A large body of evidence shows that daily consumption of EVOO confers numerous health benefits, including a significantly reduced risk of cardiovascular disease (CVD).
Factors that contribute to CVD include cholesterol, inflammation, blood vessel function, insulin resistance, and high blood pressure (hypertension). The protective effects of EVOO are attributed to its bioactive components, oleic acid (OA) and more than 30 polyphenols.
In this concise review, we’ll look closely at the mechanisms by which OA works in the body to modify and improve these factors.
What is OA? Oleic acid is a monounsaturated fatty acid (MUFA) that makes up approximately 70 to 80 percent of EVOO by volume. MUFAs and PUFAs (polyunsaturated fatty acids) are the key components of liquid fats, such as vegetable oils and the fats in fish.
Lowers “bad” cholesterol and blood lipid levels: OA lowers LDL or “bad” cholesterol by increasing the amount of LDL that is removed from the blood by the liver and reducing the amount that is produced. In scientific terms, OA increases hepatic LDL receptor activity. Similarly, OA helps lower triglyceride levels by stimulating the liver to increase the breakdown and removal of the proteins that produce triglycerides.
Helps regulate blood pressure: After eating, we experience what is termed the postprandial reflex—a rise in blood triglycerides and increase in blood pressure. When OA enters cell membranes, signals are sent from the intestines to the blood vessels to release vasodilators, which relax the blood vessels, and to block the release of vasoconstrictors, which tighten the blood vessels and raise blood pressure.
Protects the blood vessel lining: Damage to the blood vessel lining (the endothelium) is a major risk factor for CVD. By stimulating the release of vasodilators, OA helps protect the endothelium. OA also blocks signals from inflammatory proteins that are released with the postprandial reflex, reducing oxidative stress (which can lead to cell damage) and helping prevent atherosclerosis (buildup of cholesterol plaques in the arteries).
Increases insulin sensitivity: In a study of patients with obesity, OA was shown to up-regulate—increase the activity of—a gene that increases insulin sensitivity. OA also reduces insulin resistance in vascular smooth muscle cells, which make up the blood vessel walls.
Studies continue to reveal the ways in which OA exerts its multiple health-promoting effects. In 2018, the FDA determined that evidence supported a qualified health claim that the daily consumption of 20g daily of high-OA oil (EVOO or other high-oleic oil) may reduce the risk of coronary heart disease.
Stay tuned for part II, in which we’ll explore how the polyphenols in EVOO exert powerful protective effects against CVD.
References: 1. Lu Y, Zhao J, Xin Q, et al. Food Science and Human Wellness. 2024;13:529-540. 2. Pirahanchi Y, Sinawe H, Dimri M. Biochemistry, LDL Cholesterol (National Library of Medicine, 2023). 3. Zheng C, Khoo C, Furtado J, Ikekawi K, Sacks FM. Am J Clin Nutr. 2008;88(2):279-281. 4. US Food and Drug Administration. Constituent Update, November 19, 2018. https://www.fda.gov/food/cfsan-constituent-updates/fda-completes-review-qualified-health-claim-petition-oleic-acid-and-risk-coronary-heart-disease.
Orange-Raspberry Muffins Recipe, Spotlight on Almond Flour, Juicing Fruit, The Benefits of Limiting Processed and Red Meats, and High Intensity Interval Training (HIIT)
Packaged gluten-free baked goods are often tasteless, not to mention filled with additives and other unhealthy ingredients. In just a few minutes, you can bake your own delicious muffins that are so tasty that they won’t provoke eye rolls from gluten lovers. While gluten should be avoided only by those with a sensitivity or celiac disease, a recent study found that everyone can benefit from eating fewer processed and red meats—the health benefits are astounding. Then read about a newly discovered benefit of high-intensity interval training (HIIT).
The combination of olive oil and almond flour creates a tender crumb that rivals any flour-based batter and a muffin that’s infinitely more nutritious. I like to use “tulip-shaped” cupcake liners because you can fill them right up to the level of your baking tin for very tall muffins. Also, topping the batter with berries after filling the liners helps keep the fruit from falling to the bottom.
Ingredients
3 cups almond flour
1-1/2 teaspoons baking powder
1/2 teaspoon fine sea salt
3/4 cup extra-virgin olive oil
1/2 cup sugar, divided use
Freshly grated zest of 1 large orange
1/2 cup fresh orange juice
6 eggs, separated
1 tablespoon vanilla paste
1 cup raspberries
Directions
Step 1
Preheat your oven to 350°F. Place tulip-shaped cupcake liners in the cups of a 12-muffin tin; set aside.
