the recent statistics, Croatian men and women lead in European overweight lists, which implies pessimistic prognosis in terms of incidence and prevalence of NCDs in the future. One of the possible solutions to overcome weight problems is turn to traditional balanced and sustainable diets, such as the Mediterranean diet. In this study, we assessed adherence towards Mediterranean diet using a validated questionnaire in an online survey and associated adherence scores with several demographic and anthropometric data. Based on the results of a validated Mediterranean Diet Adherence Screener (N = 3326), we assessed the adherence score to be 7.6 ± 2.5. The score tended to depend on sex, residence, age, education, income, and body mass index (BMI); indeed, women, residents of a coastal part of the country, older volunteers, those possessing a higher education degree, those with higher income, and those with lower BMI were associated with higher scores. As income was one of the significant findings related to higher adherence scores, we developed a dietary plan complying with Mediterranean diet principles that, on average, costed less than the average traditional balanced diet menu. Taken together, this study brought new findings regarding target groups who need to be encouraged to make lifestyle changes, and highlighted the first steps on how to make them.
... In this study, compared to low polyphenol olive oil, high polyphenol olive oil significantly improved measures of oxidized LDL (Standard Mean Difference: -0.44) total cholesterol (MD 4.5 mg/dL) and HDL cholesterol (Mean difference of 2.37 mg/dL). 10 With respect to the effect of anthocyanin on blood lipids 4 studies will be discussed. In 2016, Liu et al conducted a systematic review and meta-analysis of 6 studies including over 500 participants. ...
... EVOO mengandung polifenoll dengan konsentrasi tinggi yaitu hydroxytyrosol dan oleuropein yang mampu menurunkan kondisi inflamasi dan stres oksidatif penyebab disfungsi endotell pada kondisi preeklampsia (George et al., 2019). Gangguan keseimbangan faktor pro-angiogenik dan anti-angiogenik ini mengakibatkan disfungsi sistemik vaskuler. ...
Article
Preeclampsia was defined as new onset hypertension and proteinuria after 20 weeks of gestation in which the mother had no previous history of hypertension. Preeclampsia is a disorder that often occurs in pregnancy with an incidence rate of 2-8% among pregnancies in the world. Preeclampsia ranks 2nd as a cause of maternal death (MMR). In East Java, preeclampsia was ranked 1st as the cause of AKI in 2016. Preeclampsia as one of the main causes of maternal death can be detected and treated properly before the emergence of life-threatening complications such as eclampsia. In severe cases, preeclampsia increases the risk of comorbidities such as Hemolysis, Elevated Liver Enzyme Levels, and Low Platelet Levels (HELLP) syndrome, edema, Disseminated Vascular Coagulation (DIC), and eclampsia/cerebral edema, whereas in fetus preeclampsia is associated with intrauterine growth restriction. (IUGR), prematurity and fetal death. Extra virgin olive oil (EVOO) is obtained from olives in a mechanical way that does not change the composition of the oil. Research on EVOO has been widely studied in a broad spectrum which explores its content as antioxidants and also anti-inflammatory polyphenols and tocopherols that can be used as anti-oxidants and also anti-inflammatory. The purpose of this study was to prove the role of EVOO on placental and fetal weight in preeclampsia model Wistar rats. The design of this study was experimental (quasi experimental) with a posttest only control group design approach. This study consisted of 5 groups, negative group, positive group (preeclampsia model rats), treatment groups 1, 2 and 3, namely preeclampsia rats that were given EVOO in 3 different doses (each 0.5ml/day, 1ml/day, 2 ml/day). After being sacrificed, the placenta and fetus are weighed to determine their weight. The results showed that the administration of EVOO was effective in increasing the weight of the placenta and fetus in preeclampsia model rats with a P value of 0.000 (P<0.05).
... However, a randomized controlled trial for oral daily doses of EPA and DHA versus olive oil (placebo) found no significant differences between treatment groups for both the signs and symptoms of DED over 12 months. 68 although, the polyphenols present in olive oil have demonstrated anti-inflammatory effects, which may have been a cofounder in this study [69][70][71] . A recent systematic review and meta-analysis concluded that long-chain omega-3 supplements may have little to no benefit on dry eye symptoms relative to placebo, although there was some improvement on clinical signs. ...
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Dry eye disease (DED) is a common disorder that remains challenging from a clinical perspective. Unstable or deficient tear film is a major factor contributing to DED and the inability to resolve the loss of tear film homeostasis that accompanies DED can result in a vicious circle of inflammation and treatment-refractory disease. Recently recognized as a multifactorial disease, the main etiological subtypes of DED are aqueous-deficient and evaporative which exist on a continuum, although evaporative dry eye (EDE) is the more frequent classification. Although attaining greater recognition in recent years, there is currently no consensus and no clear recommendation on how to manage EDE. Clarity on the early diagnosis and treatment of EDE may facilitate the avoidance of progression to chronic inflammation, permanent damage to the ocular surface, and treatment-refractory disease. The purpose of this review was to identify current best practice for management of EDE in order to help clinicians in providing accurate diagnosis and optimized treatment. We summarize recent literature considering the role of the lipid layer on tear film stability, the importance of its composition and of its dynamic behavior, and the link between its malfunction and the insurgence and maintenance of tear film-related diseases. We have provided an assessment of the best management of lipid-deficient EDE based upon an understanding of disease pathophysiology, while indicating the flow of current treatments and possible future evolution of treatment approaches. Lipid containing eye drops may be considered as a step closer to natural tears from artificial aqueous tears because they more closely mimic the aqueous and lipid layers and may be used in combination with other management approaches. As a next step, we recommend working with a wider expert group to develop full guidelines to enable patient-centered management of EDE. • Key points • Dry eye is a multifactorial disease of variable presentation with the tendency to become a chronic disease for which it is essential to identify and treat the main pathogenic mechanisms involved and tailor the treatment to the individual patient. • Early intervention is needed to prevent the vicious cycle of DED and may require a multi-faceted management approach. • EDE is not just a problem of MGD but can be the result of anything affecting blinking, mucin spreading, aqueous layer volume and content. • Lipid-containing eye drops may provide significant relief of symptoms by improving the lipid layer and its spreading ability and, as such, are an appropriate component of the overall management of lipid-deficient EDE; natural lipid-containing eye drops should be the preferred treatment.
... Available evidence supports that some dietary strategies, such as the traditional Mediterranean dietary pattern, rich in extra-virgin olive oil, fruit, and vegetables may delay or prevent chronic illness, such as CVD or type 2 diabetes (T2D) [4][5][6][7][8]. The high concentration of bioactive compounds, such as (poly)phenols, present in this dietary pattern may exert antioxidant, anti-inflammatory, and antithrombotic effects that contribute to the delay of CVD onset and progression [9][10][11]. ...
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The health benefits of plant-based diets have been reported. Plant-based diets found in Spain and other Mediterranean countries differ from typical diets in other countries. In the Mediterranean diet, a high intake of phenolic compounds through olives, olive oil, and red wine may play an important role in cardiovascular prevention. Prospective studies carried out in Mediterranean countries may provide interesting insights. A relatively young Mediterranean cohort of 16,147 Spanish participants free of cardiovascular disease (CVD) was followed (61% women, mean (SD) age 37(12) years at baseline) for a median of 12.2 years. Dietary intake was repeatedly assessed using a 136-item validated food frequency questionnaire, and (poly)phenol intake was obtained using the Phenol-Explorer database. Participants were classified as incident cases of CVD if a medical diagnosis of myocardial infarction, stroke, or cardiovascular death was medically confirmed. Time-dependent Cox regression models were used to assess the relationship between (poly)phenol intake and the incidence of major CVD. A suboptimal intake of phenolic compounds was independently associated with a higher risk of CVD, multivariable-adjusted hazard ratio for the lowest versus top 4 quintiles: 1.85 (95% CI: 1.09–3.16). A moderate-to-high dietary intake of phenolic compounds, especially flavonoids, is likely to reduce CVD incidence in the context of a Mediterranean dietary pattern.
... Our population, compared to others (especially European and North American ones), has different dietary habits. The Mediterranean diet, rich in olive oil, has been shown to reduce cardiovascular risk, as the PREDIMED study [17], as well as other studies [18,19,37] demonstrate. If we compare our results with those of the DCCT/EDIC group, which had a better overall control in terms of HbA1c (7.2% in the DCCT/EDIC group versus 7.7% in ours), our cohort shows better results from the cardiovascular point of view, despite a slightly worse control. ...
