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Dietary oleic acid intake, olive oil consumption, and risk of cardiovascular and all-cause mortality

  • 1.

    Institute of Public Health Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230027, China

  • 2.

    Department of Clinical Nutrition, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China

Cite this:
CSTR: 32290.14.JUSTC-2024-0018
https://doi.org/10.52396/JUSTC-2024-0018
More Information
  • Author Bio:

    Huihui Lu is currently a master’s student at the Division of Life Sciences and Medicine, University of Science and Technology of China, under the supervision of Prof. Wei Bao. Her research mainly focuses on dietary fats and cardiovascular diseases

    Buyun Liu is currently a Professor at the Division of Life Sciences and Medicine, University of Science and Technology of China. She received her Ph.D. degree from the School of Public Health of the Sun Yat-sen University in 2015. Her research mainly focuses on the epidemiology of chronic noncommunicablediseases and lifelong health for women

    Wei Bao is currently a Professor at the Division of Life Sciences and Medicine, University of Science and Technology of China. He received his Ph.D. degree from Tongji Medical College of Huazhong University of Science and Technology in 2011. His research interests include epidemiology and prevention of chronic diseases across the life course

  • Corresponding author: E-mail: buyunliu@ustc.edu.cn; E-mail: wbao@ustc.edu.cn
  • Received Date: 12 February 2024
  • Accepted Date: 20 May 2024
    Abstract

  • Abstract

    Objective: Oleic acid, a subtype of monounsaturated fatty acid (MUFA), is present in abundance in certain edible oils, particularly olive oils. Epidemiological evidence concerning dietary oleic acid intake and the long-term risk of mortality is lacking. This study aimed to evaluate the associations of the dietary intake of oleic acid and other specific subtypes of MUFAs, olive oil, and other vegetable oils with cardiovascular disease (CVD) and all-cause mortality. Methods: This prospective cohort study included adults aged 40 years or older who participated in the included U.S. adults National Health and Nutrition Examination Survey (NHANES). Dietary MUFA intake was assessed via 24-h dietary recall interviews in NHANES 1999–2018, and the consumption of olive oil and other vegetable oils was assessed via a food frequency questionnaire in NHANES 2003–2006. Deaths and underlying causes of death were ascertained by linkage to the National Death Index through December 31, 2019. Weighted Cox proportional hazards regression models were used to estimate the hazard ratio (HR) and 95% CIs. Results: Dietary intake of total MUFAs and oleic acid was associated with a lower risk of CVD mortality, with HRs (95% CI) of 0.62 (0.39–0.99) and 0.61 (0.39–0.97), respectively. Total MUFA and oleic acid intake were inversely associated with all-cause mortality; the multivariable-adjusted HRs were 0.77 (95% CI: 0.60–0.99) and 0.78 (95% CI: 0.62–0.99), respectively. There was no significant association between palmitoleic acid intake and all-cause mortality. The habitual consumption of olive oil, but not the consumption of other vegetable oils, was inversely associated with the risk of cardiovascular mortality. In the joint association analysis, the HRs (95% CI) of cardiovascular mortality were 0.36 (0.19–0.69) for people who exclusively consumed olive oil, 0.59 (0.27–1.32) for people who consumed both olive oil and other vegetable oils, and 0.73 (0.46–1.14) for people who exclusively consumed other vegetable oils compared with people who never consumed vegetable oils. Conclusions: In a U.S. nationally representative prospective cohort, higher dietary oleic acid intake and olive oil consumption were associated with a lower risk of cardiovascular mortality.

    Graphical abstract

    Study design chart and adjusted HRs (95% CIs) for the associations between the dietary intake of oleic acid and the consumption of other specific subtypes of MUFAs, olive oil, and other vegetable oils and CVD and all-cause mortality.

