1 1 1 1
1 1 1
ANO EDITOR: EDUARD ESCRICH 1 / •FA 'GRUPO KOY em. 1
ISBN: 978-84-124510-8-5 Legal Deposit: B 8606-2025 Printed in Spain Cover design: LovingPixel, S.L. Typesetting: Grupo Interempresas Published in September 2025 All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means without prior written permission from the Editor. Title: EDUARD ESCRICH Eduard.Escrich@uab.cat Grup Multidisciplinari per a l’Estudi del Càncer de Mama. Facultat de Medicina. Universitat Autònoma de Barcelona. https://www.uab.cat/ Reial Acadèmia de Medicina de Catalunya. Barcelona. https://ramc.cat/ © editor: comercial@grupointerempresas.com Amadeu Vives, 20-22 08750 Molins de Rei (Barcelona) Tel.: +34 936 802 027 www.grupointerempresas.com © publisher and printing by – Published by Grupo Interempresas © promoters: FUNDACIÓN PATRIMONIO COMUNAL OLIVARERO pco@pco.es Castelló 128, 2º dcha. 28006 Madrid Tel.: +34 915 324 225 www.patrimoniolivarero.com ORGANIZACIÓN INTERPROFESIONAL DEL ACEITE DE OLIVA ESPAÑOL info@interprofesionaldelaceitedeoliva.es Castelló 128, 2º dcha. 28006 Madrid Tel.: +34 915 324 225 https://oliveoilsfromspain.org www.aceitesdeolivadeespana.com olive olis and health Virgin Olive Olil Benefits Editor’s note: final English version of each chapter is the responsibility of its author; the rest of the book was written by the editor. lilFA KOY
To my parents, for their goodness, integrity, and responsibility. For shaping my destiny by their example in human values, the capacity for effort and sacrifice, tolerance of frustration, and love of life. For accepting my passion for science and adventure. Als meus pares, per la seva bondat, rectitud i responsabilitat. Per educar el meu destí amb el seu exemple en els valors humans, la capacitat d’esforç i sacrifici, la tolerància a la frustració i l’amor a la vida. Per acceptar la meva passió per la ciència i l’aventura.
OLIVE OILS AND HEALTH 8 The olive oil sector is a key part of Spain’s agri-food system. In numbers, Spain is the world’s leading producer and exporter of olive oil, with an average annual production of 1.4 million tonnes, 44% of total world output, and exports of more than two-thirds of what it produces, averaging 1 million tonnes per year. Alongside its economic weight, the sector has great social, environmental, and territorial significance. Spain has more than 2.7 million hectares of olive groves, accounting for 15.1% of all cultivated land. This is a production with a strong social, territorial, landscape, and cultural component, especially in the case of traditional olive groves. Some 330,000 farmers are engaged in olive growing, generating around 32 million workdays annually. The sector supports an important industrial network in rural areas, with 1,831 olive mills, 1,763 packaging plants, and 63 pomace oil factories, providing around 15,000 industrial jobs. And, as the icing on the cake, olive oil is Spain’s third most-exported agri-food product, reaching over 150 countries, worth more than €3.1 billion, and generating a positive trade balance of €2.6 billion. We should not forget the environmental role of olive cultivation, particularly in combating climate change: through its capacity to fix carbon; its contribution to biodiversity by harbouring a wide variety of plant and animal species; and its role in the circular economy and bioeconomy through the full utilisation of its by-products, supported by a significant processing industry. Olive oil is also gold for the environment where it is produced. Olive oil is, therefore, a product as healthy for people as it is for the land and the economy of our country. As Minister of Agriculture, Fisheries, and Food, I wish to emphasise the values and qualities that virgin olive oil production and consumption contribute to our Mediterranean culture. This is necessary and complementary information to that provided in this volume by a large group of experts and scientists, who present all the benefits this product offers for our personal health. The Government of Spain, through the Ministry of Agriculture, Fisheries, and Food, is determined to strengthen our country’s leadership in the production of this food, which has been part of our environment for millennia but remains little known in many other parts of the world. In fact, of all the added fats consumed globally, olive oil accounts for barely 3%. It continues to be a great unknown which, in exercising our leadership, we must bring to the attention of the rest of the world. prologues
