Olive Oil and Mental Health: A Scoping Review of Depression, Anxiety, and Stress Outcomes

A comprehensive scoping review explores how olive oil and its bioactive constituents may influence depression, anxiety, stress, and other mental health outcomes across clinical trials, epidemiological research, and preclinical models.

Dr. Monique Aucoin ND MSc
Vanessa Eedy

Abstract

This article summarizes a 49-study scoping review examining the relationship between olive oil intake (and its key polyphenols) and mental health. It highlights evidence for potential antidepressant and anxiolytic effects, discusses proposed mechanisms such as antioxidant and anti-inflammatory actions, and outlines current gaps in dose, duration, and clinical application.

Intro

Mental illness has become highly prevalent across the world, with a particular rise in mood and anxiety disorders. In Canada, mental health disorders impact one in five people every year.1 Through impact on social support, employment, marital status, and disability, mental illness is known to cause significant impairments on quality of life.2 With these debilitating consequences, it’s not surprising that mental illness remains one of the leading causes of disability in Canada.3 This rise in prevalence and profound impact highlights the critical need for research addressing treatments and preventative measures for mental illness.

The Mediterranean diet is well known for its numerous health benefits. It’s been found to reduce the risk of a multitude of diseases, including cancer, cardiovascular disease, metabolic disease, neurodegenerative disease, and even overall mortality.4,5 An abundance of research has recently emerged suggesting adherence to the Mediterranean diet may reduce risk and symptom severity of several mental health disorders.  A meta-analysis of randomized controlled trials found that greater adherence to the Mediterranean diet resulted in significant reductions in depressive symptoms.7 Although a large body of research exists for the health benefits of the Mediterranean diet, little is known about the health benefits of the individual foods that make up the diet, such as olive oil.

One of the major staples of the Mediterranean diet is olive oil, making up 20-25% of the diet’s total energy intake.8 On its own, olive oil has been found to have a wide variety of health benefits, including a  protective effect on cardiovascular disease, type 2 diabetes, and all-cause mortality.8 Some studies found health benefits with specific constituents of olive oil. Although olive oil is comprised of a several  compounds, the main constituents include oleic acid, an omega-9 fatty acid, and oleuropein, a phenolic compound.9 Constituents of olive oil have been found to be linked to lowers risk of cancer, owing to their anti-inflammatory and antioxidant effects.10,11 Another study found the high phenolic content of olive oil significantly decreased the levels of oxidative stress biomarkers.12 Furthermore, the polyphenols in olive oil were also found to have immunomodulatory effects, as observed by a significant reduction in symptom severity of immune-mediate inflammatory diseases.13 Each of these beneficial properties of olive oil may be contributing to the positive impact of the Mediterranean diet on mental health. However, this connection between olive oil and mental health is not fully understood. 

A recent scoping review sought to synthesize the current research on olive oil and mental health, including human experimental studies, observational studies, and animal studies.14 The effect of both olive oil and its constituents were considered in this review.

The Findings: Forty-nine studies were included in the scoping review. Of these studies, 17 were human experimental, 18 were observational, and 14 were animal studies.  While the majority of these studies were designed to assess the relationship between olive oil and mental health, 13 of the human experimental studies and four of the animal studies used olive oil as a comparator to assess the effect of another intervention, such as omega-3 fatty acids, on mental health outcomes.

All four human intervention studies designed to evaluate the impact of olive oil supplementation as an intervention reported improved mental health outcomes. These outcomes included: depression, mental health status, anxiety and depression, and stress.15–18 Of the 13 human intervention studies using olive oil as a comparator intervention, eight found improvements in mental health outcomes in both the olive oil and intervention group, four found improvements in the intervention group only, and one found no improvements in either group. The outcomes studied are presented in Figure 2.19–31

Figure 2. Human studies using olive oil as a comparator intervention.

Figure 3. Results of the observational studies assessing the relationship between olive oil consumption and mental illness.

Amongst observational studies, there was inconsistent findings with some studies reporting associations between more olive oil and higher (n=5) rate of mental illness, some reporting lower (n=8) rates of mental illness, and some reporting no association (n=5) (Figure 3).32–49 It is noted that the prospective studies primarily reported an association between higher intake and less mental illness. 