    Abstract

    Objective: Oleic acid, a subtype of monounsaturated fatty acid (MUFA), is present in abundance in certain edible oils, particularly olive oils. Epidemiological evidence concerning dietary oleic acid intake and the long-term risk of mortality is lacking. This study aimed to evaluate the associations of the dietary intake of oleic acid and other specific subtypes of MUFAs, olive oil, and other vegetable oils with cardiovascular disease (CVD) and all-cause mortality. Methods: This prospective cohort study included adults aged 40 years or older who participated in the included U.S. adults National Health and Nutrition Examination Survey (NHANES). Dietary MUFA intake was assessed via 24-h dietary recall interviews in NHANES 1999–2018, and the consumption of olive oil and other vegetable oils was assessed via a food frequency questionnaire in NHANES 2003–2006. Deaths and underlying causes of death were ascertained by linkage to the National Death Index through December 31, 2019. Weighted Cox proportional hazards regression models were used to estimate the hazard ratio (HR) and 95% CIs. Results: Dietary intake of total MUFAs and oleic acid was associated with a lower risk of CVD mortality, with HRs (95% CI) of 0.62 (0.39–0.99) and 0.61 (0.39–0.97), respectively. Total MUFA and oleic acid intake were inversely associated with all-cause mortality; the multivariable-adjusted HRs were 0.77 (95% CI: 0.60–0.99) and 0.78 (95% CI: 0.62–0.99), respectively. There was no significant association between palmitoleic acid intake and all-cause mortality. The habitual consumption of olive oil, but not the consumption of other vegetable oils, was inversely associated with the risk of cardiovascular mortality. In the joint association analysis, the HRs (95% CI) of cardiovascular mortality were 0.36 (0.19–0.69) for people who exclusively consumed olive oil, 0.59 (0.27–1.32) for people who consumed both olive oil and other vegetable oils, and 0.73 (0.46–1.14) for people who exclusively consumed other vegetable oils compared with people who never consumed vegetable oils. Conclusions: In a U.S. nationally representative prospective cohort, higher dietary oleic acid intake and olive oil consumption were associated with a lower risk of cardiovascular mortality.

    • Public Summary

    • Higher dietary oleic acid intake and olive oil consumption are associated with a lower risk of CVD mortality, suggesting the importance of habitual intake of oleic acid and olive oil for improving cardiovascular health.
    • For promoting cardiovascular health, our findings may provide some dietary recommedations.

