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Higher olive oil intake associated with lower all-cause and cardiovascular mortality

25th January 2022

Higher olive oil intake is associated with a lower total and cardiovascular mortality compared with those who rarely or never consume it

A higher olive oil intake has been linked to a lower all-cause and cardiovascular mortality compared to those who either never or rarely consume it. This was the finding of a study by researchers from the Department of Nutrition, Harvard T.H. Chan School of Public Health, Massachusetts, USA.

Olive oil (OO) consumption has been associated with a myriad of health benefits due to the presence of monounsaturated fatty acids which possess anti-inflammatory and anti-oxidant properties. Moreover, evidence from epidemiological studies show that greater olive oil intake and in-particular, extra virgin olive oil, is associated with a 39% lower risk of cardiovascular disease. Nevertheless, there is a paucity of data on the relationship between total olive oil intake on both all-cause and cause-specific mortality.

For the present study, the Harvard team used data from two ongoing prospective US cohort studies, the Nurses Health Study (NHS) which began in 1976 and the Health professionals Follow-up study (HPFS) which started in 1986. In both studies, participants are sent questionnaires, every two years to assess lifestyle factors and health status and for the present analysis, team used the baseline level of OO intake which was first captured in 1990. For the purposes of the analysis, one tablespoon was considered to be equivalent to 13.5 g of OO. Consumption of olive oil was then categorised by frequency as never or less than once/month (the reference point), > 0 < 1 teaspoon, > 1 to < 2 teaspoons and greater than half a tablespoon (equivalent to > 7 gm/day.

The researchers identified both the total number of deaths during the period of follow-up and the cause from medical records. Multivariable regression analysis was used to estimate the risk of total and cause-specific mortality and models were adjusted for a number of covariates such as age, gender, smoking status, body mass index etc.

Findings

During a 28 year follow-up period, there were 36,856 deaths and the mean OO consumption increased from 1.6g/day in 1990 to 4g/day in 2010.

Among those with the highest intake of OO, compared to the reference category, there was 19% reduced risk of total mortality (Hazard ratio, HR = 0.81, 95% CI 0.78 – 0.87) and cardiovascular mortality (HR = 0.81, 95% CI 0.75 – 0.89). In addition, the researchers found that increased OO intake reduced the risk of cancer and neurodegenerative mortality by 29% and 18% respectively.

In a further analysis, the Harvard team considered the mortality benefits of substituting other sources of fat with olive oil. For example, they calculated that replacing 10 g/day of margarine with an equivalent amount of OO was associated with a 13% lower risk of mortality and similar reductions were seen for butter, mayonnaise and dairy fat. They also observed that these reduced risk were also consistent for other causes of death.

They concluded that greater consumption of olive oil lead to reductions in all-cause and cause-specific mortalities and such reductions in risk could also be achieved when other types of fat were replaced with olive oil.

Citation

Guash-Ferre M et al. Consumption of Olive Oil and Risk of Total and Cause-Specific Mortality Among U.S. Adults J Am Coll Cardiol 2022

Physical inactivity potentially responsible for over 46,000 cancer cases in US

25th October 2021

Physical inactivity is potentially responsible for over 46,000 annual cancer cases in the US, highlighting the need for greater activity.

Physical inactivity could be the cause of 46,356 cancer cases across the US based on an analysis by researchers from the Department of Surveillance and Health Equity Science, Atlanta, US, on behalf of the American Cancer Society. The importance of undertaking physical activity as a means of reducing the risk of cancer, was highlighted in a 2019 systematic review which found strong evidence for an association between the highest versus lowest physical activity levels and reduced risks of bladder, breast, colon, endometrial, oesophageal adenocarcinoma, renal and gastric cancers. The review also identified how greater amounts of physical activity reduced cancer-specific mortality in those with breast, colorectal, or prostate cancer, with relative risk reductions of between 40 and 50 percent.

But how the risk of cancer due to physical inactivity vary across different states in the US was the question posed in the study by the American Cancer Society. The researchers estimated the proportion of cancer cases attributable to physical inactivity overall and for seven types of cancer (oesophagus, stomach, colon, breast in women, corpus uteri, kidney and bladder). The researchers drew on data from the Behavioural Risk Factor Surveillance System (BRFSS), which collects state-level estimates of various health-related behaviours including information on physical activity. The information on physical activity was drawn from surveys conducted between 2003 and 2006 across a wide age range and the number of incident cancer cases in 2013 – 2016, were obtained from the US Cancer Statistics database, to allow for a lag time between exposure prevalence and the occurrence of cancer.

The levels of physical activity were categorised in terms of metabolic equivalent task (MET) hours/week. A MET is the amount of energy an average adult expends sitting at rest. With the US physical activity guidelines recommending that adults engage in 2.5 to 5 hours/week of moderate intensity activity, this equates to at least 7.5 – 15 MET hours/week. For the purposes of their analysis, the researchers defined optimal physical activity as > 5 hours/week or > 15 MET-hours/week. The team also calculated the population attributable fraction (PAF) which can be used to quantify how a risk factor contributes to the outcome of interest compared, in this case, physical inactivity and cancer.

Findings

When optimal physical activity was defined as > 15 MET-hours/week, the overall PAF for both sexes was 3% (95% CI 2.9 – 3%). This amounted to 46,356 incident cancer cases in adults aged > 30 years, that could be attributed to physical inactivity. The overall PAF was higher in women than men (4.1% vs 1.8%), with the result that  32,089 incident cancer cases in women and 14,277 cases in men were attributable physical inactivity.

With respect to the individual cancers, stomach cancer had the highest PAF (16.9%), followed by corpus uteri (11.9%), kidney (11%), colon (9.3%), oesophagus (8.1%), breast (6.5%) and bladder (3.9%). In addition, PAF values varied across the US for the different cancer. For example, the PAF for stomach cancer was 14% in Montana and 21.1% in Kentucky.

The researchers concluded that physical inactivity was a potentially avoidable cause of a large number of cancers and that promoting physical activity could prevent many cases.

Citation

Minihan AK et al. Proportion of Cancer Cases Attributable to Physical Inactivity by US State, 2013-2016. Med Sci Sports Exerc 2021