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Background: Despite major medical advances, Type 1 Diabetes (T1D) patients still have greater morbimortality than the general population. Our aim was to describe our cohort of T1D patients and identify potential risk factors susceptible to prevention strategies. Methods: Cross-sectional, observational study, including T1D patients treated at our center, from 1 March 2017 to 31 March 2020. Inclusion criteria: T1D, age > 14 years and signed informed consent. Exclusion criteria: diabetes other than T1D, age < 14 years and/or refusal to participate. Results: Study population n = 2181 (49.8% females, median age at enrollment 41 years, median HbA1c 7.7%; 38.24% had at least one comorbidity). Roughly 7.45% had severe hypoglycemia (SH) within the prior year. Macro/microvascular complications were present in 42.09% (5.83% and 41.14%, respectively). The most frequent microvascular complication was diabetic retinopathy (38.02%), and coronary disease (3.21%) was the most frequent macrovascular complication. The risk of complications was higher in males than in females, mainly macrovascular. Patients with SH had a higher risk of complications (OR 1.42; 1.43 in males versus 1.42 in females). Conclusions: Our T1D population is similar to other T1D populations. We should minimize the risk of SH, and male patients should perhaps be treated more aggressively regarding cardiovascular risk factors.
... Kiritsakis & Markakis, 1988). In addition, olive oil contains a number of bioactive compounds such as polyphenols that are strong antioxidants and radical scavengers and inhibit low-density lipoprotein (LDL) oxidation (George et al., 2018); where the major PC in olive oil are oleuropein, hydroxytyrosol, and tyrosol, which have been focused on throughout many studies to investigate their biological properties (Tuck & Hayball, 2002). ...
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Interest in plant-based food has grown in recent years due to their primary prevention potential. Za’atar, an ancient and popular Lebanese herbal mixture, might disclose relevant clinical interest, due to the well-known intrinsic properties of its individual components. Za’atar mixture contain Origanum syriacum (Lebanese thyme), Thymbra spicata (Wild thyme), Rhus coriaria (Sumac), and Sesamum indicum (Sesame). Here we explored the history, composition, general employment, and bio-active aspects of Za’atar through available in vitro, animal, and clinical trials evidence to depict its possible role as an innovative nutraceutical tool. The combined action of Za’atar constituents is able to generate comprehensive beneficial effects on several common pathogenic pathways underlying chronic cardio-metabolic diseases and cancer. However, main available evidence derives from animal and in vitro studies. Thus, further human studies are needed to fully characterize Za’atar as a preventive and curative tool.
... Among other foods rich in polyphenols, ginger is rich in gingerols and it has been studied for its potential effects on blood pressure; a meta-analysis including six RCTs and 345 participants showed that ginger supplementation would reduce both systolic (−6.36 mmHg, 95% CI: −11.27 to −1.46, p = 0.011; I2 = 89%) and diastolic blood pressure (−2.12 mmHg, 95% CI: −3.92 to −0.31, p = 0.002; I2 = 73%), although the overall level of evidence is relatively weak due to the high heterogeneity between studies and the small number of participants [61]. Additionally, olive oil is particularly rich in polyphenols, especially phenolic acids, which have been considered most probably responsible for the health benefits of this oil; however, a meta-analysis on high-polyphenol extra-virgin olive oil including five RCTs showed no direct effect on blood pressure levels (−2.03 mmHg, 95% CI: −6.57 to 2.50, p = 0.38; I2 = 79% for systolic blood pressure; −2.70 mmHg, 95% CI: −5.71 to 0.31, p = 0.08; I2 = 78% for diastolic blood pressure) [62]. ...
Article
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The aim of this review was to explore existing evidence from studies conducted on humans and summarize the mechanisms of action of dietary polyphenols on vascular health, blood pressure and hypertension. There is evidence that some polyphenol-rich foods, including berry fruits rich in anthocyanins, cocoa and green tea rich in flavan-3-ols, almonds and pistachios rich in hydroxycinnamic acids, and soy products rich in isoflavones, are able to improve blood pressure levels. A variety of mechanisms can elucidate the observed effects. Some limitations of the evidence, including variability of polyphenol content in plant-derived foods and human absorption, difficulty disentangling the effects of polyphenols from other dietary compounds, and discrepancy of doses between animal and human studies should be taken into account. While no single food counteracts hypertension, adopting a plant-based dietary pattern including a variety of polyphenol-rich foods is an advisable practice to improve blood pressure.
... George et al. [40] To illustrate the impact of olive oil on type II diabetes Olive oil intake could be benefical for the prevention and management of type II diabetes Schwingshackl et al. [41] to investigate effects of 2 oil blends phytonutrient concentrations on blood lipid profile, compared with refined olive oil as a control borderline hypercholesterolemia extent as refined olive oil ...
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The Mediterranean Diet contains fruits, vegetables, nuts, whole grains, fish and virgin olive oil (VOO) as a key component. It is well explained that those consumption has a number of positive health effects. It has been accepted for a long time that the leading compound in olive was oleic acid as a monounsaturated fatty acid. However, the latter researches were figured out that VOO rich in natural phenolics have multifaceted influence on major diseases including cancer, diabetes, cardio-vascular diseases, neurodegenerative disease, and metabolic disorders. Recent medical studies proved that oleocanthal and oleacein, characteristic bioactive biophenol-secoiridoids in VOO, success in the anti-inflammatory and in the anti-oxidant properties, respectively. It has more recently investigated that oleocanthal and hydroxytyrosol (HT) kills cancer cells (CCs). HT and oleuropein reduces breast cancer and cutaneous melanoma cancer cells both in number and aggressiveness, and inhibits CCs multiplying. It has been declared too many times that nutrition type is the strongest factor can be caused acute and chronic diseases. However, at the same time, nutrition can also prevent some of those heavy symptoms. The main purpose of presented chapter is to meet olive's bioactive molecules and to examine how to improve our health with diet.
... Olive oil has been recognized as the golden standard or main element in the diet in healthy nutrition. In addition to oleic acid, minor constituents such as triterpenes, polyphenols, tocopherols and sterols add bioactive properties to virgin olive oil (VOO) [10][11][12][13] . ...
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Purpose Despite numerous reports on the beneficial effects of olive oil in the cardiovascular context, very little is known about the olive tree’s wild counterpart ( Olea europaea , L. var. sylvestris ), commonly known as acebuche (ACE) in Spain. The aim of this study was to analyse the possible beneficial effects of an extra virgin ACE oil on vascular function in a rodent model of arterial hypertension induced by L-NAME (N G -nitro-L-arginine methyl ester). Methods Four experimental groups of male Wistar rats were studied: 1) normotensive rats (Control group); 2) normotensive rats fed a commercial diet supplemented with 15% (w/w) ACE oil (Acebuche group); 3) rats made hypertensive following administration of L-NAME (L-NAME group); and 4) rats treated with L-NAME and simultaneously supplemented with 15% ACE oil (LN+ACE group). All treatments were maintained for 12 weeks. Results Besides a significant blood pressure-lowering effect, the ACE oil-enriched diet counteracted the alterations found in aortas from hypertensive rats in terms of morphology and responsiveness to vasoactive mediators. In addition, a decrease in hypertension-related fibrotic and oxidative stress processes was observed in L-NAME-treated rats subjected to ACE oil supplement. Conclusion Using a model of arterial hypertension via nitric oxide depletion, here we demonstrate the beneficial effects of a wild olive oil based upon its vasodilator, antihypertensive, antioxidant, antihypertrophic and antifibrotic properties. We postulate that regular inclusion of ACE oil in the diet can alleviate the vascular remodelling and endothelial dysfunction processes typically found in arterial hypertension, thus resulting in a significant reduction of blood pressure.
... Evidence from the literature suggests that olive oil phenolics play a role in the maintenance of endothelial function through oxidative-stress-related mechanisms, including a higher NO bioavailability [9]. Hydroxytyrosol (HT) and tyrosol (TYR) are two bioactive phenolic acids abundant in extra virgin olive oil (EVOO) and have been the subject of a range of investigations elucidating their role on the health benefits associated with the regular consumption of EVOO [10][11][12], including the prevention of cardiovascular diseases and the maintenance of healthy vascular function [3,9,13]. A substudy of the PREDIMED trial, for example, showed that EVOO consumption resulted in lower circulating inflammatory biomarkers and cardiovascular risk factors, suggesting a dose-dependent anti-inflammatory effect of EVOO polyphenols [13]. ...
Article
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Nitric oxide (NO) is an important signaling molecule involved in many pathophysiological processes. NO mediates vasodilation and blood flow in the arteries, and its action contributes to maintaining vascular homeostasis by inhibiting vascular smooth muscle contraction and growth, platelet aggregation, and leukocyte adhesion to the endothelium. Dietary antioxidants and their metabolites have been found to be directly and/or indirectly involved in the modulation of the intracellular signals that lead to the production of NO. The purpose of this study was to investigate the contribution of conjugated metabolites of hydroxytyrosol (HT) and tyrosol (TYR) to the release of NO at the vascular level, and the related mechanism of action, in comparison to their parental forms. Experiments were performed in human aortic endothelial cells (HAEC) to evaluate the superoxide production, the release of NO and production of cyclic guanosine monophosphate (cGMP), the activation of serine/threonine-protein kinase 1 (Akt1), and the activation state of endothelial nitric oxide synthase (eNOS). It was observed that the tested phenolic compounds enhanced NO and cGMP concentration, inhibiting its depletion caused by superoxide overproduction. Moreover, some of them enhanced the activation of Akt (TYR, HT metabolites) and eNOS (HT, HVA, TYR-S, HT-3S). Overall, the obtained data showed that these compounds promote NO production and availability, suggesting that HT and TYR conjugated metabolites may contribute to the effects of parental extra virgin olive oil (EVOO) phenolics in the prevention of cardiovascular diseases.