9 Virgin Olive Oil Benefits I am optimistic about the future of this sector, because exporting both health and gastronomy is an unbeatable combination in current and future consumer trends. The olive oil sector is continuously growing worldwide. Nevertheless, with our millennia-old experience we have the competitive asset of providing quality. We produce a considerable amount of olive oil, and we need to make it the best. This, therefore, is the objective of the recently established legislation regarding the quality of olive oil and olive pomace oil. It represents a series of new quality standards implementing traceability, production, and packing of the final product. Such regulations will allow Spanish olive oil to be positioned with the highest quality worldwide and with the maximum guarantees at production process level. Moreover, in order to promote the image of extra virgin olive oil, a good practices code, with voluntary membership, will be developed in agreement between the Ministries of Agriculture, Fisheries, and Food and Consumer Affairs, as well as with the representative associations of producers, distributors, and consumers. All of this with the goal to contribute to a cycle that, from beginning to end, promotes major health benefits in the fullest sense of the word. Luis Planas-Puchades Spanish Minister of Agriculture, Fisheries, and Food
OLIVE OILS AND HEALTH 10 The Mediterranean diet has one ingredient common to all its recipes: olive oil. Its flavour, nutritional values, and health-promoting properties make it a unique product of which we Spaniards can feel proud. The book you now hold in your hands focuses on what is perhaps the least known benefit of olive oil: its relationship with health. This is addressed from a multidisciplinary perspective, ranging from cardiovascular health to its impact on cancer risk, and also including its effects on cognitive decline, the immune system, and other areas. It does so with the rigour that characterises the professionals from different disciplines who have contributed to it. This is a popular science work that brings us closer to the beneficial properties of a product that is always present on our tables: olive oil. Enjoy learning more about one of the cornerstones of our Mediterranean diet and of healthy eating. Carolina Darias-San Sebastián Spanish Minister of Health
11 Virgin Olive Oil Benefits Both the wild olive (acebuche) and the cultivated olive tree arose in the eastern Mediterranean lands around the Neolithic period, following a series of transformations of the original species that appeared during the Tertiary era. They later spread to the soils on both shores of that sea. As a Mediterranean tree accustomed to variable, and at times demanding, climates, it faces dry and temperate or hot summers, rainy springs and autumns, and mild or cold winters. The olive tree stands out for its remarkable ability to adapt to these changing, and sometimes extreme, environmental conditions. It is always content with the rain that falls and withstands the cold up to a certain freezing point. A resistant, austere, and humble tree, a branch of which, in the beak of the dove of the Greek goddess Irene, seeks to inspire the difficult peace among peoples. Both are also symbols of God’s peace with humankind after the Flood, and of an offer of harmony between enemy combatants. And it came to pass at the end of forty days, that Noah opened the window of the ark which he had made: And he sent forth a raven, which went forth to and fro, until the waters were dried up from off the earth. Also he sent forth a dove from him, to see if the waters were abated from off the face of the ground; But the dove found no rest for the sole of her foot, and she returned unto him into the ark, for the waters were on the face of the whole earth: then he put forth his hand, and took her, and pulled her in unto him into the ark. And he stayed yet other seven days; and again he sent forth the dove out of the ark; And the dove came in to him in the evening; and, lo, in her mouth was an olive leaf plucked off: so Noah knew that the waters were abated from off the earth. (Genesis 8:6-11) -Holy Bible, King James VersionThe oil has journeyed through the history of humankind, serving multiple purposes, both sacred and profane. Since antiquity, in Egypt, Greece, the Roman Empire, and the Islamic world, it was regarded as a staple food and emblematic of what we now call the Mediterranean diet. Its non-food uses were also of great importance, including medical applications; religious practices (offerings, anointings); prizes (the crowning of champions at the Olympic Games of ancient Greece); anointings (royalty, warriors, and gymnasts; protection against the sun and the cold); body care (after bathing, massages, cosmetics, and perfumes); domestic uses (lighting); and other practical purposes (soap, food preservation, waterproofing, lubrication, or craftsmanship). Small wonder that a traditional Spanish saying highlights its many virtues: “El aceite de oliva es armero, relojero y curandero” (“Olive oil is a gunsmith, a watchmaker, and a healer”.) editor’s preface