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    • References(35)
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    National Center For Health Statistics. The Linkage of National Center for Health Statistics Survey Data to the National Death Index– 2019 Linked Mortality File (LMF): Linkage Methodology and Analytic Considerations. 2021 . https://www.cdc.gov/nchs/data/datalinkage/2019NDI-Linkage-Methods-and-Analytic-Considerations-508.pdf. Accessed December 8, 2023.
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    Johnson C L, Paulose-Ram R, Ogden C L, et al. National health and nutrition examination survey: analytic guidelines, 1999-2010. In:Vital and Health Statistics:Series 2. National Center for Health Statistics, 2013 .
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    U. S. Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans. 2008 . https://health.gov/sites/default/files/2019-09/paguide.pdf. Accessed December 8, 2023.
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    Mazidi M, Mikhailidis D P, Sattar N, et al. Association of types of dietary fats and all-cause and cause-specific mortality: A prospective cohort study and meta-analysis of prospective studies with 1,164,029 participants. Clinical Nutrition, 2020, 39 (12): 3677–3686. doi: 10.1016/j.clnu.2020.03.028
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    [18]
    Zhang Y L, Jing L L, Xu X, et al. Dietary fatty acids intake and all-cause and cardiovascular mortality in patients on peritoneal dialysis. Clinical Nutrition, 2023, 42 (11): 2188–2197. doi: 10.1016/j.clnu.2023.09.002
    [19]
    Lotfi K, Salari-Moghaddam A, Yousefinia M, et al. Dietary intakes of monounsaturated fatty acids and risk of mortality from all causes, cardiovascular disease and cancer: A systematic review and dose-response meta-analysis of prospective cohort studies. Ageing Research Reviews, 2021, 72: 101467. doi: 10.1016/j.arr.2021.101467
    [20]
    Schwingshackl L, Hoffmann G. Monounsaturated fatty acids, olive oil and health status: a systematic review and meta-analysis of cohort studies. Lipids in Health and Disease, 2014, 13: 154. doi: 10.1186/1476-511X-13-154
    [21]
    Bermúdez M A, Pereira L, Fraile C, et al. Roles of palmitoleic acid and its positional isomers, hypogeic and sapienic acids, in inflammation, metabolic diseases and cancer. Cells, 2022, 11 (14): 2146. doi: 10.3390/cells11142146
    [22]
    Garg M L, Blake R J, Wills R B. Macadamia nut consumption lowers plasma total and LDL cholesterol levels in hypercholesterolemic men. The Journal of Nutrition, 2003, 133 (4): 1060–1063. doi: 10.1093/jn/133.4.1060
    [23]
    Griel A E, Cao Y, Bagshaw D D, et al. A macadamia nut-rich diet reduces total and LDL-cholesterol in mildly hypercholesterolemic men and women. The Journal of Nutrition, 2008, 138 (4): 761–767. doi: 10.1093/jn/138.4.761
    [24]
    Mozaffarian D, Cao H, King I B, et al. Circulating palmitoleic acid and risk of metabolic abnormalities and new-onset diabetes. The American Journal of Clinical Nutrition, 2010, 92 (6): 1350–1358. doi: 10.3945/ajcn.110.003970
    [25]
    Kim D S, Maden S K, Burt A A, et al. Dietary fatty acid intake is associated with paraoxonase 1 activity in a cohort-based analysis of 1,548 subjects. Lipids in Health and Disease, 2013, 12: 183. doi: 10.1186/1476-511X-12-183
    [26]
    Bremer J, Norum K R. Metabolism of very long-chain monounsaturated fatty acids (22: 1) and the adaptation to their presence in the diet. Journal of Lipid Research, 1982, 23 (2): 243–256. doi: 10.1016/S0022-2275(20)38153-0
    [27]
    Zhang Y, Zhuang P, Wu F, et al. Cooking oil/fat consumption and deaths from cardiometabolic diseases and other causes: prospective analysis of 521, 120 individuals. BMC Medicine, 2021, 19: 92. doi: 10.1186/s12916-021-01961-2
    [28]
    Schwingshackl L, Christoph M, Hoffmann G. Effects of olive oil on markers of inflammation and endothelial function—A systematic review and meta-analysis. Nutrients, 2015, 7 (9): 7651–7675. doi: 10.3390/nu7095356
    [29]
    Wang Q, Liu R J, Chang M, et al. Dietary oleic acid supplementation and blood inflammatory markers: a systematic review and meta-analysis of randomized controlled trials. Critical Reviews in Food Science and Nutrition, 2022, 62 (9): 2508–2525. doi: 10.1080/10408398.2020.1854673
    [30]
    Hernáez Á, Remaley A T, Farràs M, et al. Olive oil polyphenols decrease LDL concentrations and LDL atherogenicity in men in a randomized controlled trial. The Journal of Nutrition, 2015, 145 (8): 1692–1697. doi: 10.3945/jn.115.211557
    [31]
    Fernández-Castillejo S, Valls R M, Castañer O, et al. Polyphenol rich olive oils improve lipoprotein particle atherogenic ratios and subclasses profile: A randomized, crossover, controlled trial. Molecular Nutrition & Food Research, 2016, 60 (7): 1544–1554. doi: 10.1002/mnfr.201501068
    [32]
    Saibandith B, Spencer J P E, Rowland I R, et al. Olive polyphenols and the metabolic syndrome. Molecules, 2017, 22 (7): 1082. doi: 10.3390/molecules22071082
    [33]
    Schwingshackl L, Lampousi A M, Portillo M P, et al. Olive oil in the prevention and management of type 2 diabetes mellitus: a systematic review and meta-analysis of cohort studies and intervention trials. Nutrition & Diabetes, 2017, 7: e262. doi: 10.1038/nutd.2017.12
    [34]
    Gaforio J J, Visioli F, Alarcón-De-La-Lastra C, et al. Virgin olive oil and health: Summary of the III International Conference on Virgin Olive Oil and Health Consensus Report, JAEN (Spain) 2018. Nutrients, 2019, 11 (9): 2039. doi: 10.3390/nu11092039
    [35]
    Millman J F, Okamoto S, Teruya T, et al. Extra-virgin olive oil and the gut-brain axis: influence on gut microbiota, mucosal immunity, and cardiometabolic and cognitive health. Nutrition Reviews, 2021, 79 (12): 1362–1374. doi: 10.1093/nutrit/nuaa148
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    Figure  1.  Flow chart of participant selection.

