Consumption of Olive Oil and Risk of Total and Cause-Specific Mortality Among U.S. Adults

Abstract

Background: Olive oil consumption has been shown to lower cardiovascular disease risk, but its associations with total and cause-specific mortality are unclear.

Objectives: The purpose of this study was to evaluate whether olive oil intake is associated with total and cause-specific mortality in 2 prospective cohorts of U.S. men and women.

Methods: The authors used multivariable-adjusted Cox proportional-hazards models to estimate HRs for total and cause-specific mortality among 60,582 women (Nurses' Health Study, 1990-2018) and 31,801 men (Health Professionals Follow-up Study, 1990-2018) who were free of cardiovascular disease or cancer at baseline. Diet was assessed by a semiquantitative food frequency questionnaire every 4 years.

Results: During 28 years of follow-up, 36,856 deaths occurred. The multivariable-adjusted pooled HR for all-cause mortality among participants who had the highest consumption of olive oil (>0.5 tablespoon/day or >7 g/d) was 0.81 (95% CI: 0.78-0.84) compared with those who never or rarely consumed olive oil. Higher olive oil intake was associated with 19% lower risk of cardiovascular disease mortality (HR: 0.81; 95% CI: 0.75-0.87), 17% lower risk of cancer mortality (HR: 0.83; 95% CI: 0.78-0.89), 29% lower risk of neurodegenerative disease mortality (HR: 0.71; 95% CI: 0.64-0.78), and 18% lower risk of respiratory disease mortality (HR: 0.82; 95% CI: 0.72-0.93). In substitution analyses, replacing 10 g/d of margarine, butter, mayonnaise, and dairy fat with the equivalent amount of olive oil was associated with 8%-34% lower risk of total and cause-specific mortality. No significant associations were observed when olive oil was compared with other vegetable oils combined.

Conclusions: Higher olive oil intake was associated with lower risk of total and cause-specific mortality. Replacing margarine, butter, mayonnaise, and dairy fat with olive oil was associated with lower risk of mortality.

Keywords: cause-specific mortality; nutrition; olive oil; plant oils; total mortality.

Figure 1:. Mortality associated with olive oil substituted for other fats.

HR(95% CI) for mortality substituting 10g of olive oil for equivalent amount of other fats. Abbreviations: NHS, Nurses’ Health Study, HPFS, Health Professionals Follow-up Study. Model was adjusted for age, ethnicity, ancestry, married, living alone, smoking status, alcohol intake, physical, family history of diabetes, myocardial infarction or cancer, multivitamin use, aspirin use, in women postmenopausal status and menopausal hormone use, energy intake, BMI, red meat, fruits and vegetables, nuts, soda, whole grains, and the intake of trans fat, and mutually adjusted for the intake of other types of fat. Results were pooled using a pooled dataset and stratifying by cohort and time period.

Central Illustration:. Potential mechanisms for olive oil intake and mortality.

Olive oil is high in bioactive compounds and has been associated with lower risk of total and cause-specific mortality in 2 prospective cohorts including 92,383 U.S. men and women followed for up to 28 years. Potential mechanisms of these associations include olive oil being less susceptible to oxidation, having anti-inflammatory and anti-atherogenic properties, improving oxidative stress, endothelial function, lipid profile, insulin sensitivity and blood pressure.