Heart-Healthy Cooking Oil: What the Research Says, and Why Extra Virgin Olive Oil Leads
If you are looking for a heart-healthy cooking oil, the evidence gives a clearer answer than the supermarket shelf suggests. The first and biggest decision is to cook with a liquid, non-tropical plant oil rather than butter, lard, ghee or coconut oil — that swap is what the American Heart Association's 2017 review of the trials credits with roughly 30% less cardiovascular disease. The second decision is which liquid oil. Here extra virgin olive oil leads: it is the cooking oil most closely tied to randomised trials of heart outcomes, through the PREDIMED trial, and it carries its own polyphenol health claim in the EU and UK registers. It does not win every measure, and this guide says where it doesn't. It is also a food, not a medicine.
For our own oil, see our cold-pressed single-estate extra virgin olive oil from Marrakech.
The Short Answer
- The heart-health gain comes mostly from the swap: randomised trials that replaced saturated fat with polyunsaturated vegetable oil cut cardiovascular disease by about 30%, according to the American Heart Association's 2017 presidential advisory (Sacks et al., Circulation) [1].
- The American Heart Association's shopping rule is simple: choose a non-tropical liquid oil with less than 4 grams of saturated fat per tablespoon and no partially hydrogenated oil.
- Extra virgin olive oil has unusually strong outcome evidence for a cooking oil. In the PREDIMED trial of 7,447 Spanish adults at high cardiovascular risk, a Mediterranean diet supplemented with extra virgin olive oil was linked to fewer major cardiovascular events than a reduced-fat control diet (hazard ratio 0.69) [2].
- The "extra virgin" part matters: in the EUROLIVE trial of 200 healthy men, HDL cholesterol rose and oxidative-stress markers fell in step with an olive oil's polyphenol content [3].
- Olive oil is not the winner on everything. A 2018 network meta-analysis of 54 trials ranked safflower and rapeseed oil above olive oil for lowering LDL cholesterol [4], and a 28-year US cohort found no significant difference between olive oil and other vegetable oils [5].
- Sidr & Stone's olive oil is a cold-pressed, unfiltered, single-estate extra virgin oil from Marrakech. We do not yet publish a laboratory polyphenol figure, so we make no polyphenol claim for our own bottle.
What Makes a Cooking Oil "Heart-Healthy"?
A heart-healthy cooking oil is one that is mostly unsaturated fat, low in saturated fat, free of trans fat, and used in place of solid fats rather than on top of them. The American Heart Association's practical test is a non-tropical liquid oil with less than 4 grams of saturated fat per tablespoon — which rules in olive, rapeseed (canola), sunflower, safflower, corn, soybean and peanut oil, and rules out butter, lard, shortening, palm oil and coconut oil.
The reason is the evidence on replacement. The 2017 American Heart Association presidential advisory led by Frank Sacks reviewed the trials and concluded that lowering saturated fat and replacing it with polyunsaturated vegetable oil reduced cardiovascular disease by about 30% [1]. The same idea sits in the UK and EU health-claim register, which permits the statement that "replacing saturated fats in the diet with unsaturated fats contributes to the maintenance of normal blood cholesterol levels" for foods high in unsaturated fat.
So the first question is not "olive or rapeseed?" It is "liquid plant oil or solid fat?" Our ranked guide to the healthiest cooking oil sets out every common oil's fat profile side by side; this article stays with the heart.
