CoChat
Sign Up
Cited by 7

The DOI matches its Crossref record; 4 of the 4 references it cites were found in a registry or an index.

Exploring the Role of Extra Virgin Olive Oil (EVOO) in MASLD: Evidence from Human Consumption

Bernardino, Melvin, Tiribelli, Claudio, Rosso, Natalia·2025·Nutrients
DOI 10.3390/nu17182932
Open this paper in CoChat — free account

Abstract

Background/Objectives: Metabolic dysfunction-associated steatosis liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD) is the leading cause of liver related morbidity and mortality affecting 38% of the adult global population. As of now, there is no clear consensus on a standardized pharmacological treatment for MASLD; therefore, lifestyle interventions particularly diet and exercise remain the first-line approach for both prevention and management. Extra virgin olive oil (EVOO), the primary source of fat in the Mediterranean diet. (MD) is widely recognized as a key contributor to its well-documented health benefits. As a central component of this dietary pattern, EVOO has demonstrated promising therapeutic potential due to its high phenolic content. The primary aim of this review is to synthesize existing human studies examining the effects of olive oil primarily EVOO on key pathological features of MASLD. Methods: A systematic search of human clinical and observational studies was conducted across major databases. Key outcomes assessed include hepatic steatosis, inflammation, oxidative stress, fibrosis, liver enzymes, and anthropometric measures. Study quality was evaluated using the Academy of Nutrition and Dietetics Quality Criteria Checklist. Results: This review included 25 high-quality studies, 12 of which assessed olive oil alone and 13 evaluated the MD emphasizing extra virgin olive oil (EVOO). EVOO-rich interventions consistently improved hepatic steatosis, liver enzyme levels (ALT, AST), and inflammatory markers in MASLD patients, particularly when paired with calorie-restricted or MD patterns. Benefits were dose- and type-dependent, with EVOO showing superior effects compared to refined olive oils. Modest improvements in lipid profiles and insulin resistance were observed. Longer study durations and higher EVOO intake (>30–50 g/day) yielded greater improvements. Findings suggest EVOO may exert beneficial effects on liver health through its anti-inflammatory and antioxidant properties. Future studies on EVOO’s role in MASLD should use well-characterized oils with known polyphenol and bioactive compound levels and include clear biomarkers of oxidative stress, inflammation, and liver health outcomes on humans. Overall, EVOO represents a promising, non-pharmacological strategy for MASLD prevention and management. Conclusions: Current evidence suggests that EVOO, particularly when rich in phenolic compounds, is a promising dietary strategy for managing MASLD due to its hepato-protective effects, especially within a Mediterranean diet framework. However, findings are limited by study heterogeneity and a lack of high-quality randomized controlled trials, highlighting the need for future research to refine optimal dosing, assess long-term outcomes, and clarify underlying mechanisms.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3390/nu17182932

Cites

4 of 4 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Research works printed but not linked: 75