... OO extracts have shown protective effects against several diseases, such as hypertension, diabetes, sepsis, obesity, osteoporosis, neurodegeneration, and chronic kidney diseases [31][32][33]. OO consumption decreases the risk of all-cause mortality [34]. OO and its active derivatives showed antioxidant and anti-inflammatory effects [35]. ...
Article
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Women and men share similar diseases; however, women have unique issues, including gynecologic diseases and diseases related to menstruation, menopause, and post menopause. In recent decades, scientists paid more attention to natural products and their derivatives because of their good tolerability and effectiveness in disease prevention and treatment. Olive oil is an essential component in the Mediterranean diet, a diet well known for its protective impact on human well-being. Investigation of the active components in olive oil, such as oleuropein and hydroxytyrosol, showed positive effects in various diseases. Their effects have been clarified in many suggested mechanisms and have shown promising results in animal and human studies, especially in breast cancer, ovarian cancer, postmenopausal osteoporosis, and other disorders. This review summarizes the current evidence of the role of olives and olive polyphenols in women’s health issues and their potential implications in the treatment and prevention of health problems in women.
... Fruits and leaves of the olive oil tree (Olea europaea L.) contain significant amounts of hydrophilic and lipophilic bioactives including flavones, phenolic acids, phenolic alcohols, secoiridoids, and hydroxycinnamic acid derivates (15). As a result of their anti-inflammatory, antioxidant, and antimicrobial actions, olive-derived phytogenics have shown beneficial health effects in human (16)(17)(18) and livestock (19)(20)(21) health. However, limited information is available on their effects on aquaculture fish species (22). ...
Article
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In the present study, the modulation of the transcriptional immune response (microarray analysis) in the head kidney (HK) of the anadromous fish Atlantic salmon (Salmo salar) fed a diet supplemented with an olive fruit extract (AQUOLIVE®) was evaluated. At the end of the trial (133 days), in order to investigate the immunomodulatory properties of the phytogenic tested against a bacterial infection, an in vivo challenge with Aeromonas salmonicida was performed. A total number of 1,027 differentially expressed genes (DEGs) (805 up- and 222 downregulated) were found when comparing the transcriptomic profiling of the HK from fish fed the control and AQUOLIVE® diets. The HK transcripteractome revealed an expression profile that mainly favored biological processes related to immunity. Particularly, the signaling of i-kappa B kinase/NF-kappa and the activation of leukocytes, such as granulocytes and neutrophils degranulation, were suggested to be the primary actors of the innate immune response promoted by the tested functional feed additive in the HK. Moreover, the bacterial challenge with A. salmonicida that lasted 12 days showed that the cumulative survival was higher in fish fed the AQUOLIVE® diet (96.9 ± 6.4%) than the control group (60.7 ± 13.5%). These results indicate that the dietary supplementation of AQUOLIVE® at the level of 0.15% enhanced the systemic immune response and reduced the A. salmonicida cumulative mortality in Atlantic salmon smolts.
... Olive oil, its composition and, its positive effects on human health as a major component of MD have been thus extensively documented and reviewed in the literature [6][7][8][9][10]. [24,25] The olive oil industry has also been adapting the application of ultrasound technology within the field of oil production, thanks to its effects on cell disruption. ...
Article
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The objective of this review is to illustrate the state of the art in high-power ultrasound (HPU) application for olive oil extraction with the most recent studies about the effects of HPU treatment on oil yield, quality, chemical composition, as well as on the consumer’s perception. All the examined works reported an increase in oil yield and extractability index through the use of HPU, which was ascribed to reduced paste viscosity and cavitation-driven cell disruption. Olive oil legal quality was generally not affected; on the other hand, results regarding oil chemical composition were conflicting with some studies reporting an increase of phenols, tocopherols, and volatile compounds, while others underlined no significant effects to even slight reductions after HPU treatment. Regarding the acceptability of oils extracted through HPU processing, consumer perception is not negatively affected, as long as the marketer effectively delivers information about the positive effects of ultrasound on oil quality and sensory aspect. However, only a few consumers were willing to pay more, and hence the cost of the innovative extraction must be carefully evaluated. Since most of the studies confirm the substantial potential of HPU to reduce processing times, improve process sustainability and produce oils with desired nutritional and sensory quality, this review points out the need for industrial scale-up of such innovative technology.
... Therefore, our results show that Nutri-Score does not appear to negatively impact the perception of olive oil by Spanish consumers and does not affect their intended behavior in relation to the recommendations to favor olive oil among added fats. This recommendation is linked to the epidemiological studies, especially meta-analysis and interventional trials, which consistently show a beneficial association between olive oil consumption as part of a Mediterranean diet and health, particularly in relation to the prevention of cardiovascular diseases [17][18][19]. Some other meta-analyses published in the scientific literature [20][21][22] also support the health benefits of rapeseed and walnut oils in the prevention of cardiovascular diseases (as their consumption is associated with healthier blood lipid profiles), so many countries recommend favoring olive oil, rapeseed oil and walnut oil among vegetable oils. ...
Article
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It has been suggested that the current ranking of olive oil by Nutri-Score (C) is not in line with its nutritional quality and could have a negative impact on the sales and consumption of olive oil, especially compared to other added fats with lower nutritional qualities One of the objectives of this study is to investigate consumers’ understanding of Nutri-Score when comparing the nutritional quality of added fats, and to test whether or not Nutri-Score has a negative impact on the image and the choice of olive oil in a sample of Spanish consumers. A cross-sectional study of 486 Spanish adults (mean age ± SD: 45.8 ± 14.0 years; 48.6% women) was conducted. Subjects were recruited through a web panel provider to participate in an online questionnaire. Almost 80% of participants declared that Nutri-Score was useful for recognizing the differences in nutritional quality between the eight added fats presented in the study; 89.1% rightly identified that olive oil was among the added fats with the best nutritional quality (vs. 4.1% for rapeseed oil (Nutri-Score C), and less than 3% for other added fats (Nutri-Score D or E)). When asked about which added fat they would buy more frequently, 86.2% of participants selected olive oil. Then, after being reminded that among added fats, the Nutri-Score C given to olive oil was the best grade, a majority of participants declared that they would keep consuming olive oil as much as before (71.4%). Finally, almost 78% of participants thought that Nutri-Score should be displayed on olive oil. In conclusion, the results of our study suggest that displaying Nutri-Score on olive oil was well accepted and understood by a large majority of participants who appeared to accept the current ranking of the Nutri-Score for olive oil (Nutri-Score C).
... The dietary consumption of extra virgin olive oil (EVOO) has a number of benefits: antioxidant properties and anti-inflammatory, anti-cancer, and cardio-protective effects [3,4]. ...
Article
Since ancient times, vegetables have been preserved in oil, to be consumed throughout the year, and not just during the period in which they were harvested. Dried tomato slices in Extra Virgin Olive Oil (EVOO) are one of the most famous Italian preserves. This is the first study which aimed to investigate the shelf-life parameters of this preserve during the 12 months of storage in both light and dark conditions. For this purpose, quality and CIELab color parameters were analysed in EVOO alone and as preserving liquid; total phenols and carotenoids content as well as β-carotene and lycopene content, a fatty acids profile, and antioxidant activities were examined. Results showed that samples stored in the dark are protected against degradative processes. Moreover, after 6 months of storage, the EVOO used as preserving liquid is enriched by the phytochemicals contained in dried tomato slices. This enrichment of EVOO by tomato bioactive compounds is reflected in the increase in the antioxidant activity of the oil independently by the presence of light during storage.
... George et al. [40] To illustrate the impact of olive oil on type II diabetes Olive oil intake could be benefical for the prevention and management of type II diabetes Schwingshackl et al. [41] to investigate effects of 2 oil blends phytonutrient concentrations on blood lipid profile, compared with refined olive oil as a control borderline hypercholesterolemia extent as refined olive oil ...
Chapter
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The Mediterranean Diet contains fruits, vegetables, nuts, whole grains, fish and virgin olive oil (VOO) as a key component. It is well explained that those consumption has a number of positive health effects. It has been accepted for a long time that the leading compound in olive was oleic acid as a monounsaturated fatty acid. However, the latter researches were figured out that VOO rich in natural phenolics have multifaceted influence on major diseases including cancer, diabetes, cardiovascular diseases, neurodegenerative disease, and metabolic disorders. Recent medical studies proved that oleocanthal and oleacein, characteristic bioactive biophenol-secoiridoids in VOO, success in the anti-inflammatory and in the antioxidant properties, respectively. It has more recently investigated that oleocanthal and hydroxytyrosol (HT) kills cancer cells (CCs). HT and oleuropein reduces breast cancer and cutaneous melanoma cancer cells both in number and aggressiveness, and inhibits CCs multiplying. It has been declared too many times that nutrition type is the strongest factor can be caused acute and chronic diseases. However, at the same time, nutrition can also prevent some of those heavy symptoms. The main purpose of presented chapter is to meet olive’s bioactive molecules and to examine how to improve our health with diet.
