Olive Oil and the Mediterranean Diet Enhances the Function of HDL Cholesterol (2021)

To decrease the risk for cardiovascular disease, many people try to control the amount of dietary cholesterol they consume. Fats, particularly those found in baked goods and processed items, are a good place to start. According to the American Heart Association, common oils found in baked goods such as palm oil, kernel oil, and coconut oil are high in saturated fats that can increase harmful cholesterol levels (1). Why does that matter? Here’s a simple breakdown –– high cholesterol levels in the blood can increase plaque formation. Excess plaque then accumulates in the arteries, causing them to become blocked or narrowed, resulting in cardiovascular disease. But that doesn’t have to be your fate. Dietary and lifestyle changes can improve your body’s cholesterol functions and provide protective effects against cardiovascular diseases.

It can be as easy as a simple swap too! Extra virgin olive oil (EVOO), one of the primary sources of fat in the Mediterranean diet, is rich in antioxidants, monounsaturated fatty acids, and minor bioactive compounds –– all of which can help protect your heart! Plus, it’s a versatile oil that can be used in place of other fat in most dishes.

Let’s take a look at how EVOO and the Mediterranean diet can enhance your body’s cholesterol function.

What is Cholesterol?

Cholesterol is a type of sterol fat found in your blood, which can be both good and bad. Having a lot of cholesterol can pose a problem for your health because excess cholesterol levels can increase your risk for health complications such as cardiovascular disease. Although excess cholesterol is not ideal, cholesterol is essential for your body to function.

There are two sources of cholesterol — your body and diet! Your body produces 80% cholesterol in the liver and intestines. Meanwhile, 20% of cholesterol is obtained through your diet. Some sources of cholesterol are dairy products, meat, and poultry. High consumption of these foods can increase cholesterol production in the liver, which results in unhealthy levels of cholesterol. Often this is caused by the high content of saturated fats and trans fat found in foods that are high in cholesterol.

Why is Cholesterol Important?

Though cholesterol has a bad reputation, it performs many vital functions within the body. It’s essential for the production of hormones, vitamin D, and fat-dissolving bile acids, and it can be found in cells throughout the body. Cholesterol attaches to protein molecules, called lipoproteins, which travel through the bloodstream.

Extra Virgin Olive Oil and Cholesterol:

EVOO is rich in monounsaturated fatty acids, polyphenolic, and bioactive compounds that can increase high density lipoproteins (HDL) functions. In a randomized, double-blind, controlled study, 33 hypercholesterolemic participants with total cholesterol levels greater than 300 mg/dL consumed 25 ml of virgin olive oil per day with their meal for three weeks. Upon completion, they were given lower-quality olive oil with poor polyphenolic content for two weeks. The researchers recorded the participants fasting blood samples before and after each intervention. The study determined that “a functional virgin olive oil, enriched with olive oil and thyme polyphenol compounds (250 mg/kg of each), promoted the expression of several genes regulating HDL cholesterol efflux capacity” (2). Researchers reported that increasing the consumption of virgin olive oil can enhance the expression of key HDL cholesterol efflux genes in the reverse cholesterol transport pathway (RCT), which is where macrophages in the blood vessel transport and excrete cholesterol from the vessel walls to the liver. Study findings tell us that extra virgin olive oil consumption can improve the efficiency of RCT and cholesterol efflux capacity, which plays a vital role in the RCT pathway by removing excess cholesterol in your body.

The Mediterranean Diet and Cholesterol

The Mediterranean diet has been shown to reduce cholesterol levels and improve overall health. In a one-year research study, 296 participants were randomly assigned to the Mediterranean diet supplemented with either virgin olive oil or nuts or a low-fat control diet. Both Mediterranean diets supplemented with virgin olive oil and nuts resulted in improved cholesterol efflux capacity. The low-fat control diet group reported no significant improvement (3). After one year of intervention, the study found that the Mediterranean diet provides improvements in many HDL functions, including “cholesterol efflux capacity, cholesterol metabolism, antioxidant/anti-inflammatory properties, and vasodilatory capacity” amongst participants with high-risk for cardiovascular diseases (3). Cholesterol efflux capacity is a major biological function for HDL because it enables HDL to remove excess cholesterol from the cells. This suggests that adherence to the Mediterranean diet protects against cardiovascular diseases by improving the four HDL functions, including cholesterol efflux capacity, HDL cholesterol metabolism, HDL antioxidant/anti-inflammatory properties, and vasoprotective properties. Try different foods to include in your Mediterranean diet to decrease the risk for cardiovascular disease. Also, you can check out a grocery shopping guide for the Mediterranean diet.

Key Takeaway:

Cholesterol can be found throughout the body, and it is essential for producing hormones, vitamin D, and fat-dissolving bile acid. Though necessary, excess cholesterol can result in health complications such as cardiovascular diseases. Research indicates that olive oil and the Mediterranean diet can improve the RCT pathway and cholesterol efflux capacity, which removes excess cholesterol from the peripheral cells, helping to manage cholesterol levels for individuals who are at high risk for cardiovascular diseases.

Written by Joanna Chen

Reviewed by Kelly Powers, MA, RDN, a Registered Dietitian Nutritionist who takes a holistic approach to nutrition and health. Kelly is a recipe developer with a food blog highlighting whole foods, simple recipes, and her life in San Francisco. She’s the creator of 52 Weeks, a weekly meal plan program that helps users get back in the kitchen and feed themselves well. Kelly is also a co-founder of Olivaio.

Photo Credits: pexels.com/@Trang Doan; pexels.com/@Malidate Van; pexels.com/@Patrícia Paixao; pexels.com/@Alexy almond; 

Frequently Asked Questions:

Q: Why do we need cholesterol for the body to function?
A: There are misconceptions regarding cholesterol being bad for your body because as it can clog your arteries and result in heart conditions. It is, however, important for cellular function throughout your body, such as building cells and producing hormones and vitamin D.

Q: Why are olive oil and the Mediterranean diet good for managing cholesterol?
A: Research indicates that consumption of olive oil and adherence to the Mediterranean diet can enhance cholesterol efflux capacity and improve the efficiency of the reverse cholesterol transport pathway.

Q: What is the cholesterol efflux capacity?
A: The cholesterol efflux capacity is an important mechanism for high density lipoprotein (HDL) function. The research findings indicate that consumption of olive oil and the Mediterranean diet enriched with olive oil can promote cholesterol efflux capacity, allowing HDL to remove excess cholesterol from your body.