Step 2
In a large bowl, sift together the almond flour, baking powder, and salt. In a separate bowl, whisk together the olive oil, 1/4 cup sugar, orange zest and juice, egg yolks, and vanilla. Fold in the flour mixture.
Step 3
In a very large bowl or the bowl of a stand mixer, beat the egg whites on a low speed to break them up, about a minute. Once they start to foam, increase the speed to high and add the remaining sugar. Whip until the whites form stiff peaks, then use a large spatula to gently fold them into the almond flour mixture in 3 or 4 batches, rotating your mixing bowl as you move your spatula from the center out to the sides. Don’t overmix to avoid deflating the batter—a few streaks of whites are OK.
Step 4
Use a large ice cream scoop to fill the paper liners up to the level of your baking tin. Top with equal amounts of berries. Bake the muffins for 30 to 40 minutes, until the tip of a sharp knife comes out clean. Serve warm or at room temperature.
Yields 12 muffins
Healthy Ingredient Spotlight
Almond Flour
Almond flour, like other nut flours, is wonderful for baking, whether you’re making muffins, a cake like a dacquoise or torte, cookies, or even pie shells. You can grind your own from fresh almonds or buy it by the bag. Some brands are made of blanched almonds, but those made with the almond skins offer even more nutrients. Like almonds themselves, almond flour is naturally rich in vitamin E and other antioxidants, manganese, and magnesium, with a healthy dose of protein and fiber. To keep it fresh, store it in the fridge or freezer.
Quick Kitchen Nugget
Juicer or Hand Squeezer?
When a recipe calls for any type of citrus juice, fresh-squeezed is a must. The question then becomes whether to use a hand press or an electric citrus juicer. The answer depends on how much juice you’ll be making.
For a few tablespoons up to a cup, a metal hand press (look for one with ergonomic handles) will work well with minimal strain on your hands—it does take effort to squeeze its handles together, and you might need different sizes for juicing limes, lemons, and oranges effectively. For juicing large quantities, it pays to have an electric juicer for ease and speed; this countertop appliance can handle all sizes of citrus and can be stored in a cabinet when not needed. There are also large, commercial-grade manual juicers that sit on a flat surface and that you operate by pushing down on a lever to extract the juice, but these tend to take up a lot of counter space.
For Your Best Health
The Benefits of Limiting Processed and Red Meats
While many studies have identified links between frequent consumption of processed meat and chronic disease, few have evaluated the impact on multiple health outcomes. Some previous research also suggested that unprocessed red meat may contribute to chronic disease risk, but evidence has been limited.
Now, a team from the University of Edinburgh’s Global Academy of Agriculture and Food Systems, together with researchers from the University of North Carolina, Chapel Hill, has used data from a Centers for Disease Control and Prevention national health survey to create a simulated, representative sample of the US adult population—called a microsimulation—in order to estimate how changes in meat consumption affect adults’ risk of diabetes, cardiovascular disease, colorectal cancer, and death. The effects were evaluated in the overall population and separately based on age, sex, household income, and ethnicity.
This microsimulation is the first to estimate the effects of reducing processed meat and unprocessed red meat consumption, from between 5 percent and 100 percent, on multiple health outcomes in the US. They found that cutting processed meat intake by 30 percent (the equivalent of around 10 slices of bacon a week) would prevent more than 350,000 cases of diabetes and lead to 92,500 fewer cardiovascular disease cases and 53,300 fewer colorectal cancer cases over a decade.
The researchers also analyzed the impacts of reducing unprocessed red meat intake alone and cutting consumption of both processed meat and unprocessed red meat. Cutting unprocessed red meat intake alone by 30 percent, which would mean eating around one less quarter-pound beef burger a week, resulted in more than 732,000 fewer diabetes cases, 291,500 fewer cardiovascular disease cases, and 32,200 fewer colorectal cancer cases. Reducing consumption of both by 30 percent resulted in 1,073,400 fewer diabetes cases, 382,400 fewer cardiovascular disease cases, and 84,400 fewer colorectal cancer cases.
The finding that more disease cases were prevented by reducing unprocessed red meat than by reducing processed meat is partly due to the average daily intake of unprocessed red meat being higher than that of processed meat, at 47 grams a day versus 29 grams a day, respectively. As less is known about the effect of eating unprocessed red meat on chronic disease risk, the team said these estimates should be interpreted with caution and that more research is needed.