... Conversely, the latter correlation between SFA consumption and ASCVD risk is negative in European patients [20] whose prevalent source of SFAs is represented by dairy products [35]. Moreover, the cross-sectional analysis highlights that frequent use of olive oil correlates with lower levels of TC; a meta-analysis by George, E. S. et al. reported that TC levels decreased linearly with high consumption of polyphenols olive oil [36]. ...
Article
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Background: Dyslipidemia is one of the major causes of atherosclerotic cardiovascular disease (ASCVD) and a Mediterranean Diet (MD) is recommended for its prevention. The objectives of this study were to evaluate adherence to an MD at baseline and follow-up, in a cohort of dyslipidemic patients, and to evaluate how different food intakes can influence lipid profile, especially how different sources of saturated fatty acids impact lipid phenotype. Methods: A retrospective analysis was conducted on 106 dyslipidemic patients. Clinical characteristics, lipid profile, and food habits data were collected at baseline and after three months of follow-up with counseling. Adherence to an MD was evaluated with a validated food-frequency questionnaire (MEDI-LITE score). Results: The cross-sectional analysis showed that higher consumption of dairy products correlated independently with higher levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) and with lower triglycerides (TG) levels. Instead, lower HDL-C and TG levels and higher TC levels were independently associated with higher consumption of meat products. Adherence to an MD significantly improved after the follow-up period, from a mean value of 10 ± 3 (median 10, IQR 8-12) to 13 ± 2 (median 14, IQR 12-15), p < 0.0001. Conclusions: Dyslipidemic patients benefit from counseling for improving their adherence to an MD. The high intake of dairy products was associated with less atherogenic hyperlipidemia, which was characterized by higher levels of TC and HDL-C as compared withs the intake of an excessive amount of meat products, which was associated with higher levels of TC and TG and lower levels of HDL-C.
... Most of the studies conducted to investigate the effect of chain length and degree of saturation of dietary fatty acids on lipid profiles have been conducted with synthetic TGs and fatty acids with limited range of chain length variation. It is also challenging to work with oils of plant origin for the studies involving the nutritional effects of chain length and degree of saturation due to the presence of varying amounts of natural phenolic substances that can affect the quality of lipid parameters (George et al., 2019). Medium chain fatty acids have also been shown to improve the absorption of small polar molecules such as phenolic antioxidants and flavonoids compared to long chain fatty acids in the intestine (Prasadani et al., 2017). ...
Article
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We investigated the effect of the chain length and the degree of saturation of fatty acids in dietary triglycerides on serum lipid profiles and hepatic lipid metabolism in Wistar rats. Fat component of the basal diet (soybean oil) was replaced with fats with fatty acids of different chain lengths and saturation and the serum lipids were monitored for 150 days. Principal component (PC) analysis of serum lipid components was related to chain length and saturation. The combined effect of chain length and saturation on PC 1 scores was evaluated by multiple regression analysis. The results indicated that average chain length of the fatty acids of triglycerides has a higher influence on the quality of serum lipid parameters than the average degree of saturation. Expression of selected genes responsible for lipid metabolism showed similar trends in medium chain saturated and long chain polyunsaturated diet groups. Practical applications Dietary lipids contain a wide range of saturated and unsaturated fatty acids with different chain lengths. Overall contribution of these different fatty acids decides the health effects of the lipids in the diet. Present study shows that the fats with medium chains and higher degree of saturation and fats with long chains and higher degree of unsaturation (lower degree of saturation) affect serum lipid parameters and expression of hepatic genes involved in the lipid metabolism in a similar manner. Such information is important for physicians to plan dietary schemes to improve the nutritional health and manage the noncommunicable diseases.
... In a previous multicenter study [18], each 10 g daily increase in EVOO consumption in the context of Mediterranean diets was associated with reduced risk of cardiovascular disease and mortality by 10% and 7%, respectively, among individuals with increased cardiovascular risk. In a recent metaanalysis [19], high-polyphenolic EVOO consumption in the context of Mediterranean diets was associated with lower cardiovascular risk. In addition, a Mediterranean diet enriched with EVOO without caloric restrictions was associated with reduced risk of T2DM among individuals at risk for cardiovascular disease [20]. ...
Article
Background Effects of olive oil on cardiovascular risk have been controversial. We compared the effects of high-polyphenolic extra virgin olive oil (EVOO) and refined olive oil without polyphenols on endothelial function (EF) in adults at risk for Type 2 diabetes mellitus (T2DM). Methods Randomized, controlled, double-blind, crossover trial of 20 adults (mean age 56.1 years; 10 women, 10 men) at risk for T2DM (i.e., as defined by either prediabetes or metabolic syndrome) assigned to one of two possible sequence permutations of two different single dose treatments (50 mL of high-polyphenolic EVOO or 50 mL of refined olive oil without polyphenols), with 1-week washout. Participants received their olive oils in a smoothie consisting of ½ cup frozen blueberries and 1 cup (8 oz) low-fat vanilla yogurt blended together. Primary outcome measure was EF measured as flow-mediated dilatation. Participants were evaluated before and 2 h after ingestion of their assigned olive oil treatment. Results EVOO acutely improved EF as compared to refined olive oil (1.2 ± 6.5% versus −3.6 ± 3.8%; p = 0.0086). No significant effects on systolic or diastolic blood pressure were observed. Conclusions High-polyphenolic EVOO acutely enhanced EF in the study cohort, whereas refined olive oil did not. Blood pressure effects were not observed. Reports on the vascular effects of olive oil ingestion should specify the characteristics of the oil. Clinical trial registration number NCT04025281
... In addition to their potent anti-oxidant properties, these compounds have shown many additional biological activities both in vitro and in vivo systems. Indeed, several controlled human intervention trials have now confirmed that rich-polyphenols EVOO is able to improve some cardiovascular risk factors and prevent cardiovascular events [12]. Nevertheless, many studies have clearly demonstrated that EVOO phenolic compounds possess many other biological functions that can be correlated to their anti-cancer [11,13], antiinflammatory, anti-aging, and neuroprotective activities [14,15]. ...
Article
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Many studies demonstrated that olive oil (especially extra virgin olive oil: EVOO) phenolic compounds are bioactive molecules with anti-cancer, anti-inflammatory, anti-aging and neuroprotective activities. These effects have been recently attributed to the ability of these compounds to induce epigenetics modifications such as miRNAs expression, DNA methylation and histone modifications. In this study, we systematically review and discuss, following the PRISMA statements, the epigenetic modifications induced by EVOO and its phenols in different experimental systems. At the end of literature search through “PubMed”, “Web of Science” and “Scopus”, 43 studies were selected.Among them, 22 studies reported data on miRNAs, 15 on DNA methylation and 13 on histone modification. Most of the “epigenomic” changes observed in response to olive oil phenols’ exposure were mechanistically associated with the cancer preventive and anti-inflammatory effects. In many cases, the epigenetics effects regarding the DNA methylation were demonstrated for olive oil but without any indication regarding the presence or not of phenols. Overall, the findings of the present systematic review may have important implications for understanding the epigenetic mechanisms behind the health effects of olive oil. However, generally no direct evidence was provided for the causal relationships between epigenetics modification and EVOO health related effects. Further studies are necessary to demonstrate the real physiological consequences of the epigenetics modification induced by EVOO and its phenolic compounds.
... In addition to their potent anti-oxidant properties, these compounds have shown many additional biological activities both in vitro and in vivo systems. Indeed, several controlled human intervention trials have now confirmed that rich-polyphenols EVOO is able to improve some cardiovascular risk factors and prevent cardiovascular events [12]. Nevertheless, many studies have clearly demonstrated that EVOO phenolic compounds possess many other biological functions that can be correlated to their anti-cancer [11,13], antiinflammatory, anti-aging, and neuroprotective activities [14,15]. ...
Article
Full-text available
Many studies demonstrated that olive oil (especially extra virgin olive oil: EVOO) phenolic compounds are bioactive molecules with anti-cancer, anti-inflammatory, anti-aging and neuroprotective activities. These effects have been recently attributed to the ability of these compounds to induce epigenetics modifications such as miRNAs expression, DNA methylation and histone modifications. In this study, we systematically review and discuss, following the PRISMA statements, the epigenetic modifications induced by EVOO and its phenols in different experimental systems. At the end of literature search through “PubMed”, “Web of Science” and “Scopus”, 43 studies were selected.Among them, 22 studies reported data on miRNAs, 15 on DNA methylation and 13 on histone modification. Most of the “epigenomic” changes observed in response to olive oil phenols’ exposure were mechanistically associated with the cancer preventive and anti-inflammatory effects. In many cases, the epigenetics effects regarding the DNA methylation were demonstrated for olive oil but without any indication regarding the presence or not of phenols. Overall, the findings of the present systematic review may have important implications for understanding the epigenetic mechanisms behind the health effects of olive oil. However, generally no direct evidence was provided for the causal relationships between epigenetics modification and EVOO health related effects. Further studies are necessary to demonstrate the real physiological consequences of the epigenetics modification induced by EVOO and its phenolic compounds.
