When nutrition science focuses only on macro and micronutrients, it misses an important and powerful health lever: polyphenols.
Polyphenols are a large family of natural phytonutrients from plants, including fruits, vegetables, tea, coffee, cacao, and olive oil. They protect plants against environmental threats like UV radiation, pathogens, and oxidative stress, and they produce the colors and bitter flavors that support a plant’s survival.
Polyphenols are being studied for their potential contributions to human health. The health benefits of polyphenols have been studied in terms of cardiovascular health, metabolic function, cognitive protection, gut microbiome diversity, and more, much of which I will cover below.
As a former cardiothoracic surgeon who has now practiced Restorative Medicine for over 25 years, I have built my dietary framework with deep consideration for polyphenols and their clinical importance. And I have published numerous abstracts and papers in peer reviewed journals on their effects on humans. And that’s what I will share with you today in this guide, with a special emphasis on an underutilized polyphenol source: olive oil.
This guide covers:
And so much more!
Polyphenols are a family of over 8000 phytonutrients found in plant foods, including fruits, vegetables, herbs, spices, nuts, seeds, legumes, and others. While each polyphenol is distinct, they all share a similar structure consisting of multiple phenolic rings.1
There are four primary polyphenol subclasses:
Also called bioflavonoids, flavonoids are the largest and most researched subclass, with over 4000 distinct plant compounds. They are found widely throughout the plant kingdom, including berries, apples, onions, green tea, and citrus fruits. The subclasses include:
Are found in some red fruits, herbs, radishes, onions, garlic, and olive oil. Examples include gallic acid and chlorogenic acid.
The most studied and famous polyphenol in the stilbenes category is resveratrol, found in red grapes, red wine, and berries.
Are primarily found in seeds, including flax and sesame seeds.1, 2
Olive oil also contains simple phenolic “alcohols”, including hydroxytyrosol and tyrosol.
Polyphenols are secondary metabolites produced by plants in response to stress. Stress from UV radiation, bacterial or fungal pathogens, insects, and other harsh environmental conditions causes the plant to increase polyphenol production. In other words, polyphenols serve a primary biological function. In plants, polyphenols act to protect their energy producing organelles (the equivalent to our mitochondria) from damage.
Polyphenols give plants and their leaves an unpleasant taste to discourage insects and animals from eating them. For example, hydroxytyrosol is found primarily in the leaves and drupe (olive) of the olive tree. It’s bitter and accounts for the bitter taste in extra virgin olive oil. Some polyphenols give berries their red, purple, and blue colors. Olive oil’s green color, however, comes from chlorophyll and related pigments.3
Polyphenols not only serve a biological function in plants but also have biological properties in humans that support health in multiple ways.
Polyphenols are famous for antioxidant activity. They act directly as antioxidants by scavenging free radicals and protecting cells, proteins, enzymes, and other structures. They act indirectly by boosting the body’s antioxidant systems.3
Side note: The polyphenols and antioxidants difference: Antioxidants are a much bigger category than polyphenols, and include specific vitamins, minerals, phytonutrients, and even many polyphenols. In other words, polyphenols can be antioxidants, but not all antioxidants are polyphenols.
Beyond antioxidant effects, research suggests that polyphenols also produce anti-inflammatory signaling by inhibiting NF-kB and other inflammatory pathways. They also support gut microbiome health by “feeding” beneficial bacteria in the colon. Additionally, they may have epigenetic effects, often favorably modifying genetic expression. Overall, studies indicate the benefits of polyphenols for both short-term and long-term health and further explain the health effects of including whole plant foods in the diet.3
Most polyphenols, however, have particularly low absorption and bioavailability in the body, which is why both the polyphenol concentration level and delivery method matter.
Let’s take extra virgin olive oil as an example. It contains both water-soluble and fat-soluble polyphenols (and over 200 phytochemicals in total). Hydroxytyrosol is a water-soluble phenolic compound whose concentration in olive oil varies with olive variety, growing conditions, and other factors. It’s one of several phenolic compounds found in extra virgin olive oil, and it has favorable bioavailability – it’s quickly metabolized and absorbed, with amounts peaking in the blood about one hour after ingestion.3
Hydroxytyrosol is one of several phenolic compounds in extra virgin olive oil that may contribute to its health benefits. It may help explain why olive oil drives the health benefits of a Mediterranean diet. Research on the Mediterranean diet evaluates the overall eating pattern, making it difficult to isolate the effects of any single compound. That said, for heart and metabolic health, the practical takeaway is to include olive oil alongside a variety of plant foods, such as vegetables, fruits, pressure-cooked beans, and nuts.