The Heart Evidence Behind Extra Virgin Olive Oil
Extra virgin olive oil leads among cooking oils because it has been tested where it matters most: in randomised trials measuring heart attacks, strokes and cardiovascular deaths, not only blood markers. Few everyday cooking oils have a comparable body of modern outcome research.
| Study | Design and size | What it found | Main limit |
|---|---|---|---|
| PREDIMED (Estruch et al., NEJM, 2018) [2] | Randomised trial, 7,447 adults aged 55–80 at high risk, no heart disease at entry | Mediterranean diet plus extra virgin olive oil: 3.8% had a major cardiovascular event vs 4.4% on the control diet (HR 0.69) | Republished in 2018 after randomisation irregularities; tested a whole diet, not the oil alone |
| PREDIMED olive oil analysis (Guasch-Ferré et al., BMC Medicine, 2014) [6] | Analysis of olive oil intake within the PREDIMED cohort | Each extra 10 g a day of extra virgin olive oil was associated with 10% lower cardiovascular disease risk | Observational analysis within a trial population |
| CORDIOPREV (Delgado-Lista et al., Lancet, 2022) [7] | Randomised trial, 1,002 people with established coronary heart disease, 7 years | Mediterranean diet vs low-fat diet: 87 vs 111 major cardiovascular events (adjusted HR 0.719–0.753) | Single centre; effect clearer in men; funding included olive oil foundations |
| Nurses' Health Study and HPFS (Guasch-Ferré et al., JACC, 2022) [5] | Cohort, 92,383 US adults, 28 years | More than half a tablespoon a day linked to 19% lower cardiovascular death vs rarely or never | Observational; no significant difference vs other vegetable oils |
PREDIMED is the anchor. Estruch and colleagues assigned 7,447 people to a Mediterranean diet with extra virgin olive oil, a Mediterranean diet with nuts, or advice to reduce dietary fat; the olive oil group had a hazard ratio of 0.69 for major cardiovascular events compared with the control diet [2]. The honest footnote is that the original 2013 paper was retracted and republished in 2018 after randomisation problems at some sites — the results held when the 1,588 affected participants were excluded.
CORDIOPREV extends the picture to people who already have coronary heart disease: over seven years, a Mediterranean diet beat a low-fat diet for major cardiovascular events [7]. That is research on an eating pattern under medical supervision — not a reason for anyone with a heart condition to change their diet without their care team.
Why "Extra Virgin" Matters: Polyphenols and the EU Claim
Extra virgin olive oil is pressed mechanically and never refined, so it keeps polyphenols such as hydroxytyrosol, tyrosol and the oleuropein complex. Refined olive oil, "light" olive oil and pomace oil lose most of them. That difference shows up in research.
The EUROLIVE trial (Covas et al., Annals of Internal Medicine, 2006) gave 200 healthy men in five European countries 25 mL a day of three olive oils that were alike except for polyphenol content — low (2.7 mg/kg), medium (164 mg/kg) and high (366 mg/kg) — in a randomised crossover design [3]. HDL cholesterol rose in a straight line with polyphenol content, the total-to-HDL cholesterol ratio fell, and markers of oxidative stress fell as polyphenols rose. These were three-week periods measuring blood markers, not heart attacks, but the dose-response pattern is the clearest evidence that the grade of olive oil matters.
Regulators recognise one specific effect. Commission Regulation (EU) No 432/2012, as published on legislation.gov.uk, permits the claim that "olive oil polyphenols contribute to the protection of blood lipids from oxidative stress". It may be used only for olive oil containing at least 5 mg of hydroxytyrosol and its derivatives per 20 g of oil, with the consumer told that the effect is obtained with a daily intake of 20 g. That is a claim about protecting blood fats from oxidation — not a claim about preventing heart disease — and it attaches to a measured polyphenol level, not to the words "olive oil". Our explainer on olive oil polyphenols goes further into the compounds themselves.
Where Other Oils Hold Their Own
The fair objection to "olive oil leads" is that other liquid oils do some things as well or better. On LDL cholesterol alone, they do. Schwingshackl and colleagues' 2018 network meta-analysis of 54 trials in the Journal of Lipid Research ranked safflower oil first and rapeseed oil second for lowering LDL; every liquid oil studied, olive included, lowered LDL more than butter [4].
The 28-year US cohort points the same way. Guasch-Ferré and colleagues found that replacing 10 g a day of margarine, butter, mayonnaise or dairy fat with olive oil was associated with 8–34% lower mortality, but olive oil showed no significant advantage over other vegetable oils [5]. In plain terms: moving from solid fat to any good liquid oil does most of the work.