Article
Owing to the importance of the maternal diet, numerous studies have examined the effects of olive oil on pregnancy outcomes. This study provides a systematic review to evaluate the evidence between olive oil consumption and maternal-fetal outcomes. We hypothesized that olive oil reduced the risk of adverse pregnancy complications. We searched the Web of Science, Scopus, PubMed, and Biblioteca Virtual em Saúde electronic databases (October and November 2021). The keywords used were pregnancy, olive oil, and pregnancy outcomes. This review included all the available studies in English and Portuguese. The exclusion criteria were (i) unrelated to olive oil consumption, (ii) other outcomes, and (iii) animal studies. The review included nine articles, six experimental and three observational. In maternal outcome studies (n=6), a higher olive oil consumption was associated with a lower prevalence of gestational diabetes mellitus, preeclampsia, and cardiovascular risk. In fetal outcome studies (n=8), olive oil consumption was associated with a lower risk for small- or large-for-gestational-age infants. Olive oil consumption confers protective effects on pregnancy outcomes. However, further studies are needed, specifically designed for the impact of olive oil consumption on maternal-fetal outcomes.
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Resumen La incorporación de una dieta saludable, ejercicio físico regular junto a la supresión del hábito tabáquico son las primeras medidas para reducir el riesgo cardiovascular en los pacientes con dislipemia aterogénica. En estas personas se debe mejorar la calidad nutricional de su alimentación, sustituyendo los alimentos con mayor efecto aterogénico, por otros de efecto más saludable. Hay una sólida evidencia de que los patrones alimentarios de base vegetal, bajos en ácidos grasos saturados, colesterol y sodio, con un alto contenido en fibra, potasio y ácidos grasos insaturados, son beneficiosos y reducen la expresión de los factores de riesgo cardiovascular. Este documento se centra en el papel que juega la nutrición en la prevención y tratamiento de la dislipemia aterogénica, aportando las evidencias actuales que sirvan de herramienta a los profesionales de la salud en su manejo clínico. Para facilitar su lectura dichas recomendaciones se expondrán en un formato de tablas amigable, jerarquizando por diferentes niveles de evidencia.
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Passion fruit is a dietary plant with the protective proterties against many diseases such as cardiovascular diseases. The aim of this study was to explore the biological properties (anti-oxidant, anti-inflammatory, anti-lipid, and vascular relaxation) of the P. edulis extracts obtained from seed (PSEE) and fruit (PFWE). Thin-layer chromatography (TLC) and HPLC were used to analyze the phytochemical constituents in the extracts. Antioxidant and enzyme inhibition properties were examined. Anti-inflammatory activities of PFWE and PSEE were evaluated in lipopolysaccharide (LPS)-induced macrophages and ex-vivo vascular relaxation were also determined. A high contents of piceatannol and polyphenolic stilbene were found in PSEE extracts. On the other hand, beta-carotene and gamma-tocopherol were predominant in PFWE. PFWE exhibited stronger anti-oxidant activity than PSEE. Both PSEE and PFWE showed significant inhibition of lipase and cholesterol esterase activities. However, only PFWE showed minimal inhibitory effect against HMG-CoA reductase. PSEE and PFWE caused a significant reduction of nitric oxide level in LPS-induced inflammation in RAW264.7 cells. Both extracts also showed ex-vivo vasorelaxation of rat aortic rings. It has been demonstrated that PFWE and PSEE possesses anti-oxidant activity, anti-inflammatory activity, pancreatic lipase and cholesterol esterase, and ex-vivo vasorelaxation of rat aortic rings, however, the activity of HMG-CoA reductase was inhibited by only PFWE. These findings suggest the beneficial effect of PSEE and PFWE against hyperlipidemia thus preventing the development of hypertension. However, further investigations in animal are needed to elucidate.
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Podocyte injury is a common cause of proteinuric kidney diseases. Uncontrollable progressive podocyte loss accelerates glomerulosclerosis and increases the risk of end-stage renal disease. To date, owing to the complex pathological mechanism, effective therapies for podocyte injury have been limited. Accumulating evidence supports the indispensable role of autophagy in the maintenance of podocyte homeostasis. A variety of natural compounds and their derivatives have been found to regulate autophagy through multiple targets, including promotes nuclear transfer of transcription factor EB and lysosomal repair. Here, we reviewed the recent studies on the use of natural compounds and their derivatives as autophagy regulators and discussed their potential applications in ameliorating podocyte injury. Several known natural compounds with autophagy-regulatory properties, such as quercetin, silibinin, kaempferol, and artemisinin, and their medical uses were also discussed. This review will help in improving the understanding of the podocyte protective mechanism of natural compounds and promote their development for clinical use.
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Objectives: To investigate the extent of multiplicity of results in study reports of nutrition research, and the methods specified in systematic reviews to select results for inclusion in meta-analyses. Methods: MEDLINE and Epistemonikos were searched (January 2018 - June 2019) to identify systematic reviews with meta-analysis of the association between food/diet and health-related outcomes. A random sample of these reviews was selected, and for the first presented ('index') meta-analysis, rules used to select effect estimates to include in this meta-analysis were extracted from the reviews and their protocols. All effect estimates from the primary studies that were eligible for inclusion in the index meta-analyses were extracted. Results: Forty-two systematic reviews were included, 14 of which had a protocol. In 29% of review protocols and 69% of reviews, at least one decision rule to select effect estimates when multiple were available was specified. In 69% (204/325) of studies included in the index meta-analyses, there was at least one type of multiplicity of results. Conclusions: Authors of systematic reviews of nutrition research should anticipate encountering multiplicity of results in the included primary studies. Specification of methods to handle multiplicity when designing reviews is therefore recommended.
Article
Olive oil is one of the most important ingredients in the Mediterranean diet, in which its polyphenols adversely affect dietary lipid oxidation. In this study, the effect of olive oil polyphenols on lipid oxidation of high-fat beef during digestion was determined. Thirty-three phenolic compounds were tentatively identified, and the contents of 3,4-dihydroxyphenylethanol-elenolic acid dialdehyde (3,4-DHPEA-EDA), 3,4-dihydroxyphenylethanol-elenolic acid (3,4-DHPEA-EA), p-hydroxyphenylethanol elenolic acid (p-HPEA-EA) and hydroxytyrosol were higher than those of other compounds. In an in vitro model, the production of lipid oxidation products, including hydroperoxides, malondialdehyde, 4-hydroxy-2-hexenal and 4-hydroxy-2-nominal, were significantly inhibited by olive polyphenol in the gastrointestinal digests. Compared with the other four groups, the inhibition was better when the polyphenol content reached 600 mg GAE/kg. The 3,4-DHPEA-EDA and 3,4-DHPEA-EA played a better antioxidant role in the stomach stage, while hydroxytyrosol showed the more potent antioxidant activity in the intestinal phase. Electron spin resonance technology showed that two main free radicals, including alkyl radical and alkoxy radical, were detected during the high-fat beef digestion, and olive polyphenols could significantly reduce their formation. All these results showed that the lipid oxidation could be significantly inhibited by olive oil with higher polyphenol content, indicating that the consumption of olive oil with abundant levels of polyphenols could reduce lipid oxidation of high-fat meat during digestion.
Article
Dietary (poly)phenols have been extensively studied for their vasculoprotective effects and consequently their role in preventing or delaying onsets of cardiovascular and metabolic diseases. Even though early studies have ascribed the vasculoprotective properties of (poly)phenols primarily on their putative free radical scavenging properties, recent data indicate that in biological systems, (poly)phenols act primarily through genomic and epigenomic mechanisms. The molecular mechanisms underlying their health properties are still not well identified, mainly due to the use of physiologically non-relevant conditions (native molecules or extracts at high concentrations, rather than circulating metabolites), but also due to the use of targeted genomic approaches aiming to evaluate the effect only on few specific genes, thus preventing to decipher detailed molecular mechanisms involved. The use of state-of-the-art untargeted analytical methods represents a significant breakthrough in nutrigenomics, as these methods enable detailed insights into the effects at each specific omics level. Moreover, the implementation of multi-omics approaches allows integration of different levels of regulation of cellular functions, to obtain a comprehensive picture of the molecular mechanisms of action of (poly)phenols. In combination with bioinformatics and the methods of machine learning, multi-omics has potential to make a huge contribution to the nutrition science. The aim of this review is to provide an overview of the use of the omics, multi-omics, and integrative approaches in studying the vasculoprotective properties of dietary (poly)phenols and address the potentials for use of the machine learning in nutrigenomics.