Research on olive oil’s most potent polyphenol, hydroxytyrosol, suggests both anti-inflammatory and antioxidant mechanisms of action, which influence many body systems and may play a unique role in cardiovascular and brain health.4
In the cardiovascular system, studies indicate hydroxytyrosol helps to protect LDL cholesterol from oxidation. In the EU, olive oil has been approved to carry the following health claim: “olive oil polyphenols contribute to the protection of blood lipids from oxidative stress,” making it one of the few natural foods to receive regulatory recognition. To carry this claim, olive oil must contain at least 5 mg of hydroxytyrosol and its derivatives (related compounds naturally found in olives) per 20 grams of oil (about 1½ tablespoons). The label must explain that this benefit is obtained by consuming that amount daily and also to not assume that all extra virgin olive oils contain enough of these compounds to qualify.4, 5
Animal studies suggest that hydroxytyrosol can cross the blood-brain barrier (the protective filter that controls which substances enter the brain). This finding has prompted research into its potential effects on brain health, and while it doesn’t yet establish a benefit in humans, the emerging evidence is positive.6
I’ll cover more olive oil polyphenols health benefits related to the heart and brain in subsequent sections, meanwhile, I’d like to discuss a current health trend related to olive oil.
Taking a daily "shot" of extra virgin olive oil, rather than using it only as a cooking or finishing oil, has become a popular wellness practice in recent years. Dr. Steven Gundry was an early proponent, recommending patients take olive oil shots for decades. In a November 2019 episode of The Dr. Gundry Podcast (episode 69, "For better health, do a shot (of this)"), he described the morning olive oil shot as a habit common in Spain and Italy and recommended it to listeners. In 2021, his company, Gundry MD, established National Polyphenol Day on July 11 to raise public awareness of polyphenols, and encouraged participants to mark the day with a shot of olive oil. The practice has since spread widely on social media.
One proposed rationale for consuming olive oil this way is to increase daily intake of extra virgin olive oil and its naturally occurring polyphenols, including hydroxytyrosol, tyrosol, oleuropein derivatives, and oleocanthal. Polyphenol content varies widely depending on olive variety, harvest timing, processing methods, and storage conditions, as these compounds can degrade with exposure to light, heat, and oxygen. If you enjoy taking olive oil as a daily “shot,” it can be a simple way to incorporate it into your routine. However, research examining the health effects of extra virgin olive oil has generally studied total daily intake rather than the timing or method of consumption, so using it in meals is also consistent with the evidence. The amount and frequency of intake needed to produce measurable health benefits remain areas of ongoing research.
We often think of olive oil as the heart-healthy choice, but it’s not beneficial because of the type of fat (oleic acid) it contains, but primarily from the polyphenol content.
The PREDIMED trial, the landmark study on a polyphenol-rich Mediterranean diet, was conducted in Spain and followed participants for almost 5 years to learn more about cardiovascular outcomes. Study participants followed a Mediterranean diet, with added olive oil or nuts, or a reduced-fat diet. The study suggests an inverse association between the Mediterranean diet and cardiovascular risk, as those following a Mediterranean pattern had fewer cardiovascular events than those on a low-fat eating plan.7
We’ve already mentioned that the polyphenol hydroxytyrosol is rapidly absorbed and binds to LDL cholesterol, acting as an antioxidant and cardioprotective molecule, which is supportive of endothelial flexibility and arterial function. Still, the hydroxytyrosol benefits don’t end there.4
Metabolic syndrome (characterized by abdominal obesity, elevated blood glucose, high blood pressure, and dyslipidemia) often precedes cardiovascular disease. Research suggests that hydroxytyrosol from olive oil may support a healthy lipid profile, blood sugar, insulin sensitivity, and help to counteract the inflammation and oxidative stress associated with cardiovascular risk.8
As a cardiothoracic surgeon, I view polyphenol intake as one of the most actionable steps a person can take to support cardiovascular health without a prescription.
Because many polyphenols are poorly absorbed in the small intestine, they reach the colon and interact with the gut microbiome in a bidirectional relationship. While we typically think of fiber as a prebiotic food source for beneficial bacteria, polyphenols also act as prebiotics, modulating the gut microbiome and may improve microbiome composition and diversity.9
Additionally, beneficial microorganisms can convert polyphenols into more bioavailable forms, which are then absorbed into the body, and play a role in brain, heart, metabolic, and immune health.9
Akkermansia muciniphila, is an example of a beneficial bacteria that relies on polyphenols, especially the deep red, purple, and blue polyphenols in berries. It is considered a marker of a healthy gut and plays a role in metabolic health. Researchers have observed lower Akkermansia levels in those with inflammation and metabolic dysfunction.10
In vivo studies suggest flavonoids, phenolic acids, and stilbenes increase Akkermansia levels. Clinical studies in humans indicate that dietary polyphenol intake also influences Akkermansia, suggesting a way to use nutrition to shape health.10
Despite better bioavailability of the fat-soluble hydroxytyrosol in olive oil, some reaches the gut microbiome in the colon, where hydroxytyorsol metabolites are produced. These metabolites support intestinal barrier integrity, making tight junctions tighter, which is potentially beneficial for intestinal permeability (“leaky gut”) conditions and gastrointestinal disorders.11,12
The Mediterranean diet, rich in polyphenols, is well known as a heart-healthy diet, but it also supports brain health. The brain has a high metabolic rate and energy requirements, making it more prone to oxidative stress. High oxidative stress and neuroinflammation are common features of neurodegenerative diseases.3
Polyphenols can help reduce inflammation and oxidative stress and may help explain why the Mediterranean diet is associated with brain protection and better cognitive outcomes. The PREDIMED trial we looked at for cardiovascular health also suggests that a Mediterranean diet with olive oil or nuts supports better cognition than a low-fat diet.3, 11
Overall, a polyphenol-rich diet is considered neuroprotective. The blood-brain barrier, however, is selectively permeable and doesn’t allow all polyphenols to get through. Those that can pass the barrier, including hydroxytyrosol and resveratrol, may be particularly valuable compounds to study in brain health research.3, 6
Hydroxytyrosol can enter the brain and is more abundant in there than in other tissues. Interestingly, the brain has an internal source of hydroxytyrosol that it makes from dopamine. In the brain, hydroxytyrosol affects the NF-kB inflammatory pathway and emerging research is investigating it for Alzheimer’s, Parkinson’s, multiple sclerosis, and other conditions. Some research is even considering the potential of polyphenols as anti-amyloid molecules (amyloid plaques characterize Alzheimer’s disease). While we currently have limited large-scale randomized controlled trials, this is a promising area of research and one that I’ll certainly be following.6, 14
After all this discussion of polyphenols and the potential benefits, let’s look at the most potent, high-polyphenol foods. These are superfoods!
Dr. Gundry Polyphenols - Top polyphenol food sources:
For polyphenols, food quality and delivery matter.
The concentrations of polyphenols in high-polyphenol foods will vary widely depending on a variety of factors. Let’s look at the polyphenol content of olive oil as a great example. The abundance of polyphenols depends on:
In other words, not all olive oil is created equal when it comes to hydroxytyrosol and overall polyphenol content. Extra virgin olive oil will have higher levels than more processed or refined products. Additionally, harsh growing conditions produce higher polyphenol olive oil because the olive tree must generate more protective defenses in unfavorable conditions. For this reason, research suggests that organic olive oil has more hydroxytyrosol than conventionally grown products.19
We’ve already touched on the bioavailability of polyphenols and hydroxytyrosol, but it’s worth mentioning again that hydroxytyrosol is a fat-soluble polyphenol and unique in this way. It has low bioavailability in water, but a much higher bioavailability in oil, since that’s how it naturally occurs and is consumed. Therefore, it’s much better to get hydroxytyrosol from extra virgin olive oil than any isolated form.3
Over 40 years of patient observation and studying dietary science have shaped the clinical framework I’ve shared in my New York Times best-selling books. My goal is to help you bring these ideas into your own kitchen with confidence.
One feature of the Mediterranean diet deserves particular attention and after today’s discussion Im sure you feel confident that it’s the abundance of polyphenol-rich foods. Extra virgin olive oil, berries, vegetables, and nuts provide compounds that may contribute to the diet’s health benefits alongside fiber, unsaturated fats, and other nutrients. Olive oil is a favorite of mine because it offers both unsaturated fats and phenolic compounds, including hydroxytyrosol (and makes nourishing foods delicious!).
Let’s bring this to your table. Here’s one simple day of eating that puts these ideas into practice:
Make this work for your life though! Frozen produce and ready-to-eat pressure-cooked beans can save time, and you can adjust portions to your appetite or work with a registered dietitian to understand what healthy portions look like for your personal health and body weight goals.
A familiar, affordable extra virgin olive oil is a good starting point; there’s no need to spend hours scrutinizing labels and shopping to try these meals. Use it in place of butter or creamy dressings and let it help you enjoy a wider variety of plants.
Choose one meal to try today, bring out the olive oil, and enjoy a delicious step toward caring for yourself well!
Meet the author, Lizzy Swick, M.S. RDN
Nutrition and Integrative Medicine Clinician, Coach, Author, Registered Dietitian focusing on Women’s Health
Citations:
Make Gundry MD™ a part of your health and wellness lifestyle
Our most popular products
Gundry MD Coupons
Gundry MD Reviews
Most Popular Gundry MD Articles
5 Ways to Remove Lectins From Your Favorite Foods
Weekday Recipe Ideas For Breakfast, Lunch, And Dinner On A Lectin-free Diet
Top Foods For Mitochondrial Uncoupling
The Truth About Lectins In Rice: Does Rice Have Lectins?
The Dr. Gundry Diet Food List: A Comprehensive Lectin-Free Diet Plan
Is Wheatgrass Really Good For You?
A Quick Cereal Recipe For Your Breakfast (Lectin-free)
A Low-Lectin Lifestyle: Are Cucumbers High In Lectins?
Consuming Dairy Products On A Lectin-free Diet: What To Eat And What To Avoid
The Health Benefits Of The Coconut
What Dr. Gundry Wants You To Know About Chia Seeds
A Comprehensive List of “Deadly” Nightshades
7 High Sugar Fruits To Ban (Plus, Which Fruits To Eat Instead)
Reducing Dietary Lectins: Do Almonds Have Lectins?
How To Make Tomatoes Safer To Eat
Dr. Gundry’s Carrot Cake Muffins Recipe (Lectin-free)
How to Kick-Start a Lectin-free Diet (the 3-day detox)
Loading...