Lindsay Jaacks, PhD, professor, Personal Chair of Global Health and Nutrition at the University of Edinburgh, and one of the authors of the study, said, “Cutting consumption of meat has been recommended by national and international organizations to reduce greenhouse gas emissions, including by the Climate Change Committee here in the UK and the United Nations Intergovernmental Panel on Climate Change. Our research finds that these changes in diets could also have significant health benefits in the US, and so this is a clear win-win for people and planet.”
The study, “Estimated effects of reductions in processed meat consumption and unprocessed red meat consumption on occurrences of type 2 diabetes, cardiovascular disease, colorectal cancer, and mortality in the USA: a microsimulation study,” was published in TheLancet Planetary Healthand was funded by the Wellcome Trust.
Fitness Flash
An Exercise Brain Boost That Can Last for Years
A longitudinal study led by Emeritus Professor Perry Bartlett, PhD, and Daniel Blackmore, PhD, of the University of Queensland’s Queensland Brain Institute found that high-intensity interval exercise improves brain function in healthy older adults for up to five years. The research was published inAging and Disease.
Dr. Bartlett said it is the first controlled study of its kind to show that exercise can not only delay cognitive decline but also boost cognition in healthy older adults. “Six months of high-intensity interval training (HIIT) is enough to flick the switch,” Dr. Bartlett said. “In earlier preclinical work, we discovered exercise can activate stem cells and increase the production of neurons in the hippocampus, improving cognition. In this study, a large cohort of healthy 65- to 85-year-old volunteers joined a six-month exercise program, did biomarker and cognition testing, and had high-resolution brain scans.”
During the study, the researchers assessed the impact of three exercise intensities: low—predominantly motor function, balance, and stretching; medium—brisk walking on a treadmill; and high—four cycles of running on a treadmill at near maximum exertion. Participants exercised three times a week, for between 36 and 45 minutes per session including warmup and cooldown, and under supervision for 6 months.
Dr. Blackmore said only the high-intensity interval exercise led to cognitive improvement that was retained for up to five years. “On high-resolution MRI scans of that group, we saw structural and connectivity changes in the hippocampus, the area responsible for learning and memory,” he said. “We also found blood biomarkers that changed in correlation to improvements in cognition. Biomarkers can be useful in predicting the effectiveness of the exercise a person is doing.”
Aging is one of the biggest risks for dementia, a condition that affects almost half a million Australians. “If we can change the trajectory of aging and keep people cognitively healthier for longer with a simple intervention like exercise, we can potentially save our community from the enormous personal, economic, and social costs associated with dementia,” Dr. Bartlett said.
With one out of three people aged 85 likely to develop dementia, Dr. Blackmore said, the impact of the research is far-reaching. “Our finding can inform exercise guidelines for older people and further research could assess different types of exercise that could be incorporated. We are now looking at the genetic factors that may regulate a person’s response to exercise to see if we can establish who will and who will not respond to this intervention. The use of biomarkers as a diagnostic tool for exercise also needs further research,” he added.
Since HIIT has benefits for people of any age, from heart health to a metabolism boost, talk to your doctor or personal trainer about adding it to your exercise regimen.
The combination of olive oil and almond flour creates a tender crumb that rivals any flour-based batter and a muffin that’s infinitely more nutritious. I like to use “tulip-shaped” cupcake liners because you can fill them right up to the level of your baking tin for very tall muffins. Also, topping the batter with berries after filling the liners helps keep the fruit from falling to the bottom.
Ingredients
3 cups almond flour
1-1/2 teaspoons baking powder
1/2 teaspoon fine sea salt
3/4 cup extra-virgin olive oil
1/2 cup sugar, divided use
Freshly grated zest of 1 large orange
1/2 cup fresh orange juice
6 eggs, separated
1 tablespoon vanilla paste
1 cup raspberries
Directions
Step 1
Preheat your oven to 350°F. Place tulip-shaped cupcake liners in the cups of a 12-muffin tin; set aside.
Step 2
In a large bowl, sift together the almond flour, baking powder, and salt. In a separate bowl, whisk together the olive oil, 1/4 cup sugar, orange zest and juice, egg yolks, and vanilla. Fold in the flour mixture.
