Francesco Cipriani, M.D. - ars.toscana.it · Francesco Cipriani, M.D. Tuscan Regional Health Agency. ... - colon - uterus - prostate. FAT AND CANCER epidemiologic studies. EVOO components

Olive oil and health

Francesco Cipriani, M.D.

Tuscan Regional Health Agency

www.ars.toscana.it

Life expectancy at birth (years) – WHO, 2008

COUNTRY MALE FEMALE COUNTRY MALE FEMALEJapan 79 86 Canada 78 83Tuscany* 79 84 Norway 78 83Switzerland 79 84 Netherlands 78 82Iceland 79 83 New Zealand 78 82Sweden 79 83 France 77 84Cyprus 79 82 Austria 77 83Israel 79 82 Luxembourg 77 83Monaco 78 85 Belgium 77 82Italy 78 84 Germany 77 82Andorra 78 84 Greece 77 82S. Marino 78 84 Ireland 77 82Spain 78 84 Ireland 77 82Australia 78 83 Malta 77 81

* From: Regional Agency for Health, Tuscany Region 2006

Life expectancy at birth by gender- Tuscany

65

70

75

80

85

90

85,0

80,1

71,6

78,6

Female

Male

750

850

950

1.050

1.150

1.250

1.350

1.450

1.550

1.650

1.750

Mortality rates– Tuscany and Italy

Italy

Tuscany

Death causes in Tuscany

Tumori28,9%

Respiratorio7,3%

Altre11,8%

Traumi3,9%

Cardiocircolatorio39,9%

Neurologico4,1%

Digerente4,1%

Caridovascular diseases 40%

Cancer 29%

Respiratory 7%

Neurologic 4%

Gastrointesti 4%

Injuries 4%

Others 12%

Causes of cancerTobacco 30Diet and nutrition 30Infection (H. pylori, EBV,HPV,HCV.HBV,HIV, Schystosoma, …)

18Occupation 4-5Alcohol 3-6Genetic factors 4Environment 1-4Contaminated foods ?Drugs ?Radiation (Rx, UV, EMF) ?Hormonal and reproductive factors ?

Human laboratory studies (metabolic studies)

Animal studies

Epidemiologic studies

Diet and diseases

Cardiovascular diseases (CVD)Coronary hearth disease (CHD)Cerebrovascular diseases (CVD)Peripheral artery disease (PAD)

CancerGastrointestinal, Prostate, Breast, Others

Overweight, Obesity, Eating disordersDiabetes

HypertensionOsteoporosis

Gastrointestinal diseases (cirrhosis, gallstones)Dental disease

’60s - Ancel KeysMediterranean Diet

Seven different countries• The Seven Countries Study effectively documented the variations in CHD risk related to diet and

culture and demonstrated that the major risk factors are universal.

From: The seven countries study [http://sevencountriesstudy.com/]

Mediterranean Diet

Mediterranean Diet

A diet typical of the Mediterranean region, characterized by a pattern: high in fruits and vegetables, cereals and bread, potatoes, poultry, beans, nuts, olive oil and fish, low in red meat and dairymoderate in alcohol consumption.

- General mortality - 9 %

- CVD mortality - 9 %

- Cancer mortality - 6 %

- Parkinson and Alzheimer - 13 %

Source: (Sofi et al., 2008)

After 40 years of epidemiological studies on Mediterranean diet and health ……….

Blood lipids and CVD

CHOLESTEROL– LDL = “bad”

CHOLESTEROL – HDL = “good”

TRIGLYCERIDS

POSTPRANDIAL LIPIDS

Type of fats is more relevant than quantity

Dietary fats and health

DIETARY FATS and LDL/HDL RATIO effectsFATTY ACID C = NAME FOODS Blood lipids

C TOT

C LDL

CHDL

TRG

SATURURED 6 0 - CAPROIC BUTTER

8 0 - CAPRYLIC BUTTER

10 0 - CAPRIC BUTTER, COCONUT, PALM

12 0 - LAURIC BUTTER, COCONUT, PALM

14 0 - MYRISTIC BUTTER, COCONUT, PALM

16 0 - PALMITIC BUTTER, MEAT

18 0 - STEARIC BUTTER, MEAT, LARD

16 1 7 PALMITOLEICO FISH OIL

MONOUNSATURED 18 1 9 OLEIC OLIVE OIL, Avocado, Other seeds

POLYUNSATURED (PUFAs)