Thesis
Among the physiological and metabolic changes occurring with ageing, the ageing of heart function is a key determinant of health. The death number from CVDs is expected to reach over 23.6 million by 2030. An estimated 17.9 million people died from CVDs in 2019 in the UK, representing 32% of all global deaths. Evidence suggested that the Mediterranean diet supplemented with extra virgin olive oil (EVOO) (25-50 ml/day) is highly reported as associated with a reduction of CV risk factors. However, the acceptability of the Mediterranean diet and the feasibility of this dietary pattern which includes consumption of olive oil remains unknown among Caucasians and East Asians in Northeast England. An Online Survey with two ethnicities in equal number and similar mean age and BMI that were undertaken for this PhD programme indicating that the acceptability and frequency of olive oil intake among East Asians is higher with a great MD score (8.02±SD1.8) (p<0.001) while Caucasians who consume olive oil were scored higher for MD score (6.51±SD2.2) (p<0.001), scored higher for MD acceptability (10.21±SD2.3) (p=0.017) and reported lower perceived barriers to healthy eating (PBHE) (1.81±SD4.0) (p=0.03) than non-consumers. Olive oil intake is likely to be positively associated with older age, higher MD score, higher MD acceptability and lower PBHE in both ethnicities. Evidence examining the effectiveness of nuts and olive oil, on both traditional and novel CV risk factors, in a comprehensive study in adults with different ethnic background is lacking. Our systematic reviews and meta-analysis of previous relevant literature on nuts that were undertaken for this PhD programme showed that nuts improve TC (MD: -7.54; 95% CI: -10.2 to -4.89; p < 0.00001; I2=59%, n=66), HDL (MD: 0.89; 95% CI: 0.04 to 1.75; P=0.04; I2= 53%; n=67), LDL (MD: -7.21; 95% CI: -9.38 to -5.04; P< 0.00001; I2= 68%; n=68), TG (MD: -8.83; 95% CI: -13.12 to -4.53; P< 0.0001; I2= 64%; n=65) and FMD (MD: 0.74; 95% CI: 0.09 to 1.39; P=0.03; I2=5%, n=10). The non-Asiangroup potentially tends to benefit more CV biomarkers with moderate nut consumption than Asian group. Olive oil systematic review reported that olive oil improves biomarker - PAI-1 (MD: -1.02ng/ml, 95% CI: -1.92 to -0.12; p = 0.03, I2 = 0%). Nevertheless, studies on olive oil on different ethnicities were lacking. A 6-week, cross-over, randomised controlled dietary interventional study with 2 weeks interventional duration was undertaken to test the effects of EVOO on cardiovascular health. Overall, this study provided evidence on the benefits of over a 2-week period produced a positive effect on 24-hour SBP including daytime SBP, night-time DBP and MAP and TC, LDL for all participants. For East Asians, olive oil exerts a beneficial effect on 24-hour SBP and daytime SBP, MAP while night�time DBP was improved among Caucasians following EVOO. EVOO intake also has a positive effect on blood lipids - TC and circulating biomarkers - sE-selectin in East Asians while LDL and non-HDL are improved among Caucasians after EVOO intake. The findings reported in the present thesis could be valuable to health professionals to develop more effective interventions and could also help the public to make better informed food choices relating to cardiovascular health
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Hydroxytyrosol (HT) and punicalagin (PC) exert cardioprotective and antiatherosclerotic effects. This study evaluated the effect of an oral supplement containing HT and PC (SAx) on dyslipidemia in an adult population. A randomized, double-blind, controlled, crossover trial was conducted over a 20-week period. SAx significantly reduced the plasma levels of triglycerides (TG) in subjects with hypertriglyceridemia (≥150 mg/dL) (from 200.67 ± 51.38 to 155.33 ± 42.44 mg/dL; p < 0.05), while no such effects were observed in these subjects after the placebo. SAx also significantly decreased the plasma levels of low-density lipoprotein cholesterol (LDL-C) in subjects with high plasma levels of LDL-C (≥160 mg/dL) (from 179.13 ± 16.18 to 162.93 ± 27.05 mg/dL; p < 0.01), while no such positive effect was observed with the placebo. In addition, the placebo significantly reduced the plasma levels of high-density lipoprotein cholesterol (HDL-C) in the total population (from 64.49 ± 12.65 to 62.55 ± 11.57 mg/dL; p < 0.05), while SAx significantly increased the plasma levels of HDL-C in subjects with low plasma levels of HDL-C (<50 mg/dL) (from 44.25 ± 3.99 to 48.00 ± 7.27 mg/dL; p < 0.05). In conclusion, the supplement containing HT and PC exerted antiatherosclerotic and cardio-protective effects by considerably improving dyslipidemia in an adult population, without co-adjuvant treatment or adverse effects.
Chapter
Background and aim: Cardiovascular disease remains the primary cause of noncommunicable disease- related death. The present systematic review and meta-analysis was performed to assess the possible benefit of the green coffee bean extract on cardio-metabolic markers. Methods: PubMed, Scopus, Web of Science, and Cochrane Library were systematically searched to identify clinical trials that examined the effect of green coffee bean extract on cardio-metabolic risk factors including serum lipid profiles, glycemic status-related markers, blood pressure, and anthropometric indices. Since the included RCTs were carried out in different settings, random effect models were used to conduct all meta-analyses. Results: Fifteen studies (19 arms) consisting of 637 participants were included. The results indicated that green coffee bean extract significantly reduced levels of total cholesterol (-5.93 mg/dl; 95% CI: -9.21, -2.65; I2: 0%), fasting plasma glucose (-2.21 mg/dl; 95% CI: -3.94, -0.48; I2: 32%), systolic blood pressure (-3.08 mmHg; 95% CI: -4.41, -1.75; I2: 26%), diastolic blood pressure (-2.27 mmHg; 95% CI: -3.82, -0.72; I2: 61%), body weight (-1.24 kg; 95% CI: -1.82, -0.66; I2: 15%), and BMI (-0.55 kg/m2; 95% CI: -0.88, -0.22; I2: 73%). Although the pooled effect size of LDL-C, fasting insulin, and waist circumstance were significant, the results were significantly influenced by individual studies. No significant effect was detected for triglycerides, HDL-C, HbA1C, and HOMA-IR. However, the nonsignificant pooled effect size for triglyceride levels was influenced by one individual study. Conclusion: The present study suggests that green coffee been extract consumption can improve total cholesterol, triglycerides, body weight, blood pressure, and fasting plasma glucose.
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Objectives : To investigate how often review authors encounter multiple results from included studies that are eligible for inclusion in a particular meta-analysis, and how often methods to select results are specified. Methods : MEDLINE and Epistemonikos were searched (January 2018 – June 2019) to identify systematic reviews with meta-analysis of the association between food/diet and health-related outcomes. A random sample of these reviews was selected, and for the first presented (‘index’) meta-analysis, rules used to select effect estimates to include in this meta-analysis were extracted from the reviews and their protocols. All effect estimates from the primary studies that were eligible for inclusion in the index meta-analyses were extracted (e.g. when a study report presented effect estimates for blood pressure at 3 weeks and 6 weeks, both unadjusted and adjusted for covariates, and all were eligible for inclusion in a meta-analysis of the effect of red meat consumption on blood pressure, we extracted all estimates and classified the study as having “multiplicity of results”). Results : Forty-two systematic reviews with 325 studies (104 randomized, 221 non-randomized) were included; 14 reviews had a protocol. In 29% of review protocols and 69% of reviews, authors specified at least one decision rule to select effect estimates when multiple were available. In 68% of studies included in the index meta-analyses, there was at least one type of multiplicity of results. Conclusions : Authors of systematic reviews of nutrition studies should anticipate encountering multiplicity of results in the included primary studies. Specification of methods to handle multiplicity when designing reviews is therefore recommended.
Article
Objective: The primary objective of this study was to determine the effects of a healthy diet supplemented with extra virgin olive oil or pecan nuts on plasma fatty acid (PFA) in patients with stable coronary artery disease (CAD). Research Methods & Procedures: Patients aged 40 to 80 years were randomized to one of three dietary interventions (allocation ratio 1: 1: 1): healthy diet based on guidelines (control group [CG]), healthy diet supplemented with 30 g/day of pecan nuts (PNG), or a healthy diet supplemented with 30 mL/day of extra virgin olive oil (OOG). PFA were identified at baseline and at the end of follow-up (12 weeks), and correlations between dietary fatty acids intake, PFA, and clinical biomarkers of the lipid profile were also assessed before and after the interventions. Results: Among 149 participants included in the analysis (CG: n = 43; PNG: n = 51; OOG: n = 55), correlations were observed between food intake, PFA, and lipid profile before and after interventions independent of statins used, but all correlations were considered weak. At the end of the study, the OOG showed increased concentrations of oleic fatty acid independently of the type of statin in use (1.49%, 95% confidence interval 0.08 – 2.89; P = 0.029); however, there were no significant differences between the groups regarding the final mean values of oleic fatty acid or in the other PFAs. Conclusions: In patients with stable CAD, there were no significant differences in PFA after 12 weeks according to dietary interventions evaluated.