OLIVE OILS AND HEALTH 12 Olive oil has always been linked to health. From the time of the Greco-Roman physicians to the present day, its nutritional and therapeutic properties have been highly valued. In ancient times, this was based on empirical reasoning; nowadays, the aim is to seek solid scientific evidence for the relationship between olive oil and health, while countering false claims that, without scientific basis, put forward unfounded opinions. A primitive surgery, certain foods, and the healing properties of plants were the only resources available to physicians in ancient times for treating disease. Their knowledge relied solely on popular wisdom, personal observation, and an enviable foresight, since some of their recommendations have, to a greater or lesser extent, been confirmed today. The ancient Greek poet Homer (8th century BC) referred to olive oil as “liquid gold”. Hippocrates (460 BC – 370 BC), physician also from Ancient Greece, called it “the great healer” and prescribed it for many medical conditions. Dioscorides (Anazarbus, present-day Turkey, 40 – 90), a Greek physician, pharmacologist, and botanist, in his work “De Materia Medica” includes a chapter titled “On the Wild and Cultivated Olive Tree”. He states that “its crushed leaves, applied as a poultice, heal sores and St. Anthony’s fire”. He also gives remedies for diseased gums and loose teeth, which should be anointed with oil from the wild olive tree until they appear white. Galen (Pergamon, currently Turkey, 129 – 216), a Greek physician, surgeon, and philosopher, practised in the Roman Empire, where he served as physician to emperors and also to gladiators. He used olive oil with water and beeswax to create the first moisturising cream in history. In the 12th century, the brilliant Hispano-Arabic medical tradition initiated by Abulcasis was revived thanks to the Banu Zuhr family and the physician-philosophers Averroes and Maimonides. Abulcasis (Medina Azahara, 936/40 – Córdoba, 1009/1013), Andalusian physician and surgeon, recommended olive oil for massages; as a laxative, when mixed with an equal amount of hot barley water; as enemas for colic caused by constipation; and even applied to the eyes to improve vision. Avenzoar (Peñaflor, 1073 - Seville, 1162), a remarkable Hispano-Arabic physician, was the first of the Banu Zuhr and an excellent clinician. In his “Treatise on Dietetics” and “Book that Facilitates Therapeutics and Dietetics”, he advised that food should be cooked with olive oil: “the flesh of lamb with abundant oil”, “the quality of fried eggs improves if they are prepared with fresh olive oil of low acidity”, “physicians prefer that fish be cooked with oil, so that its delicate flesh is balanced”. Averroes (Córdoba, 1126 – Marrakech, 1198), Hispano-Arabic philosopher and physician, intuited that a proper diet “prevents disease”. In his “General Treatise on Medicine” he wrote that olive oil, “if extracted from ripe and wholesome olives and if its properties have not been artificially altered, may
13 Virgin Olive Oil Benefits be perfectly assimilated by the human constitution”. He further affirmed: “The best eggs are hen’s eggs. When fried in olive oil they are very good, for foods seasoned with oil are most nourishing; but the oil must be new, of low acidity, and from olives. In general, it is a most suitable food for man”. Maimonides (Córdoba, 1138 – Cairo, 1204), a Sephardi physician, philosopher, astronomer, and rabbi, wrote in his “Mishneh Torah” that “all the illnesses suffered by humans, or at least the great majority of them, are the consequence of a deficient or excessive diet”. In an extract from his medical aphorisms, he urged his disciples to cultivate critical observation and reasoning, a lesson still relevant today regarding food and health: “If someone tells you that he has proof from his own experience of something that confirms his theory, even if he is a person of great authority, seriousness, and morality, you must still doubt him. Do not let your mind be carried away by the novelties he recounts; instead, examine his theories and beliefs carefully, just as you should with what he claims to have seen. Consider the matter well, and do not allow yourself to be easily persuaded…”. Al-Arbuli (Nasrid Kingdom of Granada, between the 13th–14th or 14th–15th centuries), an Andalusian scientist, was the author of an important “Treatise on Foods”, in which he emphasised the crucial role of diet in the preservation of health. In Chapter VI, concerning “The qualities of pickles, spices, sauces, and oils”, he stated that “olive oil is the most suitable fat for the human