Figure 4. Animal intervention and comparator studies.

Of the 10 animal studies designed to evaluate the impact of olive oil supplementation as an intervention, 9 reported significant improvements in mental health outcomes with higher olive oil consumption (Figure 4).50–59 Lastly, all four animal studies using olive oil as a comparator found no improvement in mental health outcomes in the olive oil group (Figure 4).60–63

Discussion and Implications: 

The mechanism by which olive oil exerts its effects on mental health is not well understood. However, these benefits may be attributed to its anti-inflammatory and antioxidant properties. One of the proposed factors involved in the pathogenesis of mental illness is oxidative stress.64 Specific compounds in olive oil have been found to protect against oxidative stress, namely hydrophilic polyphenols, including oleuropein, demethyloleuropein, and ligstroside.65,66  Other compounds have been found to inhibit inflammatory pathways, namely 3,4-dihydroxyphenylglycol (DHPG) and hydroxytyrosol (HT).67 Other studies suggest olive oil may have impacts on mental health by reducing 5-hydroxytryptamine, 5-hydroxyindoleacetic acid, and dopamine, while increasing homovinilic acid, a metabolite of dopamine.55 It has been suggested that the anxiolytic effects are a result of the reduction of 5-hydroxytryptamine synthesis and metabolism, while the anti-depressive effects are a result of the increase in dopamine release and turnover.55

Varying dosages of olive oil were used among the studies included in the scoping review, ranging from 280 mg to 8 g per day. Studies also assessed different durations of olive oil intake. Based on these inconsistencies, it is challenging to define a clear dosage recommendation for use of olive oil for mental health in a clinical setting. Furthermore, although the scoping review suggests a possible therapeutic role for olive oil, there are still many gaps in the scientific knowledge on this topic. More research is necessary to identify the dose of olive oil that is most helpful and the mental health conditions most likely to respond.

It’s important to also discuss the poor suitability of olive oil as a placebo in mental health research. Ten of the 13 human studies using olive oil as a comparison treatment reported improvement in mental health outcomes in the participants receiving olive oil. These findings suggest olive oil may not be inert in terms of mental health and therefore may be a poor choice for use as a placebo.

Olive oil is a reasonably accessible food as it’s found in many grocery stores. It’s also very versatile and can be easily added to a variety of foods, such as salads, breads, pasta, and cooked vegetables. Nearly any spice or herb can be infused in olive oil to offer a bit of a twist to its flavor. For example, infusions may include rosemary, chili flakes, and lemon to name a few. Olive oil has also recently been gaining popularity for use in desserts and even coffee. However, it’s important to note that olive oil has a relatively low smoke point. Based on the low smoke point, there is a common assumption that extra virgin olive oil is not an ideal choice for cooking at high temperatures. This assumption is founded in the idea that smoke point indicates an oil’s ability to withstand heat and thus defines its suitability for cooking. However, recent evidence suggests that when compared to other edible oils with smoke points that are higher, extra virgin olive oil may be able to withstand higher cooking temperatures than previously thought.68,69 

Overall, the Mediterranean diet, a diet renowned for its substantial health benefits including mental health, uses olive oil as a staple ingredient. Recommending the Mediterranean diet, particularly with an emphasis on olive oil, is a valuable treatment in naturopathic care for patients with mood and anxiety disorders. More research is needed to fully understand the precise effects of this food on mental health symptoms. 

Dr. Monique Aucoin, ND, MSc is a licensed naturopathic doctor, researcher, and educator with over a decade of clinical experience focused on mental health and nutritional psychiatry. She is a Senior Research Fellow at the Canadian College of Naturopathic Medicine (CCNM) and an Adjunct Professor at the University of Guelph’s Human Health and Nutritional Sciences Department, where she advances research on the role of diet and nutrients in the prevention and treatment of mood and anxiety disorders. Dr. Aucoin has authored more than 35 peer-reviewed scientific publications, led the world’s first clinical trial assessing dietary counseling for generalized anxiety disorder, and teaches evidence-based practice and research methodology to naturopathic students. In practice, she collaborates with individuals to integrate evidence-based nutrition, lifestyle, and natural therapeutics to optimize mental well-being.

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Author: NDNR