Extra virgin olive oil (EVOO), due to its antioxidant, anti-inflammatory, anti-cancer and cardiovascular protective effects, represents a functional food. Not by chance, it was called the ”Elixir of the youth and health” by the Ancient Greeks, who were the first to observe its therapeutic properties. It is a cornerstone in the Mediterranean Diet, one of the healthiest nutritional patterns and part of the UNESCO’s intangible cultural heritage, which emphasizes an abundant intake of seasonal vegetables and fruits, legumes, whole grains and nuts, moderate intake of seafood, fish and milk products, and a low consumption of meat, while red wine is usually consumed with the meals.
EVOO became an object of scientific research since the 1960’s. The “Seven Countries Study”, guided by Ancel Keys, focused to the nutritional practices of people living in the rural areas of the Mediterranean basin, especially Crete and Southern Italy, in order to explain longevity and lower incidences of many chronic diseases. The study showed that replacing saturated fats with unsaturated fats, including polyunsaturated fatty acids (PUFA) and monounsaturated fatty acids (MUFA), mainly sourced from the extra virgin olive oil, is associated with less cardiovascular events and reduced risk of other chronic diseases.
The benefits of EVOO are mainly due to its composition. In vitro and in vivo studies involving humans and animals have demonstrated that EVOO’s unsaturated fatty acids and phenolic compounds have remarkable and beneficial effects by acting in a synergistic way. The predominant MUFA present in EVOO is the oleic acid and it has remarkable cardiovascular beneficial effects. Among the phenolic compounds, hydroxytyrosol, oleocanthal and oleuropein are the most studied and proven for their remarkable antioxidant activities.
Antioxidants can counteract the effects of oxidative species, such as free radicals and reactive oxygen species. The latter represent products of metabolic pathways, or environmental factors which may cause oxidation and consequent structural and functional damage to the main biomolecules of the body, such as nucleic acids, lipids, and proteins, a process which is called oxidative stress. In the long term, oxidative stress is related with the ageing process and can result in development of many diseases, such as cancer or metabolic, cardiovascular, inflammatory and neurological diseases.
An imbalance between the production of oxidative species from one side, and the availability of antioxidants from the other side, can be detrimental for the human health. As the de novo antioxidant production in the body is limited, the presence of dietary antioxidants, such as the phenolic compounds present in EVOO, is of great importance, as they are naturally bioavailable, easily absorbed and ready to counteract the oxidative stress. In this context, EVOO is a great source of a variety of powerful, bioavailable components, which are directly related to its health properties, thus reducing the morbidity and contributing to prevention or slowing the progression of diseases associated with oxidative stress.
A special emphasis regarding EVOO beneficial effects regards cardiovascular disease (CVD) prevention. CVD is a group of disorders such as ischaemic heart disease (myocardial infarction), stroke and peripheral arterial disease, caused by the accumulation of fatty deposits on the inner walls of the arteries (a process called atherosclerosis) and consequent blockage of blood circulation to the heart, brain, arms or legs. Major CVD risk factors are high levels of blood cholesterol, hypertension, diabetes, smoking and sedentary lifestyle. There is an evidence that EVOO’s fatty acids (MUFA and PUFA) act against atherosclerosis by lowering the levels and oxidation of low density lipoprotein (LDL, “ the bad cholesterol”) and triglycerides, while increasing the high density lipoprotein (HDL, “the good cholesterol”), which helps fend off the formation of fatty patches. As discussed before, phenolic compounds are capable of blunting oxidative stress, which, in terms of CVD prevention, is translated to better endothelial (vascular wall) and platelet function, thus reducing the formation of clots.
Furthermore, there is strong scientific evidence that using EVOO as a main source of fats in the diet can reduce the incidence certain cancer types, such as breast, colorectal, and prostate cancer, due to its anti-oxidant and anti-inflammatory effects. The cancer-preventing mechanisms of EVOO seem to be related to the ability of its MUFA-oleic acid to specifically regulate cancer-related oncogenes, which are critical to the aetiology, invasion, progression, and metastasis of tumours (for example suppression of HER2, a gene implicated in breast cancer). Also phenolic compounds from EVOO can exert an inhibitory action on cancers, acting as blocking and/or suppressive agents at several stages of cancer progression.
In summary, EVOO, the hallmark of the Mediterranean diet, has been proven to have numerous health and well-being benefits. It is a powerful regulator of cardiovascular risk factors, thus contributing to prevention of cardiovascular diseases, and it contributes to prevention of different types of cancer, which represent the two main causes of morbidity and mortality. Its anti-oxidative and anti-inflammatory properties are also related to less incidence of metabolic, chronic inflammatory and degenerative diseases. For all the above benefits, EVOO supports healthy ageing and its daily consumption is the proof of the Hippocrates’s “Let food be thy medicine and medicine be thy food”.
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