  1. Riazi, 2022, The prevalence and incidence of NAFLD worldwide: A systematic review and meta-analysis, Lancet Gastroenterol. Hepatol., 7, 851, 10.1016/S2468-1253(22)00165-0 · DOI · Paper page
  2. Younossi, 2024, Epidemiology of metabolic dysfunction-associated steatotic liver disease, Clin. Mol. Hepatol., 31, S32, 10.3350/cmh.2024.0431 · DOI · Paper page
  3. Eslam, 2020, A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement, J. Hepatol., 73, 202, 10.1016/j.jhep.2020.03.039 · DOI · Paper page
  4. Buzzetti, 2016, The multiple-hit pathogenesis of non-alcoholic fatty liver disease (NAFLD), Metabolism, 65, 1038, 10.1016/j.metabol.2015.12.012 · DOI · Paper page
  5. Kim, 2025, Metabolic Dysfunction–Associated Steatohepatitis Diagnosis and Management in Germany: Insights from an Expert Consensus Panel, Liver Int., 45, e70225, 10.1111/liv.70225 · DOI
  6. Zeng, 2024, The role of dietary modification in the prevention and management of metabolic dysfunction-associated fatty liver disease: An international multidisciplinary expert consensus, Metabolism, 161, 156028, 10.1016/j.metabol.2024.156028 · DOI
  7. Bucciantini, M., Leri, M., Nardiello, P., Casamenti, F., and Stefani, M. (2021). Olive Polyphenols: Antioxidant and Anti-Inflammatory Properties. Antioxidants, 10. · DOI
  8. Reyes-Goya, C., Santana-Garrido, Á., Espinosa-Martín, P., Vázquez, C.M., and Mate, A. (2024). Wild and cultivated olive trees: Nutraceutical insights of extra virgin olive oils in cardiovascular and ocular diseases. Biochim. Biophys. Acta BBA Mol. Basis Dis., 1870. · DOI
  9. Jimenez-Lopez, C., Carpena, M., Lourenço-Lopes, C., Gallardo-Gomez, M., Lorenzo, J.M., Barba, F.J., Prieto, M.A., and Simal-Gandara, J. (2020). Bioactive Compounds and Quality of Extra Virgin Olive Oil. Foods, 9. · DOI
  10. Assy, 2009, Olive oil consumption and non-alcoholic fatty liver disease, World J. Gastroenterol., 15, 1809, 10.3748/wjg.15.1809 · DOI
  11. Foscolou, 2018, Olive oil consumption and human health: A narrative review, Maturitas, 118, 60, 10.1016/j.maturitas.2018.10.013 · DOI
  12. Handu, 2016, Academy of Nutrition and Dietetics Methodology for Conducting Systematic Reviews for the Evidence Analysis Library, J. Acad. Nutr. Diet., 116, 311, 10.1016/j.jand.2015.11.008 · DOI
  13. Myers, E., Parrott, J., Cummins, D., and Splett, P. (2011). Funding Source and Research Report Quality in Nutrition Practice-Related Research. PLoS ONE, 6. · DOI
  14. Mondon, C., Tan, P.Y., Chan, C.L., Tran, T.N., and Gong, Y.Y. (2024). Prevalence, determinants, intervention strategies and current gaps in addressing childhood malnutrition in Vietnam: A systematic review. BMC Public Health, 24. · DOI
  15. Kenneally, 2017, Efficacy of dietary and physical activity intervention in non-alcoholic fatty liver disease: A systematic review, BMJ Open Gastroenterol., 4, e000139, 10.1136/bmjgast-2017-000139 · DOI
  16. Kanwal, 2024, Metabolic dysfunction–associated steatotic liver disease: Update and impact of new nomenclature on the American Association for the Study of Liver Diseases practice guidance on nonalcoholic fatty liver disease, Hepatology, 79, 1212, 10.1097/HEP.0000000000000670 · DOI
  17. Hsu, 2024, From NAFLD to MASLD: Implications of the new nomenclature for preclinical and clinical research, Nat. Metab., 6, 600, 10.1038/s42255-024-00985-1 · DOI
  18. Rinella, 2023, A multisociety Delphi consensus statement on new fatty liver disease nomenclature, J. Hepatol., 79, 1542, 10.1016/j.jhep.2023.06.003 · DOI · Paper page