Article
Olive oil is an important food with interesting functional properties and is widely indicated as a hypolipidemic, oxidative stress reliever and hypolipidemic agent due to its chemical structures and biological functions. The present study analyzed the hypoglycaemic, hypolipidemic, technological, and sensory potential of 4-methoxycinnamic acid (PCO–C) diester aggregate olive oil, obtained from the wax powder from carnauba (Copernicia prunifera). Zebrafish was used as an experimental obesity model. After developing obesity, with hyperglycemia and hyperlipidemia, fishes were submitted to extra virgin olive oil aggregated to 4-methoxycinnamic acid diester (PCO–C + AZ) or not, for 4 days. Also, the product PCO–C + AZ was submitted to rheological and sensory analysis. The PCO–C + AZ shown a 43% reduction (p < 0.01) in blood glucose and the rheological findings did not show any change in the quality parameters of olive oil due to the aggregation to PCO–C. Oil + PCO–C (100 mg/kg) was able to reduce (***p < 0.001) cholesterol and triacylglycerol levels of animals in the treatment group when compared to animals in the control group. In addition, all the treatments used were able to significantly reduce the hepatic levels of reactive oxygen species ((**p < 0.01 vs. Control). Additionally, the acceptability of the product shown all acceptability index (IA%) parameters above 70%. Thus, we concluded that the product PCO–C + AZ has a hypoglycaemic effect, presenting quality parameters very similar to the original extra virgin olive oil.
Chapter
Adherence to the Mediterranean diet (MedDiet) has been associated with improved health and longevity. This association is due to the reductions in chronic diseases and their risk factors. A significant contributor to this reduction is extra-virgin olive oil (EVOO). EVOO contains monounsaturated fatty acids, as well as minor constituents, including phenolic compounds. This composition gives EVOO its antiinflammatory and antioxidant properties that can protect the body against diseases such as cancer, cardiovascular disease, and hypertension. Due to the major role that EVOO plays in the MedDiet, the definition of the MedDiet greatly relies on EVOO. This review explores the current evidence on the role that EVOO and its bioactive compounds play in the Mediterranean dietary pattern. The composition of EVOO, the bioavailability of its phenolic compounds, and its potential function regarding various chronic diseases will be described in detail.
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Ibuprofen (IB), is one of the commonly nonsteroidal anti-inflammatory drugs (NSAIDs), it is mostly used for the management of pain, fever and inflammations. In addition to its beneficial effects; IB has also been reported to be associated with some adverse effects. Thus, the present study was aimed to investigate the possible beneficial effects of olive oil (OO) against the IB -induced dysfunction of liver and kidney parameters in male rabbits. This study was conducted on 18 local male rabbits weighing between (900 - 1000 g) for 30 days, rabbits were divided into three equal groups; control group (C), ibuprofen group (IB), and ibuprofen +olive oil group (IB + OO), each group included six rats. At the end of experiment, blood samples were collected for biochemical assessment of the liver and kidney functions. The results showed that, IB caused a significant increase (P˂ 0.001) in alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), urea (Ur), creatinine (Cr) and uric acid (UA). A significant decrease in the total protein (TP) and albumin (AL) (P˂ 0.001) and (P˂ 0.05) respectively showed in the IB group compared to the control group. Treatment rabbits with OO showed significant improvement in renal and liver functions; the activity enzymes of ALT, AST and ALP significantly decreased, and the levels of TP and AL significantly increased. The current results were in agreement with other previous studies which informed that the IB has adverse effects on the functional capacities of the liver and the kidney. Further studies are needed to evaluate this ameliorative effect of OO on other medicines and pollutants.
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End-stage kidney disease is a strong risk factor for cardiovascular-specific mortality. Polyphenol-rich interventions may attenuate cardiovascular disease risk factors; however, this has not been systematically evaluated in the hemodialysis population. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the following databases were searched: Cochrane Library (http://www.cochranelibrary.com/), MEDLINE (https://health.ebsco.com/products/medline-with-full-text), Embase (https://www.elsevier.com/solutions/embase-biomedical-research), and CINAHL (https://www.ebscohost.com/nursing/products/cinahl-databases/cinahl-complete). Meta-analyses were conducted for measures of lipid profile, inflammation, oxidative stress, and blood pressure. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias tool and quality of the body of evidence was assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. Twelve studies were included for review. Polyphenol-rich interventions included soy, cocoa, pomegranate, grape, and turmeric. Polyphenol-rich interventions significantly improved diastolic blood pressure (Mean Difference (MD) −5.62 mmHg (95% Confidence Interval (CI) −8.47, −2.78); I2 = 2%; p = 0.0001), triglyceride levels (MD −26.52 mg/dL (95% CI −47.22, −5.83); I2 = 57%; p = 0.01), and myeloperoxidase (MD −90.10 (95% CI −135.84, −44.36); I2 = 0%; p = 0.0001). Included studies generally had low or unclear risks of bias. The results of this review provide preliminary support for the use of polyphenol-rich interventions for improving cardiovascular risk markers in haemodialysis patients. Due to the limited number of studies for individual polyphenol interventions, further studies are required to provide recommendations regarding individual polyphenol intervention and dose.
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Scope: Low paraoxonase (PON)1 activities, and high PON1 and low PON3 protein levels are characteristic of cardiovascular disease. Our aim was to assess short and long-term effects of virgin olive oils (VOO), enriched with their own phenolic compounds (PC; FVOO) or with them plus complementary PC from thyme (FVOOT), on PON-related variables and the mechanisms involved. Methods and results: Two randomized, controlled, double-blind, and crossover interventions were conducted. In an acute intake study, participants ingested three FVOOs differing in PC content. In a sustained intake study, participants ingested a control VOO and two different FVOOs with the same PC content but differing in PC source. Acute and sustained intake of VOO and FVOO decreased PON1 protein and increased PON1-associated specific activities, while FVOOT yielded opposite results. PON3 protein levels increased only after sustained consumption of VOO. Mechanistic studies performed in rat livers showed that intake of isolated PC from VOO and from thyme modulate mitogen-activated protein kinases and peroxisome proliferator-activated receptors regulating PON synthesis, while a combination of these PCs cancels such regulation. Conclusion: The present study reveals that the intake of phenol-enriched FVOOs modulates oxidative balance by modifying PON-related variables according to PC content and source, and this modulation can be perceived as beneficial. This article is protected by copyright. All rights reserved.
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Virgin olive oil (VOO) constitutes the main source of fat in the Mediterranean diet. VOO is rich in oleic acid, displaying health-promoting properties, but also contains minor bioactive components, especially phenolic compounds. Hydroxytyrosol (HT), the main polyphenol of olive oil, has been reported to be the most bioactive component. This review aims to compile the results of clinical, animal and cell culture studies evaluating the effects of HT on the features of Metabolic Syndrome (MetS) (body weight/adiposity, dyslipidemia, hypertension, and hyperglycemia/insulin resistance) and associated complications (oxidative stress and inflammation). HT was able to improve the lipid profile, glycaemia, and insulin sensitivity, and counteract oxidative and inflammatory processes. Experimental studies identified multiple molecular targets for HT conferring its beneficial effect on health in spite of its low bioavailability. However, rodent experiments and clinical trials with pure HT at biologically relevant concentrations are still lacking. Moreover, the roles of intestine and its gut microbiota have not been elucidated.
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Olive oil (OO) phenolic compounds (PC) are able to influence gut microbial populations and metabolic output. Our aim was to investigate whether these compounds and changes affect the mucosal immune system. In a randomized, controlled, double blind cross-over human trial, for three weeks, preceded by two-week washout periods, 10 hypercholesterolemic participants ingested 25 mL/day of three raw virgin OO differing in their PC concentration and origin: (1) an OO containing 80 mg PC/kg (VOO); (2) a PC-enriched OO containing 500 mg PC/kg from OO (FVOO); and (3) a PC-enriched OO containing a mixture of 500 mg PC/kg from OO and thyme (1:1, FVOOT). Intestinal immunity (fecal immunoglobulin A (IgA) and IgA-coated bacteria) and inflammation markers (C-reactive protein (CRP) and fecal interleukin 6 (IL-6), tumor necrosis factor α (TNFα) and calprotectin) was analyzed. The ingestion of high amounts of OO PC, as contained in FVOO, tended to increase the proportions of IgA-coated bacteria and increased plasma levels of CRP. However, lower amounts of OO PC (VOO) and the combination of two PC sources (FVOOT) did not show significant effects on the variables investigated. Results indicate a potential stimulation of the immune system with very high doses of OO PC, which should be further investigated.
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Scope: Lipoprotein particle measures performed by nuclear magnetic resonance (NMR), and associated ratios, may be better markers for atherosclerosis risk than conventional lipid measures. The effect of two functional olive oils, one enriched with its polyphenols (FVOO, 500 ppm), and the other (FVOOT) with them (250 ppm) and those of thyme (250 ppm), versus an standard virgin olive oil (VOO), on lipoprotein particle atherogenic ratios and subclasses profiles was assessed. Methods and results: In a randomized, double-blind, crossover, controlled trial, 33 hypercholesterolemic individuals received 25 mL/day of VOO, FVOO, and FVOOT. Intervention periods were of 3-weeks separated by 2-week washout periods. Lipoprotein particle counts and subclasses were measured by NMR. Polyphenols from olive oil and thyme modified the lipoprotein subclasses profile and decreased the LDL-P/total HDL particle (HDL-P), small HDL/large HDL, and HDL-cholesterol/HDL-P ratios, and decreased the lipoprotein insulin resistance index (LP-IR) (P<0.05). Conclusions: Olive oil polyphenols, and those from thyme provided benefits on lipoprotein particle atherogenic ratios and subclasses profile distribution. Polyphenol-enriched olive oil is a way of increasing the olive oil healthy properties while consuming the same amount of fat, as well as a useful and complementary tool for the management of cardiovascular risk individuals. This article is protected by copyright. All rights reserved.