body, owing to its great affinity with it. It is an excellent food and lacks the heaviness of other fats”. Paracelsus (Einsiedeln, Switzerland, 1493 – Salzburg, 1541), a Swiss alchemist, physician, and astrologer of the Renaissance, kept his distance from the formal teaching of his time and challenged the authority of the classical texts in favour of a more “experimental” approach. He considered the harmful action of foods to be one of the five possible causes of illness. He maintained that an infusion of olive leaves and bark was excellent for washing all kinds of sores, and that drinking one cup daily expelled intestinal worms. He also affirmed that pure olive oil was an extraordinary laxative and a relief for hepatic and renal colic, and that, when mixed with egg yolk, it soothed the pain of burns. With the passing of time and the advance of science, research, and technology, scientific evidence has gradually emerged: some of the assumptions of the ancient physicians have been confirmed, others set aside, and the importance of food, particularly olive oil, for health has been reaffirmed. The relationship between diet and health is, even today, more important than in antiquity. Although the impact of dietary factors on the body is weaker than that of other agents, such as drugs, toxins, or carcinogens, in countries like Spain, where life expectancy has increased considerably, these less intense factors, such as nutrients, have the time to exert their influence. Among other factors, a good diet helps to preserve health, while a poor one leads it towards disease. The classical Mediterranean lifestyle is healthy not only because of the in-
OLIVE OILS AND HEALTH 14 gredients of its diet, the ways of preparing them, and the leisurely and social manner of eating, but by the way you live your life. In the 1950s, Ancel Keys (1904 – 2004), the biologist who coined the term “Mediterranean Diet”, launched the first multinational epidemiological study on diet, cholesterol, and coronary heart disease, known as “The Seven Countries Study”. This study revealed the lower consumption of saturated fat in Japan and in the Mediterranean region, although in the latter total fat intake was high due to the significant consumption of olive oil. However, this took place within a generally low-calorie dietary pattern. From this study it was inferred that living in a Mediterranean country conferred a notable health advantage and was associated with longer life expectancy. By contrast, other studies from the same period concluded that olive oil should be replaced by seed oils, which, though scientifically correct at the time, but later shown to be incomplete, were found to reduce cholesterol. The Mediterranean Diet Pyramid, based on the dietary traditions of Crete, southern Italy, and Spain in the 1970s, was presented by Walter C. Willett (Hart, Michigan, 1945) at the International Conference on the Mediterranean Diet held in Cambridge, Massachusetts (USA) in 1993, and was later published in 1995 in the American Journal of Clinical Nutrition. Francisco Grande Covián (Colunga, Asturias, 1909 – Madrid, 1995), Spanish physician and researcher, regarded as the father of nutrition in Spain and a world authority in this field, devoted his life to the study of nutrition. From 1954 to 1974 he worked in Ancel Keys’ laboratory at the University of Minnesota. Grande Covián demonstrated that olive oil, then little valued, was the main protective factor against cardiovascular risk and one of the reasons behind the low incidence of myocardial infarction in Mediterranean countries. From the scientific studies carried out by Professor Grande Covián and other authors it was concluded that animal fats increase cholesterol; seed oils reduce total cholesterol but lower both the “bad” (LDL) and the “good” (HDL) fractions; while olive oil lowers the harmful fraction and maintains or even increases the protective one. He therefore concluded that olive oil exerts a superior effect in preventing atherosclerotic disease. A great communicator of nutritional science, he left several memorable phrases still recalled by present-day nutritionists: “Man first wanted to eat to survive; later he wanted to eat well and incorporated gastronomy into his cultural world. Now, in addition, he ‘wants to eat health’ (that is, to eat for health)”; “One should eat a bit of everything, but in a dessert plate”. From the late 20th century to the present, research on olive oil and health has increased notably. Drawing on considerable scientific knowledge and technological resources, it has provided important demonstrations and insights into the relationship between olive oil and health. The most significant findings are described throughout the chapters of this book.