  19. Rezaei, 2019, Olive oil lessened fatty liver severity independent of cardiometabolic correction in patients with non-alcoholic fatty liver disease: A randomized clinical trial, Nutrition, 57, 154, 10.1016/j.nut.2018.02.021 · DOI
  20. Sofi, 2010, Effects of a 1-year dietary intervention with n-3 polyunsaturated fatty acid-enriched olive oil on non-alcoholic fatty liver disease patients: A preliminary study, Int. J. Food Sci. Nutr., 61, 792, 10.3109/09637486.2010.487480 · DOI
  21. Patti, A.M., Carruba, G., Cicero, A.F.G., Banach, M., Nikolic, D., Giglio, R.V., Terranova, A., Soresi, M., Giannitrapani, L., and Montalto, G. (2020). Daily Use of Extra Virgin Olive Oil with High Oleocanthal Concentration Reduced Body Weight, Waist Circumference, Alanine Transaminase, Inflammatory Cytokines and Hepatic Steatosis in Subjects with the Metabolic Syndrome: A 2-Month Intervention Study. Metabolites, 10. · DOI
  22. Corbella, 2019, A Mediterranean Diet Rich in Extra-Virgin Olive Oil Is Associated with a Reduced Prevalence of Nonalcoholic Fatty Liver Disease in Older Individuals at High Cardiovascular Risk, J. Nutr., 149, 1920, 10.1093/jn/nxz147 · DOI
  23. Nigam, 2014, Effect of a 6-Month Intervention with Cooking Oils Containing a High Concentration of Monounsaturated Fatty Acids (Olive and Canola Oils) Compared with Control Oil in Male Asian Indians with Nonalcoholic Fatty Liver Disease, Diabetes Technol. Ther., 16, 255, 10.1089/dia.2013.0178 · DOI
  24. Kruse, 2020, Dietary Rapeseed Oil Supplementation Reduces Hepatic Steatosis in Obese Men—A Randomized Controlled Trial, Mol. Nutr. Food Res., 64, 2000419, 10.1002/mnfr.202000419 · DOI
  25. Tobin, D., Brevik-Andersen, M., Qin, Y., Innes, J.K., and Calder, P.C. (2018). Evaluation of a High Concentrate Omega-3 for Correcting the Omega-3 Fatty Acid Nutritional Deficiency in Non-Alcoholic Fatty Liver Disease (CONDIN). Nutrients, 10. · DOI
  26. Shidfar, 2018, The Effects of Extra Virgin Olive Oil on Alanine Aminotransferase, Aspartate Aminotransferase, and Ultrasonographic Indices of Hepatic Steatosis in Nonalcoholic Fatty Liver Disease Patients Undergoing Low Calorie Diet, Can. J. Gastroenterol. Hepatol., 2018, 1053710, 10.1155/2018/1053710 · DOI
  27. Valdivielso, 2017, Changes in fatty liver index after consuming a Mediterranean diet: 6-Year follow-up of the PREDIMED-Malaga trial, Med. Clín. Engl. Ed., 148, 435
  28. Yahay, 2021, The effects of canola and olive oils consumption compared to sunflower oil, on lipid profile and hepatic steatosis in women with polycystic ovarian syndrome: A randomized controlled trial, Lipids Health Dis., 20, 7, 10.1186/s12944-021-01433-9 · DOI
  29. Keshk, 2022, The Effect of a Hypocaloric Diet Containing Olive Oil on Hepatic Steatosis Grading Using Tissue Elastography: A Randomized Controlled Trial, Afro-Egypt. J. Infect. Endem. Dis., 12, 57
  30. Scorletti, 2014, Effects of purified eicosapentaenoic and docosahexaenoic acids in nonalcoholic fatty liver disease: Results from the WELCOME* study, Hepatology, 60, 1211, 10.1002/hep.27289 · DOI
  31. Quetglas-Llabrés, M.M., Monserrat-Mesquida, M., Bouzas, C., García, S., Argelich, E., Casares, M., Ugarriza, L., Llompart, I., Tur, J.A., and Sureda, A. (2024). Impact of Adherence to the Mediterranean Diet on Antioxidant Status and Metabolic Parameters in NAFLD Patients: A 24-Month Lifestyle Intervention Study. Antioxidants, 13. · DOI