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Purpose: To investigate the effect of virgin olive oil phenolic compounds (PC) alone or in combination with thyme PC on blood lipid profile from hypercholesterolemic humans, and whether the changes generated are related with changes in gut microbiota populations and activities. Methods: A randomized, controlled, double-blind, crossover human trial (n = 12) was carried out. Participants ingested 25 mL/day for 3 weeks, preceded by 2-week washout periods, three raw virgin olive oils differing in the concentration and origin of PC: (1) a virgin olive oil (OO) naturally containing 80 mg PC/kg, (VOO), (2) a PC-enriched virgin olive oil containing 500 mg PC/kg, from OO (FVOO), and (3) a PC-enriched virgin olive oil containing a mixture of 500 mg PC/kg from OO and thyme, 1:1 (FVOOT). Blood lipid values and faecal quantitative changes in microbial populations, short chain fatty acids, cholesterol microbial metabolites, bile acids, and phenolic metabolites were analysed. Results: FVOOT decreased seric ox-LDL concentrations compared with pre-FVOOT, and increased numbers of bifidobacteria and the levels of the phenolic metabolite protocatechuic acid compared to VOO (P < 0.05). FVOO did not lead to changes in blood lipid profile nor quantitative changes in the microbial populations analysed, but increased the coprostanone compared to FVOOT (P < 0.05), and the levels of the faecal hydroxytyrosol and dihydroxyphenylacetic acids, compared with pre-intervention values and to VOO, respectively (P < 0.05). Conclusion: The ingestion of a PC-enriched virgin olive oil, containing a mixture of olive oil and thyme PC for 3 weeks, decreases blood ox-LDL in hypercholesterolemic humans. This cardio-protective effect could be mediated by the increases in populations of bifidobacteria together with increases in PC microbial metabolites with antioxidant activities.
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No dietary recommendations for monounsaturated fatty acids (MUFA) are given by the National Institute of Medicine, the United States Department of Agriculture, European Food and Safety Authority and the American Diabetes Association. In contrast, the Academy of Nutrition and Dietetics, and the Canadian Dietetic Association both promote <25% MUFA of daily total energy consumption, while the American Heart Association sets a limit of 20% MUFA in their respective guidelines. The present review summarizes systematic reviews and meta-analyses of randomized controlled trials and cohort studies investigating the effects of MUFA on cardiovascular and diabetic risk factors, cardiovascular events and cardiovascular death. Electronic database Medline was searched for systematic reviews and meta-analyses using "monounsaturated fatty acids", "monounsaturated fat", and "dietary fat" as search terms with no restriction to calendar date or language. Reference lists and clinical guidelines were searched as well. Sixteen relevant papers were identified. Several studies indicated an increase of HDL-cholesterol and a corresponding decrease in triacylglycerols following a MUFA-rich diet. The effects on total and LDL-cholesterol appeared not consistent, but no detrimental effects on blood lipids were observed. Values for systolic and diastolic blood pressure were found to be reduced both during short- and long-term protocols using high amounts of MUFA as compared to low-MUFA diets. In type 2 diabetic subjects, MUFA exerted a hypoglycemic effect and reduced glycosylated hemoglobin in the long term. Data from meta-analyses exploring evidence from long-term prospective cohort studies provide ambiguous results with respect to the effects of MUFA on risk of coronary heart disease (CHD). One meta-analysis reported an increase in CHD events, however, most meta-analyses observed a lesser number of cases in participants subjected to a high-MUFA protocol. Although no detrimental side effects of MUFA-rich diets were reported in the literature, there still is no unanimous rationale for MUFA recommendations in a therapeutic regimen. Additional long-term intervention studies are required to characterized efficacy and effectiveness of recommending MUFA-rich diet among general and clinical populations.
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Background Olive oil polyphenols have been associated with several cardiovascular health benefits. This study aims to examine the influence of a polyphenol-rich olive oil on blood pressure (BP) and endothelial function in 24 young women with high-normal BP or stage 1 essential hypertension.Methods We conducted a double-blind, randomized, crossover dietary-intervention study. After a run-in period of 4 months (baseline values), two diets were used, one with polyphenol-rich olive oil (∼30 mg/day), the other with polyphenol-free olive oil. Each dietary period lasted 2 months with a 4-week washout between diets. Systolic and diastolic BP, serum or plasma biomarkers of endothelial function, oxidative stress, and inflammation, and ischemia-induced hyperemia in the forearm were measured.ResultsWhen compared to baseline values, only the polyphenol-rich olive oil diet led to a significant (P < 0.01) decrease of 7.91 mm Hg in systolic and 6.65 mm Hg of diastolic BP. A similar finding was found for serum asymmetric dimethylarginine (ADMA) (-0.09 ± 0.01 µmol/l, P < 0.01), oxidized low-density lipoprotein (ox-LDL) (-28.2 ± 28.5 µg/l, P < 0.01), and plasma C-reactive protein (CRP) (-1.9 ± 1.3 mg/l, P < 0.001). The polyphenol-rich olive oil diet also elicited an increase in plasma nitrites/nitrates (+4.7 ± 6.6 µmol/l, P < 0.001) and hyperemic area after ischemia (+345 ± 386 perfusion units (PU)/sec, P < 0.001).Conclusions We concluded that the consumption of a diet containing polyphenol-rich olive oil can decrease BP and improve endothelial function in young women with high-normal BP or stage 1 essential hypertension.American Journal of Hypertension 2012; doi:10.1038/ajh.2012.128American Journal of Hypertension (2012); doi:10.1038/ajh.2012.128.
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The Mediterranean diet is rich in vegetables, cereals, fruit, fish, milk, wine and olive oil and has salutary biological functions. Epidemiological studies have shown a lower incidence of atherosclerosis, cardiovascular diseases and certain kinds of cancer in the Mediterranean area. Olive oil is the main source of fat, and the Mediterranean diet's healthy effects can in particular be attributed not only to the high relationship between unsaturated and saturated fatty acids in olive oil but also to the antioxidant property of its phenolic compounds. The main phenolic compounds, hydroxytyrosol and oleuropein, which give extra-virgin olive oil its bitter, pungent taste, have powerful antioxidant activity both in vivo and in vitro. The present review focuses on recent works analysing the relationship between the structure of olive oil polyphenolic compounds and their antioxidant activity. These compounds' possible beneficial effects are due to their antioxidant activity, which is related to the development of atherosclerosis and cancer, and to anti-inflammatory and antimicrobial activity.
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It has been suggested that the quality of clinical trials should be assessed by blinded raters to limit the risk of introducing bias into meta-analyses and systematic reviews, and into the peer-review process. There is very little evidence in the literature to substantiate this. This study describes the development of an instrument to assess the quality of reports of randomized clinical trials (RCTs) in pain research and its use to determine the effect of rater blinding on the assessments of quality. A multidisciplinary panel of six judges produced an initial version of the instrument. Fourteen raters from three different backgrounds assessed the quality of 36 research reports in pain research, selected from three different samples. Seven were allocated randomly to perform the assessments under blind conditions. The final version of the instrument included three items. These items were scored consistently by all the raters regardless of background and could discriminate between reports from the different samples. Blind assessments produced significantly lower and more consistent scores than open assessments. The implications of this finding for systematic reviews, meta-analytic research and the peer-review process are discussed.
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Patients with peripheral vascular disease (Fontaine stage II) are characterized by ischemia of the lower extremities, atherosclerosis and alteration of blood coagulation and fibrinolysis. A randomized, two-period, crossover design was used to compare the effects of extra-virgin (VO) and refined olive (RO) oils on plasma lipids and lipoprotein composition and LDL oxidation susceptibility in free-living men with peripheral vascular disease. The oils differed in their antioxidant profile (alpha-tocopherol: 300 vs. 200 mg/kg; phenolic compounds 800 vs. 60) and concentration but not in their fatty acid composition. Subjects were randomly assigned to two groups. The first group (n = 12) received VO with which to freely cook all meals for 3 mo, followed by a 3-mo wash-out period; they then received RO for the final 3 mo. The second group (n = 12) consumed the oils in the opposite order. Energy, fat, polyunsaturated fatty acids (PUFA) and alpha-tocopherol intakes were not different when patients consumed the two oils. Profiles of the major fatty acids in plasma and LDL were not different after consumption of VO and RO. The slope of the line for LDL oxidation vs. the line for copper concentration was significantly higher after the intake of RO than after the intake of VO. Total LDL taken up by macrophages was significantly greater when the men consumed RO rather than VO. We suggest that antioxidants present in VO may protect LDL against oxidation more than does RO in men with peripheral vascular disease.