    [1]
    World Health Organization. Cardiovascular diseases (CVDs). 2021 . https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds). Accessed December 8, 2023.
    [2]
    Pallazola V A, Davis D M, Whelton S P, et al. A clinician’s guide to healthy eating for cardiovascular disease prevention. Mayo Clinic Proceedings:Innovations, Quality & Outcomes, 2019, 3 (3): 251–267. doi: 10.1016/j.mayocpiqo.2019.05.001
    [3]
    U. S. Department of Health and Human Services, and U.S. Department of Agriculture. Dietary Guidelines for Americans, 2020-2025. 2020 . https://odphp.health.gov/our-work/nutrition-physical-activity/dietary-guidelines/current-dietary-guidelines. Accessed December 8, 2023.
    [4]
    Buckland G, Mayén A L, Agudo A, et al. Olive oil intake and mortality within the Spanish population (EPIC-Spain). The American Journal of Clinical Nutrition, 2012, 96 (1): 142–149. doi: 10.3945/ajcn.111.024216
    [5]
    Guasch-Ferré M, Hu F B, Martínez-González M A, et al. Olive oil intake and risk of cardiovascular disease and mortality in the PREDIMED Study. BMC Medicine, 2014, 12: 78. doi: 10.1186/1741-7015-12-78
    [6]
    Estruch R, Ros E, Salas-Salvadó J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. The New England Journal of Medicine, 2018, 378 (25): e34. doi: 10.1056/NEJMoa1800389
    [7]
    Guasch-Ferré M, Li Y, Willett W C, et al. Consumption of olive oil and risk of total and cause-specific mortality among U.S. adults. Journal of the American College of Cardiology, 2022, 79 (2): 101–112. doi: 10.1016/j.jacc.2021.10.041
    [8]
    National Center For Health Statistics. The Linkage of National Center for Health Statistics Survey Data to the National Death Index– 2019 Linked Mortality File (LMF): Linkage Methodology and Analytic Considerations. 2021 . https://www.cdc.gov/nchs/data/datalinkage/2019NDI-Linkage-Methods-and-Analytic-Considerations-508.pdf. Accessed December 8, 2023.
    [9]
    World Health Organization. ICD-10 : international statistical classification of diseases and related health problems : tenth revision, 2nd ed. World Health Organization, 2004 . https://iris.who.int/handle/10665/42980. Accessed December 8, 2023.
    [10]
    U.S. Department of Agriculture. USDA Automated Multiple-Pass Method for Dietary Recalls. 2021 . https://www.ars.usda.gov/northeast-area/beltsville-md-bhnrc/beltsville-human-nutrition-research-center/food-surveys-research-group/docs/main-service-page/. Accessed December 8, 2023.
    [11]
    National Health And Nutrition Examination Survey. 2003–2004 Data Documentation, Codebook, and Frequencies: Food Frequency Questionnaire - Raw Questionnaire Responses. 2008 . https://wwwn.cdc.gov/Nchs/Nhanes/2003-2004/FFQRAW_C.htm. Accessed December 8, 2023.
    [12]
    Johnson C L, Paulose-Ram R, Ogden C L, et al. National health and nutrition examination survey: analytic guidelines, 1999-2010. In:Vital and Health Statistics:Series 2. National Center for Health Statistics, 2013 .
    [13]
    U. S. Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans. 2008 . https://health.gov/sites/default/files/2019-09/paguide.pdf. Accessed December 8, 2023.
    [14]
    Krebs-Smith S M, Pannucci T E, Subar A F, et al. Update of the healthy eating index: HEI-2015. Journal of the Academy of Nutrition and Dietetics, 2018, 118 (9): 1591–1602. doi: 10.1016/j.jand.2018.05.021
    [15]
    Mazidi M, Mikhailidis D P, Sattar N, et al. Association of types of dietary fats and all-cause and cause-specific mortality: A prospective cohort study and meta-analysis of prospective studies with 1,164,029 participants. Clinical Nutrition, 2020, 39 (12): 3677–3686. doi: 10.1016/j.clnu.2020.03.028
    [16]
    Yao X L, Xu X, Wang S, et al. Associations of dietary fat intake with mortality from all causes, cardiovascular disease, and cancer: A prospective study. Frontiers in Nutrition, 2021, 8: 701430. doi: 10.3389/fnut.2021.701430
    [17]
    Guasch-Ferré M, Babio N, Martínez-González M A, et al. Dietary fat intake and risk of cardiovascular disease and all-cause mortality in a population at high risk of cardiovascular disease. The American Journal of Clinical Nutrition, 2015, 102 (6): 1563–1573. doi: 10.3945/ajcn.115.116046
    [18]
    Zhang Y L, Jing L L, Xu X, et al. Dietary fatty acids intake and all-cause and cardiovascular mortality in patients on peritoneal dialysis. Clinical Nutrition, 2023, 42 (11): 2188–2197. doi: 10.1016/j.clnu.2023.09.002
