Skip to main content Accessibility help
×
Home

Olive oil consumption and risk of CHD and/or stroke: a meta-analysis of case–control, cohort and intervention studies

  • Miguel A. Martínez-González (a1) (a2), Ligia J. Dominguez (a3) and Miguel Delgado-Rodríguez (a4) (a5)

Abstract

Increasing evidence suggests that the Mediterranean diet can reduce the risk of CVD. Olive oil is the hallmark of this dietary pattern. We conducted a meta-analysis of case–control, prospective cohort studies and a randomised controlled trial investigating the specific association between olive oil consumption and the risk of CHD (101 460 participants) or stroke (38 673 participants). The results of all observational studies were adjusted for total energy intake. The random-effects model assessing CHD as an outcome showed a relative risk (RR) of 0·73 (95 % CI 0·44, 1·21) in case–control studies and 0·96 (95 % CI 0·78, 1·18) in cohort studies for a 25 g increase in olive oil consumption. In cohort studies, the random-effects model assessing stroke showed a RR of 0·74 (95 % CI 0·60, 0·92). The random-effects model combining all cardiovascular events (CHD and stroke) showed a RR of 0·82 (95 % CI 0·70, 0·96). Evidence of heterogeneity was apparent for CHD, but not for stroke. Both the Egger test (P= 0·06) and the funnel plot suggested small-study effects. Available studies support an inverse association of olive oil consumption with stroke (and with stroke and CHD combined), but no significant association with CHD. This finding is in agreement with the recent successful results of the PREDIMED randomised controlled trial.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Olive oil consumption and risk of CHD and/or stroke: a meta-analysis of case–control, cohort and intervention studies
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Olive oil consumption and risk of CHD and/or stroke: a meta-analysis of case–control, cohort and intervention studies
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Olive oil consumption and risk of CHD and/or stroke: a meta-analysis of case–control, cohort and intervention studies
      Available formats
      ×

Copyright

Corresponding author

* Corresponding author: Dr L. J. Dominguez, fax +39 091 6552952, email ligia.dominguez@unipa.it