  32. George, 2022, Impact of a Mediterranean diet on hepatic and metabolic outcomes in non-alcoholic fatty liver disease: The MEDINA randomised controlled trial, Liver Int., 42, 1308, 10.1111/liv.15264 · DOI · Paper page
  33. Marin-Alejandre, B.A., Abete, I., Cantero, I., Monreal, J.I., Elorz, M., Herrero, J.I., Benito-Boillos, A., Quiroga, J., Martinez-Echeverria, A., and Uriz-Otano, J.I. (2019). The Metabolic and Hepatic Impact of Two Personalized Dietary Strategies in Subjects with Obesity and Nonalcoholic Fatty Liver Disease: The Fatty Liver in Obesity (FLiO) Randomized Controlled Trial. Nutrients, 11. · DOI
  34. Kaliora, 2019, The Effectiveness of Mediterranean Diet in Nonalcoholic Fatty Liver Disease Clinical Course: An Intervention Study, J. Med. Food, 22, 729, 10.1089/jmf.2018.0020 · DOI · Paper page
  35. Barrea, L., Verde, L., Savastano, S., Colao, A., and Muscogiuri, G. (2023). Adherence to Mediterranean Diet: Any Association with NAFLD?. Antioxidants, 12. · DOI
  36. Montemayor, S., Mascaró, C.M., Ugarriza, L., Casares, M., Llompart, I., Abete, I., Zulet, M.Á., Martínez, J.A., Tur, J.A., and Bouzas, C. (2022). Adherence to Mediterranean Diet and NAFLD in Patients with Metabolic Syndrome: The FLIPAN Study. Nutrients, 14. · DOI
  37. Properzi, 2018, Ad Libitum Mediterranean and Low-Fat Diets Both Significantly Reduce Hepatic Steatosis: A Randomized Controlled Trial, Hepatology, 68, 1741, 10.1002/hep.30076 · DOI · Paper page
  38. Katsagoni, 2018, Improvements in clinical characteristics of patients with non-alcoholic fatty liver disease, after an intervention based on the Mediterranean lifestyle: A randomised controlled clinical trial, Br. J. Nutr., 120, 164, 10.1017/S000711451800137X · DOI · Paper page
  39. Gelli, 2017, Effect of a counseling-supported treatment with the Mediterranean diet and physical activity on the severity of the non-alcoholic fatty liver disease, World J. Gastroenterol., 23, 3150, 10.3748/wjg.v23.i17.3150 · DOI
  40. Abbate, M., Mascaró, C.M., Montemayor, S., Barbería-Latasa, M., Casares, M., Gómez, C., Angullo-Martinez, E., Tejada, S., Abete, I., and Zulet, M.A. (2021). Energy Expenditure Improved Risk Factors Associated with Renal Function Loss in NAFLD and MetS Patients. Nutrients, 13. · DOI
  41. Aller, 2015, Mediterranean Diet Is Associated With Liver Histology In Patients With Non Alcoholic Fatty Liver Disease, Nutr. Hosp., 32, 2518
  42. Baratta, 2017, Adherence to Mediterranean Diet and Non-Alcoholic Fatty Liver Disease: Effect on Insulin Resistance, Am. J. Gastroenterol., 112, 1832, 10.1038/ajg.2017.371 · DOI
  43. Schwingshackl, 2012, Monounsaturated Fatty Acids and Risk of Cardiovascular Disease: Synopsis of the Evidence Available from Systematic Reviews and Meta-Analyses, Nutrients, 4, 1989, 10.3390/nu4121989 · DOI
  44. Mancebo-Campos, V., Salvador, M.D., and Fregapane, G. (2023). EFSA Health Claims-Based Virgin Olive Oil Shelf-Life. Antioxidants, 12. · DOI
  45. George, 2019, The effect of high-polyphenol extra virgin olive oil on cardiovascular risk factors: A systematic review and meta-analysis, Crit. Rev. Food Sci. Nutr., 59, 2772, 10.1080/10408398.2018.1470491 · DOI
  46. Shabalala, S.C., Dludla, P.V., Mabasa, L., Kappo, A.P., Basson, A.K., Pheiffer, C., and Johnson, R. (2020). The effect of adiponectin in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) and the potential role of polyphenols in the modulation of adiponectin signaling. Biomed. Pharmacother., 131. · DOI
