A major study of over 7,000 people at high risk for heart disease found that those who consumed the most extra-virgin olive oil had significantly lower chances of experiencing heart attacks, strokes, and other serious heart problems. The research, which followed participants for nearly five years, showed that people eating about 2 tablespoons of extra-virgin olive oil daily had a 25% lower risk of heart disease events, and those eating the most had nearly 50% lower risk. Interestingly, regular olive oil without the special compounds found in extra-virgin versions didn’t show the same protective benefits, suggesting that the type of olive oil matters for heart health.

The Quick Take

  • What they studied: Whether eating extra-virgin olive oil could help prevent heart disease and related problems in people already at high risk
  • Who participated: 7,102 older adults (average age 55-80 years, 57.5% women) who had never had heart disease before but had other risk factors like high blood pressure or diabetes
  • Key finding: People who ate the most extra-virgin olive oil (about 2 tablespoons daily) had a 25% lower chance of having a heart attack, stroke, or other serious heart event compared to those who ate the least. Those eating the very highest amounts had nearly 50% lower risk.
  • What it means for you: If you’re at risk for heart disease, adding extra-virgin olive oil to your diet may help protect your heart. However, this doesn’t mean olive oil alone will prevent heart disease—it works best as part of a healthy overall diet and lifestyle. Regular olive oil without the special compounds didn’t show the same benefits.

The Research Details

This study followed 7,102 people who were at high risk for heart disease but hadn’t experienced any heart problems yet. Researchers asked participants every year how much olive oil they ate, keeping track of both extra-virgin olive oil (which has special protective compounds called polyphenols) and regular olive oil (which lacks these compounds). Over nearly 5 years, researchers watched to see who developed heart disease, including heart attacks, strokes, heart failure, and other serious conditions.

The researchers used a statistical method called Cox modeling to compare people who ate different amounts of olive oil while accounting for other factors that affect heart disease risk, like age, smoking, exercise, and other diet choices. They looked at both the total amount of olive oil consumed and compared the highest consumers to the lowest consumers.

This research approach is important because it tracks what people actually eat over time rather than just asking them once, which gives a more accurate picture. By distinguishing between extra-virgin and regular olive oil, the study reveals that not all olive oils are equally protective—the special compounds in extra-virgin olive oil appear to be what makes the difference. This helps doctors and nutritionists give better advice about which types of oil to recommend.

This study is considered high-quality because it involved a large number of participants, followed them for several years, and carefully tracked their diet annually. The research was part of a registered clinical trial, meaning it followed strict scientific standards. However, the study was observational, meaning researchers watched what people naturally ate rather than randomly assigning some to eat olive oil and others not to, so we can’t be 100% certain olive oil caused the benefits.

What the Results Show

Among the 7,102 participants, 621 people experienced at least one heart disease event during the study. Those who ate the most extra-virgin olive oil had a 25% lower risk of these events compared to those who ate the least. When researchers looked at the very highest consumers (top 10%) compared to the lowest consumers (bottom 10%), the difference was even more dramatic—a 48% lower risk.

The protective effect appeared across multiple types of heart problems. People eating more extra-virgin olive oil had lower risks of heart attacks, strokes, and other serious cardiovascular events. The amount that showed benefits was relatively modest—about 2 tablespoons per day for the highest-benefit group, and about 2.2 tablespoons for those with the most dramatic protection.

In contrast, regular olive oil without the special polyphenol compounds showed much weaker associations with heart disease protection. When researchers accounted for extra-virgin olive oil consumption, regular olive oil didn’t significantly reduce heart disease risk. This suggests that the specific compounds in extra-virgin olive oil—not just the oil itself—are responsible for the heart-protective benefits.

The study examined several individual heart disease outcomes separately. Extra-virgin olive oil consumption was associated with reduced risk across multiple conditions including myocardial infarction (heart attack), stroke, peripheral arterial disease (poor circulation in the legs), heart failure, and atrial fibrillation (irregular heartbeat). The consistency of benefits across different types of heart problems suggests a broad protective mechanism rather than protection against just one condition.

Previous research has suggested that olive oil is good for heart health, but this study provides stronger evidence by looking at a wider range of heart problems and by distinguishing between extra-virgin and regular olive oil. Most earlier studies didn’t track what people ate year after year, and they didn’t separate the different types of olive oil. This research confirms and expands on earlier findings while providing new insight into why extra-virgin olive oil appears superior—the polyphenols (special plant compounds) seem to be the key ingredient.

This study followed people for about 4.7 years on average, which is good but relatively short for understanding long-term health effects. The participants were mostly from Mediterranean countries where olive oil consumption is common, so results might not apply equally to other populations. The study was observational, meaning people chose how much olive oil to eat, so we can’t be certain that olive oil itself caused the benefits rather than other healthy habits of people who eat more olive oil. Additionally, the study included only people at high risk for heart disease, so we don’t know if the same benefits would apply to people at lower risk.

The Bottom Line

If you’re at risk for heart disease (due to age, high blood pressure, diabetes, or family history), incorporating extra-virgin olive oil into your diet appears to be beneficial. A reasonable target based on this research would be about 2 tablespoons (30 grams) daily, though even moderate amounts showed benefits. Use extra-virgin olive oil rather than regular olive oil for the best potential benefits. However, olive oil should be part of a broader healthy diet that includes vegetables, whole grains, fish, and nuts—not a replacement for other healthy eating habits. This research has moderate-to-strong evidence supporting the recommendation, though it’s not definitive proof.

This research is most relevant for people over 50 who have risk factors for heart disease, such as high blood pressure, high cholesterol, diabetes, or a family history of heart disease. It’s also relevant for anyone interested in heart disease prevention. People who already eat Mediterranean-style diets may already be getting these benefits. This research doesn’t apply to people with olive oil allergies or those who need to restrict fat intake for specific medical reasons—they should consult their doctor.

The benefits observed in this study developed over several years of consistent olive oil consumption. You shouldn’t expect immediate changes, but regular consumption over months and years may contribute to reduced heart disease risk. The most dramatic benefits appeared in people who maintained high olive oil consumption over the entire study period, suggesting that consistency matters more than occasional use.

Want to Apply This Research?

  • Track daily olive oil consumption in tablespoons or grams, specifically noting whether it’s extra-virgin or regular olive oil. Set a goal of 1-2 tablespoons of extra-virgin olive oil daily and log actual consumption to monitor consistency.
  • Replace other cooking oils and salad dressings with extra-virgin olive oil. Start by using it for salad dressings, dipping bread, or drizzling over finished dishes. Gradually increase usage to reach the 1-2 tablespoon daily target while reducing other less healthy oils.
  • Track weekly and monthly averages of olive oil consumption to ensure consistency. Pair this tracking with other heart-healthy behaviors like exercise, blood pressure monitoring, and overall diet quality. Review trends quarterly to identify patterns and maintain motivation.

This research suggests an association between extra-virgin olive oil consumption and reduced heart disease risk, but it is not definitive proof that olive oil alone prevents heart disease. This study was observational, meaning people chose their own olive oil consumption, so other healthy habits may have contributed to the benefits. Olive oil should be part of a comprehensive heart-healthy lifestyle including regular exercise, stress management, and a balanced diet—not a substitute for medical treatment or advice from your healthcare provider. If you have heart disease, are at high risk for heart disease, or take blood-thinning medications, consult your doctor before making significant dietary changes. Individual results may vary based on genetics, overall diet, and lifestyle factors.