15 Virgin Olive Oil Benefits This book seeks to meet the need for up-to-date, reliable, and accessible information on the health benefits of olive oil. It also aspires, in the words of Ortega y Gasset (1883 – 1955), to be “at the height of its time (that is, in step with its time)”. The promoters of this publication (“Fundación Patrimonio Comunal Olivarero” and “Organización Interprofesional del Aceite de Oliva Español”) and this Scientific Editor, through the independent patronage of the former and the latter’s thirty-six years of research on olive oil and health, have been able to confirm that olive oil possesses numerous health benefits. Two facts, however, have prompted them to promote this publication Two facts, however, have prompted them to promote this publication. On the one hand, they view with concern the abundance of information which, while often very favourable to olive oil, is either insufficiently verified or even false. Such inaccuracies discredit both the scientific community and the sector as a whole. Moreover, the misinformation generated can unjustly cast doubt upon the rigorous evidence that does exist regarding the health benefits of olive oil. On the other hand, the frequent controversies surrounding food, which create confusion and change over time, as has also been the case with olive oil since the 1950s, add to the problem. On this issue, Gregorio Marañón (1887 – 1960), an illustrious and universally renowned endocrinologist, observed that “there is no part of medicine more mutable, nor resting on shakier foundations, than the science of dietetics; scarcely a year passes without some fundamental change”. For all these reasons, the Promoters, the Editor, and the Authors declare no conflict of interest in this publication. Their sole commitment is to scientific rigour and to the dissemination of knowledge on a subject as complex, evolving, and sensitive as olive oil and health. Objectives of the book First, to provide the well-established scientific evidence available to date on the health benefits of olive oils, in accordance with the basic European regulation ([EC] No. 1924/2006, amended by [EC] No. 109/2008 of the European Parliament and of the Council of 20 December 2006 and 15 January 2008, respectively, concerning nutrition and health claims on foods). “Science is the father of knowledge, but opinions give birth to ignorance”. (Hippocrates, 460 BC – 370 BC)
OLIVE OILS AND HEALTH 16 Therefore, this is a scientific book, but its second objective is to be written in accessible language. “A science is all the more useful when its works can be universally understood; and, on the contrary, the less communicable they are, the less useful they will be”. (Leonardo da Vinci, 1452 – 1519) Other important objectives of this book are: - To provide rigorous information for professionals who are not specialists in nutrition, but who may have some connection with food and health, such as physicians, nurses, pharmacists, biologists, and others. - To encourage citizens to be critical of the messages they receive about food, and to consult trustworthy sources of information. - To promote nutritional education for health and its dissemination, with the aim of contributing to the improvement of the population’s dietary habits Structure of the book The selection of topics and authors was made after an exhaustive review of more than five hundred scientific articles published in the last five years. In fact, the choice focused, on the one hand, on those subjects and pathologies with the strongest scientific evidence regarding the health benefits of olive oils, and, on the other hand, on the most renowned Spanish researchers in the field. Once reviewed, eighteen topics were selected, each assigned to the leading specialist in the field, resulting in eighteen chapters. Since some of the main authors signed their chapters together with their collaborators, the total number of contributors amounts to thirty-six. All of them are distinguished professionals in the fields of nutrition and health, who have critically argued and reflected on the foundations of a healthy diet based on olive oil consumption. Spontaneously, this selection brought together authors who are professors, physicians, scientists, and/or researchers from universities, hospitals, and research centres, representing all the Spanish olive oil-producing regions. The Prologue of the book has been written by The Honourable Mr. Luis Planas Puchades, Minister of Agriculture, Fisheries and Food of the Government of Spain, and The Honourable Ms. Carolina Darias San Sebastián, Minister of Health. As previously stated, the publication is composed of eighteen chapters written by the Main Authors (whose names are underlined) and, in some cases, with the
17 Virgin Olive Oil Benefits participation of their Collaborators. The chapters are organised into four Units. The first unit (A), “The key role of diet in health: olive oils”, consists of six chapters and serves as an introduction. The second unit (B), “Olive oils in different stages of life and in physical activity”, contains three chapters and focuses on the preventive effects of olive oils in healthy individuals. The third unit (C), “Benefits of virgin and extra virgin olive oils against diseases”, comprises eight chapters: seven devoted to conditions for which there is a significant body of evidence, and one to other pathologies where extra virgin olive oil has also shown health benefits, though the available data are more limited. Finally, unit (D), “Olive oil in the context of the Mediterranean diet and a healthy lifestyle”, contains a single chapter that integrates these concepts. Each chapter concludes with up to five bibliographic references, intended as “For further knowledge”, for those readers who wish to deepen their understanding of the subject.” Subsequently, a glossary has been prepared by the Editor, based on the basic indications provided by all the main authors regarding the technical terms appearing in their respective chapters. In the chapters, as well as in the glossary itself, technical terms are shown in italics. Likewise, the technical terms included in the book’s index also appear in italics. In addition, the quotations from this Preface are also in italics, though without any relation to the glossary. Conversely, when the authors themselves used italics in their manuscripts, these parts appear in the chapters in highlighted text but not in italics (see the introduction to the glossary). Given the informative nature of this work, the glossary has proven not only necessary but even indispensable to facilitate understanding of the 533 technical terms that, inevitably, appear throughout the different chapters. Its purpose is also to prevent non-specialist readers from consulting unreliable sources, while providing confidence that the terms defined in the glossary are scientifically verified. Furthermore, the glossary may add value by offering intuitive explanations of technical terms encountered by individuals suffering from some of the diseases discussed in this book. Finally, a section provides information on the four health claims recognised and authorised by the “European Commission”, following evaluation by the “European Food Safety Authority” (EFSA), for the labelling and advertising of olive oil. These claims constitute unequivocal evidence of the important role this food plays in the field of health. In relation to the chapters and the glossary, all the authors have made a considerable effort to meet the challenge of reconciling the two main objectives of this book: to be scientific and, at the same time, accessible. The Editor wishes to emphasise the broadly collective nature of this book.