Why, then, put extra virgin olive oil first? Because it combines modern randomised outcome trials, its own authorised polyphenol wording and a dose-response effect tied to its grade — in an unrefined oil you can cook with day to day. Rapeseed oil is a genuinely good second choice — the comparison is in our olive oil vs canola oil guide.
How to Choose and Cook With a Heart-Healthy Oil
Six checks cover most of what matters when you buy and use an oil with your heart in mind:
- Choose a liquid, non-tropical plant oil over butter, ghee, lard, palm or coconut oil.
- Check the label: under 4 g of saturated fat per tablespoon and no partially hydrogenated oil.
- For olive oil, buy "extra virgin" — not "light", "pure" or plain "olive oil", which are refined.
- Prefer dark glass or a tin, and check the harvest or best-before date.
- Use it instead of a solid fat, not as well as one — the swap is the benefit.
- Cook gently for everyday dishes and use some raw, where its polyphenols are best preserved.
Extra virgin olive oil is suitable for normal sautéing, roasting and shallow frying; our guide to olive oil at high heat explains what happens in the pan. For the label checks in detail, see our guide to choosing a quality olive oil.
Why Sidr & Stone
The research above rewards an olive oil that is genuinely extra virgin, unrefined and fresh. Sidr & Stone's olive oil is a cold-pressed, unfiltered extra virgin oil from our own single-estate farm on the plains outside Marrakech, Morocco.
- Single-estate — Sidr & Stone's olive oil comes from our own family-owned farm near Marrakech, and we control every step from tree to bottle, with no blending across origins.
- Rain-fed — our trees are not irrigated; they take what the season gives.
- Organically grown — no synthetic fertilisers, pesticides or herbicides are used (not yet certified; certification is in progress).
- Single harvest — a small, limited batch, picked when the fruit is ready; the current batch's harvest details are on the product page.
- Cold-pressed within hours of harvest — mechanical extraction only, with no solvents, refining or deodorising.
- Unfiltered extra virgin — minimally processed, so it may show natural sediment, which is normal.
- 100% natural — a single ingredient, olive oil, with nothing added.
- Dark glass with a gold label — protective packaging against light.
- 10% of profits to charity — a brand-wide commitment.
- Fulfilment in the UK, EU, and US.
We will not tell you our oil is the most heart-healthy olive oil, and we do not apply the EU polyphenol claim to it — that claim requires a measured polyphenol level, and we have not yet published a laboratory figure. What we will say is that it is single-estate, rain-fed, organically grown and cold-pressed within hours of harvest: the unrefined, extra virgin kind of oil the heart research actually studied.
Frequently Asked Questions
What is the most heart-healthy cooking oil?
On current evidence, extra virgin olive oil: it has randomised trials of heart outcomes behind it and keeps its polyphenols because it is unrefined. Rapeseed (canola) oil is a close second and lowers LDL cholesterol slightly more in trials.
Why is replacing butter with oil good for the heart?
Butter, ghee and coconut oil are mostly saturated fat, which raises LDL cholesterol. The American Heart Association's 2017 advisory found that trials replacing saturated fat with polyunsaturated vegetable oil reduced cardiovascular disease by about 30%.
How do I check if a cooking oil is heart-healthy?
Read the nutrition panel: the American Heart Association suggests less than 4 grams of saturated fat per tablespoon and no partially hydrogenated oils. For olive oil, also check that it says "extra virgin".
Which oil is best for heart patients?
Anyone with a heart condition should follow their cardiologist or dietitian. For context, the CORDIOPREV trial of 1,002 people with coronary heart disease found fewer cardiovascular events on a Mediterranean diet than on a low-fat diet over seven years.
Is Sidr & Stone's olive oil a heart-healthy choice?
It is a cold-pressed, unfiltered extra virgin olive oil — the grade studied in PREDIMED. We do not yet publish a polyphenol figure, so we make no specific health claim for our bottle.
