Beneficial effects of dietary supplementation with olive oil, oleic acid, or hydroxytyrosol in metabolic syndrome: Systematic review and meta-analysis

Free Radic Biol Med. 2021 Aug 20:172:372-385. doi: 10.1016/j.freeradbiomed.2021.06.017. Epub 2021 Jun 18.


Background and aims: Olive oil and components might have a beneficial effect on Metabolic Syndrome (MetS). The aim of this review and meta-analysis was to assess whether those effects are related to hydroxytyrosol or oleic acid contents, or the combination of them as olive oil, and how powerful is this effect.

Methods: A systematic literature search was performed in MEDLINE via Pubmed, Web of Science (WOS) core collection, and Virtual Health Library (VHL) via LILACS and IBECS (Spain). MeSH terms used were "obesity", "body weight", "body mass index", "adipose tissue", "lipid metabolism", "LDL", "HDL", "VLDL", "insulin resistance", "glucose", "insulin", "hypertension", "arterial pressure", "olive oil", "oleic acid", and other (non-MeSH) terms: "total antioxidant capacity", "total antioxidant status", "hydroxytyrosol" (PROSPERO ID: CRD42021247614). Results of the included studies were meta-analyzed with the RevMan 5.3 program, assuming a random effects model.

Results: 76 articles (67 different trials) were identified. Hydroxytyrosol had no effect on MetS [combined standardized mean differences (SMD) = 0.01 (CI 95%: [-0.23, 0.25], I2 = 83%; p = 0.920)]. Oleic acid had no significant beneficial effect on MetS [SMD = 0.03 (CI 95%: [-0.01, 0.07], I2 = 0%); p = 0.150], but it improved lipid profile [SMD = 0.06 (CI 95%: [-0.00, 0.12], I2 = 0%); p = 0. 050]. Olive oil had no effect on MetS [SMD = -0.01 (CI 95%: [-0.05, 0.03]), I2 = 55%; p = 0.550)]. The supplementation with hydroxytyrosol, oleic acid or olive oil showed a beneficial effect on antioxidant capacity related to components of MetS [SMD = 0.31 (CI 95%: [-0.34, 0.95], I2 = 81%)]; p = 0.35).

Conclusion: Most articles compared olive oil and oleic acid with other strategies specially designed for MetS management. Our findings suggest that olive oil or oleic acid consumption are as good as the other strategies to manage MetS.

Keywords: Dyslipidemia; Hydroxytyrosol; Hypertension; Insulin resistance; Metabolic syndrome; Obesity; Oleic acid; Olive oil; Systematic review; Total antioxidant capacity; Total antioxidant status; meta-Analysis.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Dietary Supplements
  • Humans
  • Metabolic Syndrome* / drug therapy
  • Oleic Acid*
  • Olive Oil
  • Phenylethyl Alcohol / analogs & derivatives


  • Olive Oil
  • 3,4-dihydroxyphenylethanol
  • Oleic Acid
  • Phenylethyl Alcohol