OLIVE OILS AND HEALTH 18 The book is intended for the general population, and, more specifically, for public administrations at central, regional, and local levels. It is also directed towards corporate bodies, particularly those of professionals related to health (physicians, nurses, occupational therapists, pharmacists, physiotherapists, biologists, psychologists, and veterinarians), to nutrition (dietitians, nutritionists, and food technologists), and to members of the food chain. Finally, this Scientific Editor wishes to express his sincere gratitude to all those who have contributed to the making of this book: to the Spanish Government Ministers, for the recognition shown by writing its Prologue and for finding the necessary time despite their high responsibilities and numerous duties; to the Promoters, for driving forward this necessary initiative and for following it closely at every stage; to the Authors, for their mastery and the effort devoted to preparing the chapters and the preliminary indications of the glossary terms, ensuring that both were aligned with the objectives of the book and to the Publisher, for the care shown in the layout, corrections, and printing of the work. Eduard Escrich. Scientific Editor. October 2025.
19 Virgin Olive Oil Benefits ÁLVAREZ DE CIENFUEGOS-LÓPEZ, Gerardo Departamento de Ciencias de la Salud. Universidad de Jaén. Jaén. España. ÁLVAREZ–FALCÓN, Ana Luisa Grupo de Nutrición del Instituto Universitario de Investigaciones Biomédicas y Sanitarias-iUIBS, Universidad de Las Palmas de Gran Canaria, Las Palmas. España. BATTINO, Maurizio Departamento de Ciencias Clínicas. Universidad Politécnica de las Marcas. Ancona, Italia. Centro de Investigación Internacional para Alimentación Nutricional y Seguridad. Universidad de Jiangsu. Zhenjiang, China. DE LA CRUZ-ARES, Silvia Unidad de Lípidos y Aterosclerosis, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/ Departamento de Bromatología y Tecnología de los Alimentos de la Universidad de Córdoba. Córdoba. España. CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid. España. CARRASCO-PANCORBO, Alegría Departamento de Química Analítica. Facultad de Ciencias, Universidad de Granada. Granada. España. ESCRICH-I ESCRICHE, Eduard Grupo Multidisciplinario para el Estudio del Cáncer de Mama. Facultad de Medicina. Universidad Autónoma de Barcelona. Real Academia de Medicina de Cataluña. Barcelona. España. ESTRUCH-RIBA, Ramon Servicio de Medicina Interna, Hospital Clínic, IDIBAPS, Universidad de Barcelona. Barcelona y CIBER de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid. España. FERNÁNDEZ-GUTIÉRREZ, Alberto Grupo de Control Analítico Ambiental, Bioquímico y Alimentario. Departamento de Química Analítica. Facultad de Ciencias. Instituto de Nutrición y Tecnología de los Alimentos. Universidad de Granada. Granada. España. author index
OLIVE OILS AND HEALTH 20 GALLARDO-COBOS, Rosa Departamento de Economía Agraria, Finanzas y Contabilidad. Ed. Gregor Mendel. Campus de Rabanales, Córdoba. Escuela Técnica Superior de Ingeniería Agronómica y de Montes. Universidad de Córdoba. Córdoba. España. GIL, Ángel Departamento de Bioquímica y Biología Molecular II. Universidad de Granada. Granada. Instituto de Nutrición y Tecnología de los Alimentos, Centro de Investigación Biomédica, Universidad de Granada; Instituto de Investigación Biosanitaria IBS. Granada; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid. España. GUTIÉRREZ-MARISCAL, Francisco M. Unidad de Lípidos y Aterosclerosis, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba. Córdoba. España. CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España. LAMUELA-RAVENTÓS, Rosa M. Departamento de Nutrición, Ciencia de la Alimentación y Gastronomía, Facultad de Farmacia y Ciencias de la Alimentación y XIA, Instituto de Nutrición y Seguridad de los Alimentos (INSA-UB), Universidad de Barcelona. Barcelona. Consorcio CIBER, Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid. España. LARQUÉ-DAZA, Elvira Departamento de Fisiología Animal. Facultad de Biología. Universidad de Murcia, Murcia; Instituto Murciano de Investigación Biosanitaria IMIB, Murcia. Red de Excelencia en Salud Materno-Infantil (RETIC SAMID), Instituto de Salud Carlos III, Murcia España. LÓPEZ-MIRANDA, José Unidad de Lípidos y Aterosclerosis, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba, Córdoba, España. CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España.
