Olive Oil Shots: The Heart Evidence Is About Olive Oil in Meals, Not Shots on an Empty Stomach

PREDIMED assigned 7,447 Spanish adults aged 55 to 80 at high cardiovascular risk to a Mediterranean diet with extra-virgin olive oil, the same diet with mixed nuts, or advice to cut dietary fat¹. After a median of 4.8 years, major cardiovascular events occurred in 3.8% of the olive oil group and 4.4% of the control group, a hazard ratio of 0.69 (95% CI 0.53 to 0.91)¹.

Three caveats apply. The olive oil was supplied free as part of a whole-diet intervention with regular education sessions, compared with low-fat advice rather than with no olive oil¹. The original 2013 report was withdrawn after protocol deviations in randomization were found, and the results were re-analysed and republished in 2018¹. The trial was funded by Spain's Instituto de Salud Carlos III, and the extra-virgin olive oil was donated by Hojiblanca and Patrimonio Comunal Olivarero, both from the Spanish olive oil sector; the authors state that the sponsors had no role in the design, analysis or reporting¹.

Some versions of the trend borrow from the "gallbladder flush", where large amounts of olive oil and citrus juice are said to push out gallstones. In a case reported in The Lancet, a woman with gallstones on ultrasound drank 600 mL of olive oil and 300 mL of lemon juice over several hours and then passed green "stones"⁴. Analysis showed they were soap-like lumps formed from the oil in the gut, not gallstones, and her cholesterol stones were later removed by surgery⁴.

Using extra-virgin olive oil as your main cooking and salad fat fits the best trial evidence¹. Drinking it as a shot is a delivery ritual with no trials of its own, and the liver-flush claim is contradicted by the one analysed case⁴. For the compounds behind the polyphenol claims, see the hydroxytyrosol page and the olive leaf extract page.