OMEGA-6 18 2 6 LINOLEIC (LA) SEED OILS

18 3 6

–LINOLEIC SEED OILS

20 3 6 DIOMO - -LINOLEIC SEED OILS

20 4 6 ARACHIDONIC SEED OILS, LARD

OMEGA-3 18 3 3 Alfa- LINOLENIC (ALA) FISH, VEG, WALNUT OIL

20 5 3 EICOSAPENTAENOIC (EPA) FISH OILS

22 5 3 DOCOSAPENTAENOIC (DPA) FISH OILS

22 6 3 DOCOSAESAENOIC (DHA) FISH OILS

http://www.conipiediperterra.com/il-salento-eletto-territorio-dellanno-2013-0213.html/olivi-puglia-10

2014: Clouds on olive oil production in Italy…..

OLIVE OIL AND HEALTH

• Olive oil and CVD• Olive oil and Cancer• Olive oil and other diseases

OLIVE OIL AND CVD

OLIVE OIL and CVD

1- OLIVE OIL = OLEIC ACID

2- OLEIC ACID = < LDL / HDL

3- OLIVE OIL = GOOD DIETARY LIPID

OIL SATURED UNSATURED

OLEIC LINOLEIC LINOLENIC

Peanut 19,5 52,5 26,3 0,1Coconut 91,2 7,5 0,8 0,0Rape 11,0 15,0 14,0 8,0Sunflower 7,5 34,0 57,5 0,5Corn 17,2 30,0 50,0 1,0

Olive 17,2 72,9 9,3 0,5Palma 80,8 18,5 0,7 0,0Sesame 14,2 43,4 40,4 0,4Soyy

15,8 23,5 51,2 8,5Canola 7,0 61,0 21,0 11,0

FATTY ACID CONTENT OF OILS

OLIVE OIL IS MUCH MORE THAN JUST OLEIC ACID

RELEVANCE OF “MINOR” COMPONENTS OF THE

UNSAPONIFIABLE AND SOLUBLE FRACTION OF EXTRA VIRGIN OLIVE

OIL (EVOO)

Selected components of EVOO, unsaponifiable fraction (1-2%)

Hydrocarbons

(squalene, …)Sterols

Terpene alcoholsPigments

TocopherolsCarotenoids

POLIPHENOLsTyrosol

HydroxytyrosolOleuropeinLigstrosideCaffeic

acid

………….

Poliphenols of Olive Oil

• Anti-inflammatory• Antioxidant• Antimicrobial

Better control of blood pressure and insulin-sensitivity (glycemic control)

Lower lipid oxidation (Eurolive study) thanks to phenolic compounds

Lower inflammatory markers, endothelial activation and thrombogenic state

Antiarrhytmic and vasodilator effect

OLIVE OIL AND CVD Other protective mechanism of Olive Oil

OLIVE OIL AND CANCER

http://epic.iarc.fr/

Dietary factors and Cancer risk

Level of strenghtLowered

riskNo risk

IncreasedRisk

ConvincingPhysical activity Overweight

AlcoholAflatoxinsSalted fish

ProbableFruit / Vegetables Cold cuts, Cured

meat, Salted foodsHot foods

PossibleFiber, Soy, Fish, Omega-3,Vit B, C, Carotenoids, Ca, Zn, Se,

Lauric acidBetacarotene Suppl

Insufficiente Ca, Mg, Vit. C

Animal fatsHAA Nitrosamine

Dietary fats are relevant for cancer of :- breast- colon- uterus- prostate

FAT AND CANCER epidemiologic studies

EVOO components with anticancer activity

SqualeneBetasitosterolTocopherolCarotenoids

POLIPHNOLS Tyrosol, Hydroxytyrosol

OleuropeinLingstrosideSecoiridoids

Lignans………….

OLIVE OIL AND OTHER DISEASES

OLIVE OIL IS PROTECTIVE FORHypertension

(< incidence)

Diabetes

(< incidence, > control)

Obesity

Metabolic

syndrome

Cognitive impairment

(in DietMed)

gastroduodenal

ulcer

Gallstones

Rheumatoid

arthritis

Dermatopathies

……………………..

1- OLIVE OIL is certainly useful for CVD prevention (if the total caloric intake is within the limits)

2- OLIVE OIL is probably more useful to avoid tumors than other fats

3- The research on the biological effects of different substances by the acid oleic contained in olive oil, not only with respect to the atherogenic processes and cancer, is rapidly developing and is very promising

4- In any case, the OLIVE OIL has never been reported as a risk for some disease

OLIVE OIL AND HEALTH - CONCLUSIONS