Step 3
In a very large bowl or the bowl of a stand mixer, beat the egg whites on a low speed to break them up, about a minute. Once they start to foam, increase the speed to high and add the remaining sugar. Whip until the whites form stiff peaks, then use a large spatula to gently fold them into the almond flour mixture in 3 or 4 batches, rotating your mixing bowl as you move your spatula from the center out to the sides. Don’t overmix to avoid deflating the batter—a few streaks of whites are OK.
Step 4
Use a large ice cream scoop to fill the paper liners up to the level of your baking tin. Top with equal amounts of berries. Bake the muffins for 30 to 40 minutes, until the tip of a sharp knife comes out clean. Serve warm or at room temperature.
Rainbow Slaw Recipe, Spotlight on Barley, Ancient Grains to Combat Diabetes, and Exercise + Greenscape = Bliss
There’s everything to love about a no-cook side dish that’s as tasty as it is visually appealing. My twist on traditional coleslaw brings together three different cruciferous veggies—all known for their high-level nutrients—and an olive-oil based dressing that adds in a healthy dose of polyphenols. It also includes barley, a whole grain with surprising health benefits. Finally, take advantage of the warm, sunny days to move your exercise activities to a greenspace—this change of venue can have physical and emotional benefits.
Move over, mayo! A tangy vinaigrette is a great way to dress a slaw. And what a slaw this is—a colorful feast of fresh veggies enhanced with barley, an ancient grain that’s more versatile than you may think (see “Healthy Ingredient Spotlight” and “For Your Best Health” in this week’s newsletter).
Ingredients
3/4 cup uncooked hulled barley
3 tablespoons sherry vinegar
1 tablespoon Dijon mustard
1 tablespoon honey
1/4 cup chopped shallots
4 tablespoons extra virgin olive oil
1 pound head green cabbage, cored
1/2 pound head red cabbage, cored
1/2 pound Brussels sprouts, trimmed
2 yellow or red bell peppers, stems and ribs removed
1 red onion, trimmed
3 large carrots, scrubbed and peeled, if needed
1/4 cup fresh flat-leaf parsley, finely chopped
1/4 cup fresh dill, finely chopped
Coarse sea salt, to taste
Freshly ground black pepper to taste
Directions
Step 1
Prepare the barley according to package directions and set aside to cool. Make the vinaigrette by whisking together the vinegar, mustard, honey, and shallots. Slowly drizzle in the olive oil, whisking until the vinaigrette has emulsified.
Step 2
Grate all the vegetables by hand or machine and toss thoroughly in a very large glass mixing bowl along with the herbs. Add the vinaigrette and toss well again. Taste and add more vinegar, if desired, along with salt and pepper. Serve at room temperature but refrigerate any leftovers.
Yields 10 servings
Healthy Ingredient Spotlight
Barley
If you only know barley from beef barley soup, you’re missing out on so many other ways to enjoy this whole grain—as a side dish with sautéed onions, as a breakfast cereal with fruit, or as a layered parfait with yogurt, to name just a few. A toothsome swap for white rice (which has almost no fiber and few nutrients because it’s refined), barley delivers on fiber, protein, and many vitamins and minerals. It also helps keep blood glucose steady, promotes a healthy gut biome, and fills you up. Though the cooking time is longer, hulled barley retains far more nutrients than pearl barley, so shop for that. Note: Barley does contain gluten, so it’s not for people with celiac disease or gluten sensitivity.
Quick Kitchen Nugget
Make a Weekly Barley Batch
Take some time one day a week to make enough barley for four or more servings, so that it’s ready when you are. Though package directions vary, you often need 3 or 4 cups of water per cup of uncooked barley. Keep an eye on it as it cooks, since the water may evaporate before the barley is done. It should retain its shape and be chewy, not mushy.
For Your Best Health
Ancient Grains Combat Diabetes
According to the research review “Use of ancient grains for the management of diabetes mellitus: A systematic review and meta-analysis” published in the journal Nutrition, Metabolism and Cardiovascular Diseases, “there has been renewed interest in ancient grain varieties for their possible enhanced health benefits in [diabetes]. Ancient grains represent an important category of ancient cereals that have not undergone human breeding or genetic modification, thus preserving their inherent genetic features. The genetic diversity of these ancient crops not only offers a variety of food options but also represents a valuable genetic heritage to be preserved.”
The report goes on to detail the phytochemicals in ancient grains, including phytosterols, phenolic compounds like ferulic acid and lignans, flavonoids, and carotenoids, all linked to a variety of health benefits thanks to their antioxidant and anti-inflammatory properties. Among the grains in the many studies the researchers reviewed with positive results are oats, brown rice, millet, buckwheat, and barley. Many are rich in beta-glucan, a type of soluble fiber that has been shown to improve insulin sensitivity.