  47. Bouzas, C., Bibiloni, M.M., Julibert, A., Ruiz-Canela, M., Salas-Salvadó, J., Corella, D., Zomeño, M.D., Romaguera, D., Vioque, J., and Alonso-Gómez, Á.M. (2020). Adherence to the Mediterranean Lifestyle and Desired Body Weight Loss in a Mediterranean Adult Population with Overweight: A PREDIMED-Plus Study. Nutrients, 12. · DOI
  48. Panagiotakos, 2007, Adherence to the Mediterranean food pattern predicts the prevalence of hypertension, hypercholesterolemia, diabetes and obesity, among healthy adults; the accuracy of the MedDietScore, Prev. Med., 44, 335, 10.1016/j.ypmed.2006.12.009 · DOI
  49. Estruch, 2011, A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women, J. Nutr., 141, 1140, 10.3945/jn.110.135566 · DOI · Paper page
  50. Willett, 2021, The Mediterranean diet and health: A comprehensive overview, J. Intern. Med., 290, 549, 10.1111/joim.13333 · DOI · Paper page
  51. Viguiliouk, 2020, Mediterranean diet, cardiovascular disease and mortality in diabetes: A systematic review and meta-analysis of prospective cohort studies and randomized clinical trials, Crit. Rev. Food Sci. Nutr., 60, 1207, 10.1080/10408398.2019.1565281 · DOI · Paper page
  52. Sebastian, 2024, Long-term impact of mediterranean diet on cardiovascular disease prevention: A systematic review and meta-analysis of randomized controlled trials, Curr. Probl. Cardiol., 49, 102509, 10.1016/j.cpcardiol.2024.102509 · DOI
  53. Zhang, 2023, The effectiveness of lifestyle interventions for diabetes remission on patients with type 2 diabetes mellitus: A systematic review and meta-analysis, Worldviews Evid. Based Nurs., 20, 64, 10.1111/wvn.12608 · DOI
  54. Esposito, 2013, Mediterranean diet and metabolic syndrome: An updated systematic review, Rev. Endocr. Metab. Disord., 14, 255, 10.1007/s11154-013-9253-9 · DOI
  55. Hansrivijit, 2020, Mediterranean diet and the risk of chronic kidney disease: A systematic review and meta-analysis, Nephrol. Carlton Vic, 25, 913, 10.1111/nep.13778 · DOI · Paper page
  56. Charkviani, 2022, Effects of Mediterranean Diet, DASH Diet, and Plant-Based Diet on Outcomes among End Stage Kidney Disease Patients: A Systematic Review and Meta-Analysis, Clin. Pract., 13, 41, 10.3390/clinpract13010004 · DOI
  57. Soltani, 2022, Adherence to healthy dietary pattern and risk of kidney disease: A systematic review and meta-analysis of observational studies, Int. J. Vitam. Nutr. Res. Int. Z. Vitam.-Ernahrungsforschung J. Int. Vitaminol. Nutr., 92, 267, 10.1024/0300-9831/a000647 · DOI
  58. Nucci, 2024, Association between Mediterranean diet and dementia and Alzheimer disease: A systematic review with meta-analysis, Aging Clin. Exp. Res., 36, 77, 10.1007/s40520-024-02718-6 · DOI
  59. Berendsen, 2019, The Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) Diets Are Associated with Less Cognitive Decline and a Lower Risk of Alzheimer’s Disease-A Review, Adv. Nutr., 10, 1040, 10.1093/advances/nmz054 · DOI · Paper page
  60. Solch, 2022, Mediterranean diet adherence, gut microbiota, and Alzheimer’s or Parkinson’s disease risk: A systematic review, J. Neurol. Sci., 434, 120166, 10.1016/j.jns.2022.120166 · DOI
  61. Morze, 2021, An updated systematic review and meta-analysis on adherence to mediterranean diet and risk of cancer, Eur. J. Nutr., 60, 1561, 10.1007/s00394-020-02346-6 · DOI