    [19]
    Lotfi K, Salari-Moghaddam A, Yousefinia M, et al. Dietary intakes of monounsaturated fatty acids and risk of mortality from all causes, cardiovascular disease and cancer: A systematic review and dose-response meta-analysis of prospective cohort studies. Ageing Research Reviews, 2021, 72: 101467. doi: 10.1016/j.arr.2021.101467
    [20]
    Schwingshackl L, Hoffmann G. Monounsaturated fatty acids, olive oil and health status: a systematic review and meta-analysis of cohort studies. Lipids in Health and Disease, 2014, 13: 154. doi: 10.1186/1476-511X-13-154
    [21]
    Bermúdez M A, Pereira L, Fraile C, et al. Roles of palmitoleic acid and its positional isomers, hypogeic and sapienic acids, in inflammation, metabolic diseases and cancer. Cells, 2022, 11 (14): 2146. doi: 10.3390/cells11142146
    [22]
    Garg M L, Blake R J, Wills R B. Macadamia nut consumption lowers plasma total and LDL cholesterol levels in hypercholesterolemic men. The Journal of Nutrition, 2003, 133 (4): 1060–1063. doi: 10.1093/jn/133.4.1060
    [23]
    Griel A E, Cao Y, Bagshaw D D, et al. A macadamia nut-rich diet reduces total and LDL-cholesterol in mildly hypercholesterolemic men and women. The Journal of Nutrition, 2008, 138 (4): 761–767. doi: 10.1093/jn/138.4.761
    [24]
    Mozaffarian D, Cao H, King I B, et al. Circulating palmitoleic acid and risk of metabolic abnormalities and new-onset diabetes. The American Journal of Clinical Nutrition, 2010, 92 (6): 1350–1358. doi: 10.3945/ajcn.110.003970
    [25]
    Kim D S, Maden S K, Burt A A, et al. Dietary fatty acid intake is associated with paraoxonase 1 activity in a cohort-based analysis of 1,548 subjects. Lipids in Health and Disease, 2013, 12: 183. doi: 10.1186/1476-511X-12-183
    [26]
    Bremer J, Norum K R. Metabolism of very long-chain monounsaturated fatty acids (22: 1) and the adaptation to their presence in the diet. Journal of Lipid Research, 1982, 23 (2): 243–256. doi: 10.1016/S0022-2275(20)38153-0
    [27]
    Zhang Y, Zhuang P, Wu F, et al. Cooking oil/fat consumption and deaths from cardiometabolic diseases and other causes: prospective analysis of 521, 120 individuals. BMC Medicine, 2021, 19: 92. doi: 10.1186/s12916-021-01961-2
    [28]
    Schwingshackl L, Christoph M, Hoffmann G. Effects of olive oil on markers of inflammation and endothelial function—A systematic review and meta-analysis. Nutrients, 2015, 7 (9): 7651–7675. doi: 10.3390/nu7095356
    [29]
    Wang Q, Liu R J, Chang M, et al. Dietary oleic acid supplementation and blood inflammatory markers: a systematic review and meta-analysis of randomized controlled trials. Critical Reviews in Food Science and Nutrition, 2022, 62 (9): 2508–2525. doi: 10.1080/10408398.2020.1854673
    [30]
    Hernáez Á, Remaley A T, Farràs M, et al. Olive oil polyphenols decrease LDL concentrations and LDL atherogenicity in men in a randomized controlled trial. The Journal of Nutrition, 2015, 145 (8): 1692–1697. doi: 10.3945/jn.115.211557
    [31]
    Fernández-Castillejo S, Valls R M, Castañer O, et al. Polyphenol rich olive oils improve lipoprotein particle atherogenic ratios and subclasses profile: A randomized, crossover, controlled trial. Molecular Nutrition & Food Research, 2016, 60 (7): 1544–1554. doi: 10.1002/mnfr.201501068
    [32]
    Saibandith B, Spencer J P E, Rowland I R, et al. Olive polyphenols and the metabolic syndrome. Molecules, 2017, 22 (7): 1082. doi: 10.3390/molecules22071082
    [33]
    Schwingshackl L, Lampousi A M, Portillo M P, et al. Olive oil in the prevention and management of type 2 diabetes mellitus: a systematic review and meta-analysis of cohort studies and intervention trials. Nutrition & Diabetes, 2017, 7: e262. doi: 10.1038/nutd.2017.12
    [34]
    Gaforio J J, Visioli F, Alarcón-De-La-Lastra C, et al. Virgin olive oil and health: Summary of the III International Conference on Virgin Olive Oil and Health Consensus Report, JAEN (Spain) 2018. Nutrients, 2019, 11 (9): 2039. doi: 10.3390/nu11092039
    [35]
    Millman J F, Okamoto S, Teruya T, et al. Extra-virgin olive oil and the gut-brain axis: influence on gut microbiota, mucosal immunity, and cardiometabolic and cognitive health. Nutrition Reviews, 2021, 79 (12): 1362–1374. doi: 10.1093/nutrit/nuaa148
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