title: Monounsaturated fatty acids, olive oil and health status: a systematic review and meta-analysis of cohort studies.
abstract: BACKGROUND
  The aim of the present meta-analysis of cohort studies was to focus on monounsaturated fat (MUFA) and cardiovascular disease, cardiovascular mortality as well as all-cause mortality, and to distinguish between the different dietary sources of MUFA.
  
  
  METHODS
  Literature search was performed using the electronic databases PUBMED, and EMBASE until June 2nd, 2014. Study specific risk ratios and hazard ratios were pooled using a inverse variance random effect model.
  
  
  RESULTS
  Thirty-two cohort studies (42 reports) including 841,211 subjects met the objectives and were included. The comparison of the top versus bottom third of the distribution of a combination of MUFA (of both plant and animal origin), olive oil, oleic acid, and MUFA:SFA ratio in each study resulted in a significant risk reduction for: all-cause mortality (RR: 0.89, 95% CI 0.83, 0.96, p = 0.001; I2 = 64%), cardiovascular mortality (RR: 0.88, 95% CI 0.80, 0.96, p = 0.004; I2 = 50%), cardiovascular events (RR: 0.91, 95% CI 0.86, 0.96, p = 0.001; I2 = 58%), and stroke (RR: 0.83, 95% CI 0.71, 0.97, p = 0.02; I2 = 70%). Following subgroup analyses, significant associations could only be found between higher intakes of olive oil and reduced risk of all-cause mortality, cardiovascular events, and stroke, respectively. The MUFA subgroup analyses did not reveal any significant risk reduction.
  
  
  CONCLUSIONS
  The results indicate an overall risk reduction of all-cause mortality (11%), cardiovascular mortality (12%), cardiovascular events (9%), and stroke (17%) when comparing the top versus bottom third of MUFA, olive oil, oleic acid, and MUFA:SFA ratio. MUFA of mixed animal and vegetable sources per se did not yield any significant effects on these outcome parameters. However, only olive oil seems to be associated with reduced risk. Further research is necessary to evaluate specific sources of MUFA (i.e. plant vs. animal) and cardiovascular risk.
authors.affiliation: Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Althanstraße 14 (UZAII), A-1090 Vienna, Austria. lukas.schwingshackl@univie.ac.at.
authors.forename: Lukas
authors.initials: L
authors.lastname: Schwingshackl
authors.forename: Georg
authors.initials: G
authors.lastname: Hoffmann
mesh_terms: D000284:Administration, Oral; D002317:Cardiovascular Agents / Q000008:administration & dosage; D002318:Cardiovascular Diseases / Q000401:mortality / Q000517:prevention & control*; D038441:Diet, Mediterranean; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage*; D006304:Health Status; D006801:Humans; D000069463:Olive Oil; D010938:Plant Oils / Q000008:administration & dosage*; D012307:Risk Factors
chemical_list: D002317:Cardiovascular Agents; D005229:Fatty Acids, Monounsaturated; D000069463:Olive Oil; D010938:Plant Oils