This week on the Olive Health Information System website

The newsletter of the University of Navarra and the IOC dedicated to health

Article 1

The Mediterranean diet, with extra virgin olive oil as its main source of fat, has demonstrated a wide range of health benefits, largely attributed to its anti-inflammatory and immunomodulatory properties. On this basis, growing interest has focused on its potential role in the management of autoimmune diseases and chronic inflammatory disorders.

In line with this hypothesis, a recent meta-analysis including 15 studies examined the association between adherence to the Mediterranean diet and autoimmune or chronic inflammatory diseases such as rheumatoid arthritis, Crohn’s disease, ulcerative colitis, multiple sclerosis, and celiac disease. Higher adherence to the Mediterranean diet was associated with improved quality of life in individuals with multiple sclerosis and celiac disease, and to a lesser extent in those with rheumatoid arthritis. Beyond patient-reported outcomes, some studies also reported reductions in C-reactive protein levels. Importantly, one cohort study observed lower mortality among patients with Crohn’s disease and inflammatory bowel disease who showed higher adherence to the Mediterranean diet. At the mechanistic level, several studies also suggested potential beneficial effects on the gut microbiota; however, the available evidence in this area is still limited.

While these findings primarily address disease management and outcomes among affected individuals, the potential role of the Mediterranean diet in disease prevention has also been explored. In this context, another recent meta-analysis including nine studies evaluated the role of the Mediterranean diet in the primary prevention of autoimmune diseases. Higher adherence to the Mediterranean diet was associated with a reduced incidence of multiple sclerosis and Sjögren’s syndrome. However, in contrast to previous findings, no significant association was observed for rheumatoid arthritis, systemic lupus erythematosus, Crohn’s disease, or ulcerative colitis.

Taken together, the current evidence regarding the role of the Mediterranean diet in both the prevention of autoimmune diseases and the improvement of quality of life among individuals with established autoimmune conditions remains limited. Well-designed longitudinal studies are needed to clarify these associations and to better understand the underlying biological mechanisms.

Article 2

The Mediterranean diet is characterized by a high intake of plant-based foods, moderate consumption of fish and seafood, low intake of red and processed meats, and limited consumption of ultra-processed foods and added sugars. With extra-virgin olive oil as its main source of fat, this dietary pattern has been consistently associated with improved metabolic regulation, lower adiposity, and more favorable hormonal profiles.

Recent evidence from intervention studies supports these associations. The DIANA-5 trial evaluated a Mediterranean–macrobiotic diet combined with moderate physical activity in women at high risk of breast cancer recurrence. After one year, women in the intensive lifestyle intervention group (n= 769) showed more favorable body composition, metabolic markers (including blood glucose and cholesterol), and hormonal profiles than those receiving standard advice (n=773). Mediation analyses indicated that improvements in diet quality and reductions in waist circumference and fat-to-lean mass ratio explained a substantial proportion of the observed benefits on glycemia, insulin levels, metabolic syndrome components, and cholesterol concentrations.

Complementing these findings, biomarker-based evidence from the PREDIMED trial provides additional support for the metabolic benefits of the Mediterranean diet. In a case-cohort nested study, a urinary polyphenol metabolite profile—reflecting adherence to the Mediterranean diet—was identified using targeted metabolomics. Higher levels of this polyphenol signature were associated with a significantly lower incidence of major cardiovascular events, independent of traditional cardiovascular risk factors and lifestyle variables, supporting an inverse association between Mediterranean diet–derived polyphenols and cardiovascular outcomes.

Taken together, this body of evidence further reinforces existing evidence, highlighting the Mediterranean diet not only as a culturally rich dietary pattern, but also as a biologically meaningful strategy for improving metabolic health and reducing cardiometabolic risk.

Article 3

The Mediterranean diet is sustained not only by food choices, but by the skills that translate knowledge into daily practice. Cooking skills influence how foods are selected, prepared and preserved, shaping both dietary adherence and food quality. In this context, extra virgin olive oil represents a clear example of how culinary competence directly affects nutritional, functional, and sensory outcomes.

Emerging evidence points to a positive relationship between cooking skills and adherence to healthy dietary patterns. A recent study conducted in the Spanish population including children, adolescents, and adults, showed that higher levels of Mediterranean diet–related health literacy and cooking skills are linked to better dietary quality and stronger adherence to this dietary pattern. Moreover, practical culinary education initiatives, such as teaching kitchen programs implemented in university settings, demonstrate that hands-on cooking experiences improve cooking confidence and food skills, as well as the regular use of key Mediterranean ingredients, including extra virgin olive oil. These initiatives reinforce the translation of nutritional recommendations into real-life behavior.

Cooking skills also encompass informed culinary strategies aimed at enhancing and preserving olive oil quality. The growing practice of flavoring olive oil with herbs or spices has gained attention as a way to diversify sensory characteristics and potentially improve antioxidant content and oxidative stability. An analytical study using autofluorescence profiling suggests that, although flavoring may modify certain fluorescence patterns, storage conditions remain a primary determinant of oil stability over time, with oxidation-related changes observed even in flavored virgin olive oils.

Taken together, these findings underline a shared conclusion: promoting healthy dietary patterns also requires strengthening cooking skills and kitchen literacy. From production to consumption, the quality of extra virgin olive oil depends not only on how it is produced, but also on how it is used and preserved. Integrating culinary education with scientific evidence is therefore essential to fully unlock the nutritional and functional potential of extra virgin olive oil.