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

Background: Olive oil consumption has been shown to lower cardiovascular disease risk, but its associations with total and cause-specific mortality are unclear. Objectives: To evaluate whether olive oil intake is associated with total and cause-specific mortality in two prospective cohorts of U.S. men and women. Methods: We used multivariable-adjusted Cox proportional-hazards models to estimate hazard ratios 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 semi-quantitative food frequency questionnaire every 4 years. Results: During 28 years of follow-up, 36,856 deaths occurred. The multivariable-adjusted pooled HR (95% CI) for all-cause mortality among participants who had the highest consumption of olive oil (>1/2 tablespoon/d or >7g/d) was 0.81 (0.78, 0.84) as compared to those who never or rarely consumed olive oil. Higher olive oil intake was associated with 19% lower risk of cardiovascular disease mortality [0.81(0.75, 0.87)], 17% lower risk of cancer mortality [0.83(0.78, 0.89)], 29% lower risk of neurodegenerative disease mortality [0.71(0.64, 0.78)], and 18% lower risk of respiratory disease mortality [0.82(0.72, 0.93)]. In substitution analyses, replacing 10g/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.