21 Virgin Olive Oil Benefits LÓPEZ-SEGURA, Fernando Unidad de Lípidos y Arteriosclerosis. Hospital Universitario Reina Sofía de Córdoba. Nutrigenómica y Síndrome Metabólico, IMIBIC, Universidad de Córdoba. Córdoba. España. CIBEROBN, Instituto de Salud Carlos III. Madrid. España LORENZO-TAPIA, Francisco Servicio Médico. Liceo Francés Internacional de Málaga Asociación Olearum, Cultura y Patrimonio del Aceite. Málaga. España. LOZANO-CASTELLÓN, Julián Departamento de Nutrición, Ciencia de la Alimentación y Gastronomía, Facultad de Farmacia y Ciencias de la Alimentación y XIA, Instituto de Nutrición y Seguridad de los Alimentos (INSA-UB), Universidad de Barcelona. Barcelona. Consorcio CIBER, Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid. España. MARINÉ, Abel Departamento de Nutrición, Ciencias de la alimentación y Gastronomía. Facultad de Farmacia y Ciencias de la Alimentación. Campus de la Alimentación. Universidad de Barcelona. Barcelona. España. MARTÍNEZ-GONZÁLEZ, Miguel Ángel Departamento de Medicina Preventiva y Salud Pública. Universidad de Navarra, Pamplona. España. CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III. Madrid. España. IdiSNA, Instituto de Investigación Sanitaria de Navarra. Pamplona. España. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston MA, USA. MARTÍNEZ-LAPISCINA, Elena H. Rare Neurological Disorders Lead - Clinical Neurologist en European Medicines Agency. Amsterdam. Netherlands. MORAL-CABRERA, Raquel Departamento Biología Celular, Fisiología e Inmunología, Facultad de Medicina, Universidad Autónoma de Barcelona (UAB). España. NAVARRO-HORTAL, María D. Centro de Investigación Biomédica. Instituto de Nutrición y Tecnología de los Alimentos “José Mataix Verdú”. Departamento de Fisiología. Universidad de Granada. Granada. España.
OLIVE OILS AND HEALTH 22 NOTARIO-BARANDIARÁN, Leyre Unidad de Epidemiología de la Nutrición. Departamento de Salud Pública. Universidad Miguel Hernández. Campus San Juan, San Juan de Alicante, España. Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA. OLMO-GARCÍA, Lucía Departamento de Química Analítica. Facultad de Ciencias, Universidad de Granada. Granada. España. ORDOVÁS-MUÑOZ, José M. JM-USDA-HNRCA (Jean Mayer-U.S. Department of Agriculture-Human Nutrition Research Center on Aging). Universidad de Tufts. Boston, Massachusetts. USA. Instituto Madrileño de Estudios Avanzados (IMDEA-Alimentación), Madrid. España. QUILES-MORALES, José L. Centro de Investigación Biomédica. Instituto de Nutrición y Tecnología de los Alimentos “José Mataix Verdú”. Departamento de Fisiología. Universidad de Granada. Granada. Grupo de Investigación en Alimentos, Bioquímica Nutricional y Salud. Universidad Europea del Atlántico. Santander. España. RAMÍREZ-TORTOSA, César L. Servicio de Anatomía Patológica. Hospital Universitario San Cecilio de Granada. Granada. España. ROMERO-MÁRQUEZ, José M. Centro de Investigación Biomédica. Instituto de Nutrición y Tecnología de los Alimentos “José Mataix Verdú”. Departamento de Fisiología. Universidad de Granada. Granada. España. SÁNCHEZ-ZAMORA, Pedro Departamento de Economía Agraria, Finanzas y Contabilidad. Ed. Gregor Mendel. Campus de Rabanales, Córdoba. Escuela Técnica Superior de Ingeniería Agronómica y de Montes Universidad de Córdoba. Córdoba. España. SERRA-MAJEM, Lluís Rectorado y Grupo de Nutrición del Instituto Universitario de Investigaciones Biomédicas y Sanitarias-iUIBS. Universidad de Las Palmas de Gran Canaria. Las Palmas. España. CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III. Madrid. España.