  62. Toledo, 2023, Mediterranean diet and risk of breast cancer: An umbrella review, Clin. Nutr. Edinb. Scotl., 42, 600
  63. Zupo, 2023, Scientific evidence supporting the newly developed one-health labeling tool “Med-Index”: An umbrella systematic review on health benefits of mediterranean diet principles and adherence in a planeterranean perspective, J. Transl. Med., 21, 755, 10.1186/s12967-023-04618-1 · DOI
  64. Rajewski, P., Cieściński, J., Rajewski, P., Suwała, S., Rajewska, A., and Potasz, M. (2025). Dietary Interventions and Physical Activity as Crucial Factors in the Prevention and Treatment of Metabolic Dysfunction-Associated Steatotic Liver Disease. Biomedicines, 13. · DOI
  65. Green, 2014, The Influence of Dietary Fat on Liver Fat Accumulation, Nutrients, 6, 5018, 10.3390/nu6115018 · DOI
  66. Tedesco, C.C., Bonfiglio, C., Notarnicola, M., Rendina, M., Castellaneta, A., Di Leo, A., Giannelli, G., and Fontana, L. (2023). High Extra Virgin Olive Oil Consumption Is Linked to a Lower Prevalence of NAFLD with a Prominent Effect in Obese Subjects: Results from the MICOL Study. Nutrients, 15. · DOI
  67. Bonfiglio, C., Cuccaro, F., Campanella, A., Rosso, N., Tatoli, R., Giannelli, G., and Donghia, R. (2023). Effect of Intake of Extra Virgin Olive Oil on Mortality in a South Italian Cohort with and without NAFLD. Nutrients, 15. · DOI
  68. Donghia, R., Tatoli, R., Campanella, A., Losurdo, G., Di Leo, A., De Pergola, G., Bonfiglio, C., and Giannelli, G. (2024). Extra Virgin Olive Oil Reduces the Risk of Non-Alcoholic Fatty Liver Disease in Females but Not in Males: Results from the NUTRIHEP Cohort. Nutrients, 16. · DOI
  69. Flynn, M., Tierney, A., and Itsiopoulos, C. (2023). Is Extra Virgin Olive Oil the Critical Ingredient Driving the Health Benefits of a Mediterranean Diet? A Narrative Review. Nutrients, 15. · DOI
  70. Seidita, A., Soresi, M., Giannitrapani, L., Di Stefano, V., Citarrella, R., Mirarchi, L., Cusimano, A., Augello, G., Carroccio, A., and Iovanna, J.L. (2022). The clinical impact of an extra virgin olive oil enriched mediterranean diet on metabolic syndrome: Lights and shadows of a nutraceutical approach. Front. Nutr., 9. · DOI
  71. Lucas, 2011, Molecular mechanisms of inflammation. Anti-inflammatory benefits of virgin olive oil and the phenolic compound oleocanthal, Curr. Pharm. Des., 17, 754, 10.2174/138161211795428911 · DOI
  72. Sato, 2007, Dietary palatinose and oleic acid ameliorate disorders of glucose and lipid metabolism in Zucker fatty rats, J. Nutr., 137, 1908, 10.1093/jn/137.8.1908 · DOI
  73. Paniagua, 2007, Monounsaturated fat-rich diet prevents central body fat distribution and decreases postprandial adiponectin expression induced by a carbohydrate-rich diet in insulin-resistant subjects, Diabetes Care, 30, 1717, 10.2337/dc06-2220 · DOI
  74. Njei, 2024, Diagnosis and Management of Lean Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Systematic Review, Cureus, 16, e71451
  75. Chotiprasidhi, 2024, Update in lean metabolic dysfunction-associated steatotic liver disease, World J. Hepatol., 16, 452

Metadata

Authors
Bernardino, M., Tiribelli, C., & Rosso, N.
Venue
Nutrients
Publisher
MDPI AG
Published
2025-09-11
Volume
17
Issue
18
Pages
2932
ISSN
2072-6643
DOI
10.3390/nu17182932
Cited by
7
References
4
Language
en
Licence
creativecommons.org/licenses/by/4.0/ (vor)

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review