Is cooking with olive oil bad for your heart?
No. Extra virgin olive oil is stable enough for everyday sautéing and roasting. Some polyphenols are lost with heat, so using part of your oil raw keeps more of them.
Where can I buy single-estate extra virgin olive oil?
Look for a producer that names one estate and sells only extra virgin oil in dark glass. Ours is available to pre-order from our limited single-harvest batch, with fulfilment in the UK, EU, and US.
Is olive oil a medicine?
No. Olive oil is a food, not a medicine. It has a long traditional history — including being honoured in the Prophetic Sunnah — and a substantial body of modern research, particularly around polyphenols, cardiovascular health, and the Mediterranean diet pattern. It can be a worthwhile part of a healthy routine, but it does not cure diseases and is not a substitute for medical care. Be cautious of any olive oil marketed with specific disease-cure claims.
Final Thoughts
The research on heart-healthy cooking oil points in one direction before it points at any bottle: cook with a liquid plant oil instead of a solid fat. Most of the benefit lives in that swap, and rapeseed, sunflower and other liquid oils share in it.
Extra virgin olive oil earns the lead because of what sits on top: randomised outcome trials, a polyphenol effect that rises with quality, and an authorised claim that names it specifically. The condition is the grade — extra virgin, unrefined and fresh — and the context is a whole diet, not a spoonful.
Our cold-pressed single-estate extra virgin olive oil — rain-fed, organically grown and unfiltered — is available to pre-order from our limited single-harvest batch, with fulfilment in the UK, EU, and US.
Our extra virgin olive oil is grown organically on our own single-estate farm on the plains outside Marrakech: we control every step from tree to bottle, and no synthetic pesticides, herbicides or fertilisers are used. It is not yet certified organic — certification is in progress, and we will publish it as soon as it comes through.
References
- Sacks FM, Lichtenstein AH, Wu JHY, et al. Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association. Circulation. 2017;136(3):e1–e23. PMID 28620111. doi:10.1161/CIR.0000000000000510
- 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. N Engl J Med. 2018;378(25):e34. PMID 29897866. doi:10.1056/NEJMoa1800389
- Covas MI, Nyyssönen K, Poulsen HE, et al. The effect of polyphenols in olive oil on heart disease risk factors: a randomized trial. Ann Intern Med. 2006;145(5):333–341. PMID 16954359. doi:10.7326/0003-4819-145-5-200609050-00006
- Schwingshackl L, Bogensberger B, Benčič A, et al. Effects of oils and solid fats on blood lipids: a systematic review and network meta-analysis. J Lipid Res. 2018;59(9):1771–1782. PMID 30006369. doi:10.1194/jlr.P085522
- Guasch-Ferré M, Li Y, Willett WC, et al. Consumption of Olive Oil and Risk of Total and Cause-Specific Mortality Among U.S. Adults. J Am Coll Cardiol. 2022;79(2):101–112. PMID 35027106. doi:10.1016/j.jacc.2021.10.041
- Guasch-Ferré M, Hu FB, Martínez-González MA, et al. Olive oil intake and risk of cardiovascular disease and mortality in the PREDIMED Study. BMC Med. 2014;12:78. PMID 24886626. doi:10.1186/1741-7015-12-78
- Delgado-Lista J, Alcala-Diaz JF, Torres-Peña JD, et al. Long-term secondary prevention of cardiovascular disease with a Mediterranean diet and a low-fat diet (CORDIOPREV): a randomised controlled trial. Lancet. 2022;399(10338):1876–1885. PMID 35525255. doi:10.1016/S0140-6736(22)00122-2
Disclaimer: This article summarises published research, public-health guidance and health-claim regulation on cooking oils and heart health at the time of writing; research findings and product specifications may change, and readers should check current sources. Comparisons are made in good faith and in fair terms. References to the American Heart Association describe its published information and imply no affiliation or endorsement. Olive oil is a food, not a medicine, and is not a substitute for medical treatment of any condition. For any health concern, consult a qualified medical professional.