References

Hide All
1 Keys, A (1987) Olive oil and coronary heart disease. Lancet 8539, 983984.
2 Willett, WC, Sacks, F & Trichopoulou, A (1995) Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr 61, Suppl. 6, 1402S1406S.
3 Tracy, SW (2013) Something new under the sun? The Mediterranean diet and cardiovascular health. N Engl J Med 368, 12741276.
4 Keys, A, Menotti, A, Karvonen, MJ, et al. (1986) The diet and 15-year death rate in the seven countries study. Am J Epidemiol 124, 903915.
5 Gjonça, A & Bobak, M (1997) Albanian paradox, another example of protective effect of Mediterranean lifestyle? Lancet 350, 18151817.
6 Lopez-Miranda, J, Perez-Jimenez, F, Ros, E, et al. (2010) Olive oil and health: summary of the II international conference on olive oil and health consensus report, Jaen and Cordoba (Spain) 2008. Nutr Metab Cardiovasc Dis 20, 284294.
7 Huang, CL & Sumpio, BE (2008) Olive oil, the Mediterranean diet, and cardiovascular health. J Am Coll Surg 207, 407416.
8 Covas, MI, Konstantinidou, V & Fito, M (2009) Olive oil and cardiovascular health. J Cardiovasc Pharmacol 54, 477482.
9 Ruiz-Canela, M & Martinez-Gonzalez, MA (2011) Olive oil in the primary prevention of cardiovascular disease. Maturitas 68, 245250.
10 Jakobsen, MU, O'Reilly, EJ, Heitmann, BL, et al. (2009) Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. Am J Clin Nutr 89, 14251432.
11 Bertuzzi, M, Tavani, A, Negri, E, et al. (2002) Olive oil consumption and risk of non-fatal myocardial infarction in Italy. Int J Epidemiol 31, 12741277, author reply 1276–1277.
12 Ferro-Luzzi, A, James, WP & Kafatos, A (2002) The high-fat Greek diet: a recipe for all? Eur J Clin Nutr 56, 796809.
13 Alemany, M (2011) The Mediterranean diet: a group of healthy foods, a type of diet, or an advertising panacea? (Spanish). Med Clin (Barc) 136, 594599.
14 Estruch, R, Ros, E, Salas-Salvado, J, et al. for the PREDIMED investigators (2013) Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med 368, 12791290.
15 Moher, D, Liberati, A, Tetzlaff, J, et al. (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339, b2535.
16 Samieri, C, Feart, C, Proust-Lima, C, et al. (2011) Olive oil consumption, plasma oleic acid, and stroke incidence: the Three-City Study. Neurology 77, 418425.
17 Wells, GA, Shea, B & O'Connell, D, et al. (2013) The Newcastle–Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp (accessed 23 December 2013)..
18 Greenland, S & O'Rourke, K (2008) Meta-analysis. In Modern Epidemiology, 3rd ed., pp. 658659 [Rothman, KJ, Greenland, S and Lash, TL, editors]. Philadelphia, PA: Lippincott Williams and Wilkins.
19 Higgins, JPT & Thompson, SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21, 15391558.
20 Higgins, JPT, Thompson, SG, Deeks, JJ, et al. (2003) Measuring inconsistency in meta-analyses. BMJ 327, 557560.
21 Higgins, JP (2008) Commentary: heterogeneity in meta-analysis should be expected and appropriately quantified. Int J Epidemiol 37, 11581160.
22 Thorlund, K, Imberger, G, Johnston, BC, et al. (2012) Evolution of heterogeneity (I 2) estimates and their 95 % confidence intervals in large meta-analyses. PLOS ONE 7, e39471.
23 Duval, S & Tweedie, R (2000) A non-parametric “trim and fill” method of assessing publication bias in meta-analysis. J Am Stat Ass 95, 8998.
24 Sterne, JAC (editor) (2009) Meta-Analysis in Stata: An Updated Collection from the Stata Journal. College Station, TX: Stata Press.
25 Dilis, V, Katsoulis, M, Lagiou, P, et al. (2012) Mediterranean diet and CHD: the Greek European Prospective Investigation into Cancer and Nutrition cohort. Br J Nutr 108, 699709.
26 Kontogianni, MD, Panagiotakos, DB, Chrysohoou, C, et al. (2007) The impact of olive oil consumption pattern on the risk of acute coronary syndromes: the CARDIO2000 case–control study. Clin Cardiol 30, 125129.
27 Misirli, G, Benetou, V, Lagiou, P, et al. (2012) Relation of the traditional Mediterranean diet to cerebrovascular disease in a Mediterranean population. Am J Epidemiol 176, 11851192.
28 Bendinelli, B, Masala, G, Saieva, C, et al. (2011) Fruit, vegetables, and olive oil and risk of coronary heart disease in Italian women: the EPICOR Study. Am J Clin Nutr 93, 275283.
29 Fernández-Jarne, E, Martinez-Losa, E, Prado-Santamaria, M, et al. (2002) Risk of first non-fatal myocardial infarction negatively associated with olive oil consumption: a case–control study in Spain. Int J Epidemiol 31, 474480.
30 Buckland, G, Travier, N, Barricarte, A, et al. (2012) Olive oil intake and CHD in the European Prospective Investigation into Cancer and Nutrition Spanish cohort. Br J Nutr 108, 20752082.
31 Martinez-Gonzalez, MA & Gea, A (2012) Mediterranean diet: the whole is more than the sum of its parts. Br J Nutr 108, 577578.
32 Jacobs, DR Jr, Gross, MD & Tapsell, LC (2009) Food synergy: an operational concept for understanding nutrition. Am J Clin Nutr 89, 1543S1548S.
33 VanderWeele, TJ (2009) On the relative nature of overadjustment and unnecessary adjustment. Epidemiology 20, 496499.
34 Trichopoulou, A, Costacou, T, Bamia, C, et al. (2003) Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 348, 25992608.
35 Esposito, K, Marfella, R, Ciotola, M, et al. (2004) Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 292, 14401446.
36 Estruch, R, Martinez-Gonzalez, MA, Corella, D, et al. (2006) Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Ann Intern Med 145, 111.
37 Covas, MI, Nyyssonen, K, Poulsen, HE, et al. (2006) The effect of polyphenols in olive oil on heart disease risk factors: a randomized trial. Ann Intern Med 145, 333341.
38 Visioli, F & Bernardini, E (2011) Extra virgin olive oil's polyphenols: biological activities. Curr Pharm Des 17, 786804.
39 Oh, K, Hu, FB, Cho, E, et al. (2005) Carbohydrate intake, glycemic index, glycemic load, and dietary fiber in relation to risk of stroke in women. Am J Epidemiol 161, 161169.
40 Thompson, SG & Higgins, JPT (2002) How should meta-regression analyses be undertaken and interpreted? Statist Med 21, 15591573.

Keywords

Type Description Title
WORD
Supplementary materials

Martínez-González Supplementary Material
Supplementary Material 1

 Word (69 KB)
69 KB
WORD
Supplementary materials

Martínez-González Supplementary Material
Supplementary Material 2

 Word (283 KB)
283 KB
WORD
Supplementary materials

Martínez-González Supplementary Material
Supplementary Material 3

 Word (22 KB)
22 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed