Is olive oil healthy in general, or only as a replacement for saturated fats?
Olive oil is often said to be "healthy".
This study, for example, states:
For each 10 g/d increase in extra-virgin olive oil consumption,
cardiovascular disease and mortality risk decreased by 10% and 7%,
respectively. No significant associations were found for cancer and
all-cause mortality.
It's unclear if such claims are talking about olive oil as a replacement for other dietary fats, or as an addition. Are such studies controlling other factors (like olive oil being chosen by wealthier health-conscious people)?
Also, in the above study, why aren't they seeing an association with all-cause mortality? Should we assume that olive oil lowered cardiovascular mortality, but increased other mortality?
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Olive oil contains mainly monounsaturated fat made of oleic acid.
The current evidence suggests that unsaturated fat may be beneficial as replacement for saturated fat, that is by increasing unsaturated/saturated fat ratio. Most of the evidence suggest that polyunsaturated fat may be more benefical for the heart health than monounsaturated fat (Health.gov 2015, Cochrane 2015, Annual Reviews in Nutrition 2016, NMCD 2017).
There is some weak association between olive oil and reduced risk of heart disease, but the included studies could not isolate the effect from other foods consumed:
PREDIMED Study (BMC Medicine 2014)
A systematic review of 32 cohort studies (Lipids In Health and Disease 2014)
Researchers in PREDIMED study have found statistically significant association between olive oil consumption and cardiovascular mortality, but when checked for all-cause mortality, the association was no longer statistically significant.
In one meta-analyses, they concluded that olive oil may contribute to benefits of Mediterranean diet, but it's not possible to say if olive oil as such, or only as a source of unsaturated fat, is beneficial (Frontiers in Nutrition 2019). Anyway, a recent systematic review did not bring a clear conclusion about benefits of Mediterranean diet for heart health (Cochrane 2019).
In a recent systematic review, sunflower oil, was associated with lower LDL cholesterol levels than olive oil (Journal of Lipid Research 2018).
In conclusion, currently there is no clear evidence to say that olive oil as such is beneficial for heart, but it could be beneficial as one of the sources of unsaturated fat when replaced for saturated fat.
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