Separate studies done at the University of Arizona found that the beta-glucan in barley surpassed other grains in terms of cholesterol reduction—it helps flush it out of your body.
These and other research reports highlight the value of choosing these grains over refined ones—they take longer to cook but are more than worth the effort when it comes to feeling satisfied (they really fill you up!) and to improving heart health by mitigating two of its biggest risk factors: diabetes and high cholesterol.
Fitness Flash
Exercise + Greenscape = Bliss
We know from past studies that being in nature brings physical and mental health benefits similar to those of physical activity and, of course, we know the benefits of exercise in general. So could exercising in greenspace boost the separate health benefits of each?
To answer this and other questions, Jay Maddock, PhD, Regents Professor with the School of Public Health at Texas A&M University and director of the university-led collaborative Center for Health & Nature, along with Howard Frumkin, MD, DrPH, Hagler Fellow and senior vice president and director of the Land and People Lab, assessed existing evidence regarding physical activity in natural settings and developed strategies for promoting these activities. Their study, published in the American Journal of Lifestyle Medicine, identified several factors that affect how often people visit parks and natural settings, the extent to which they engage in physical activities once there, and the benefits they get from this activity.
Dr. Maddock and Dr. Frumkin found that research suggests exercising in a park or other natural setting is more beneficial than exercising indoors. Because the studies they reviewed focused on short-term outcomes (less than one year), whether these benefits occur over the long term remains to be seen. “Despite this, the research is clear that natural settings could be an effective venue for promoting physical activity,” Dr. Maddock said. “People generally enjoy being outdoors, with parks, trails, and community gardens being the most popular venues.”
What makes the outdoors more enticing? Physical features, like community centers, playgrounds, lighting, and clear signage; natural features, such as a tree canopy and scenic bodies of water; and factors like classes, festivals, a welcoming environment, and a perception of safety, as well as visitors’ strong feeling of connectedness to nature and belief that spending time in these spaces, all contribute.
“Parks and trails are particularly important due to their accessibility and widespread availability, but access varies significantly by geography, and rural areas often have less access to natural spaces because they have more privately held land,” Dr. Maddock said. “For example, nearly 98 percent of Illinois residents live within half a mile of a park, compared to only 29 percent in Mississippi.”
Getting outdoors to take in the countryside is one of my favorite parts of every fresh-pressed olive oil hunt. Here I am with Claudio Di Mercurio, one of the amazing olive growers in Penne, Italy.
Dr. Maddock and Dr. Frumkin also found that use of parks and greenspaces for physical activity varies across demographic groups, with men more likely than women to use these spaces for physical activity. In addition, a study of parks in Los Angeles found that Black adults are less likely than white adults to engage in physical activity in parks, while English-speaking Latinos are equally likely and Asian/Pacific Islanders are more likely.
“Some groups—Black, Indigenous, and other people of color, and immigrant and refugee populations, for example—often have experienced historic or current discrimination that hinders their use of natural spaces, and they routinely have less access to high-quality parks,” Dr. Frumkin said. “In addition, children, the elderly, and people with disabilities face challenges in accessing natural spaces. Ensuring that these spaces are safe and easy to navigate, with appropriate programming, could help increase their use of parks and other natural settings.”
With these complexities in mind, the researchers offered four options that health care professionals could implement to encourage the use of parks and other natural settings by their patients.
One is simply to “prescribe” nature contact to patients. “Recommending that patients spend more time in these settings is known as nature prescriptions, or ‘ParkRx,’ and while more research is needed, the studies to date suggest that this approach is effective,” Dr. Maddock said.
Another is for health professionals to model this behavior by engaging in it themselves—this is effective in promoting healthy behaviors while also enhancing the well-being of the health professionals.
A third approach is for health professionals to engage in community efforts that promote the use of outdoor spaces, such as Houston’s Be Well Communities initiative, which is supported by the M.D. Anderson Cancer Center.
Finally, health professionals could help create and maintain parks and greenspaces by steering funds into these efforts through Community Health Needs Assessments, Medicaid funds, and funds from health care conversion foundations.
“It is clear that the use of parks and natural settings for physical activities could be a potentially powerful tool for promoting two important health behaviors simultaneously,” Dr. Maddock said. “This could be especially important given that the majority of Americans do not get enough exercise or spend enough time outdoors.”