23 Virgin Olive Oil Benefits SERRANO-GARCÍA, Irene Departamento de Química Analítica. Facultad de Ciencias, Universidad de Granada. Granada. España. TORRES-COLLADO, Laura Unidad de Epidemiología de la Nutrición. Departamento de Salud Pública. Universidad Miguel Hernández. Campus San Juan, San Juan de Alicante. Alicante. CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III. Madrid. España. Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH). Alicante, España. VALLVERDÚ-QUERALT, Anna Departamento de Nutrición, Ciencia de la Alimentación y Gastronomía, Facultad de Farmacia y Ciencias de la Alimentación y XIA, Instituto de Nutrición y Seguridad de los Alimentos (INSA-UB), Universidad de Barcelona. Barcelona. Consorcio CIBER, Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid. España. VARELA-LÓPEZ, Alfonso Centro de Investigación Biomédica. Instituto de Nutrición y Tecnología de los Alimentos “José Mataix Verdú”. Departamento de Fisiología. Universidad de Granada. Granada. España. VIOQUE-LÓPEZ, Jesús Unidad de Epidemiología de la Nutrición. Departamento de Salud Pública. Universidad Miguel Hernández. Campus San Juan, San Juan de Alicante. Alicante. España. CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III. Madrid. España. Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH). Alicante. España. YUBERO-SERRANO, Elena M. Departamento de Alimentación y Salud - Instituto de la Grasa, CONSEJO SUPERIOR DE INVESTIGACIONES CIENTÍFICAS (CSIC). Sevilla, España. CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III. Madrid. España.
1 1 1 1
25 Virgin Olive Oil Benefits UNIT A THE KEY ROLE OF DIET IN HEALTH: OLIVE OILS CHAPTER 1 OLIS AND FATS 34 Abel Mariné-Font 1.1. Animal and vegetable fats 36 - Aspects and general concepts - Classification - The function of fat in human nutrition 1.2. Nutritional and dietetic properties of extra virgin olive oil 41 - Characteristics and types of olive oil - Biological properties of extra virgin oil: nutritional and dietetic aspects 1.3. The olive tree and olive oil within the Mediterranean cultural and dietary framework 43 1.4. References – For further knowledge 45 CHAPTER 2 TRANS FATTY ACIDS AND HEALTH 46 Elvira Larqué-Daza, Ángel Gil 2.1. Introduction 48 2.2. Dietetic sources and trans fatty acids consumption 49 2.3. Trans fatty acids and health in adults 51 2.4. Effects of trans fatty acids at the perinatal stage 54 2.5. Legislation for trans fatty acids 55 2.6. References – For further knowledge 57 CHAPTER 3 OLIVE OIL: PRODUCTION, TYPES OF OIL, AND COMPOSITION 58 Alberto Fernández-Gutiérrez, Alegría Carrasco-Pancorbo, Irene Serrano-García y Lucía Olmo-García 3.1. Introduction, definition, and general description of olive oil production 60 table of contents
OLIVE OILS AND HEALTH 26 3.2. Olive oil classification 62 - Commercial categories - Other classifications of interest 3.3. Olive oil composition. Key role of the minor components 65 3.4. The need for reliable methods to characterize olive oil 68 3.5. References – For further knowledge 69 CHAPTER 4 EXTRA VIRGIN OLIVE OIL IN GASTRONOMY AND HEALTH 70 Francisco Lorenzo-Tapia 4.1. Extra virgin olive oil, the backbone of the Mediterranean diet 72 4.2. The best chef, the olive oil user 74 4.3. Extra virgin olive oil, gastronomy, and health 75 4.4. References – For further knowledge 79 CHAPTER 5 BENEFITS OF THE USE OF EXTRA VIRGIN OLIVE OIL FOR COOKING 80 Rosa M Lamuela-Raventós, Julián Lozano-Castellano, Anna Vallverdú-Queralt 5.1. Comparison between the composition of extra virgin olive oil and those of other oils 82 5.2. Extra virgin olive oil in different types of cooking 83 5.3. Extra virgin olive oil for sauteing 83 5.4. Frying 84 5.5. Extra virgin olive oil for vegetables 84 5.6. Extra virgin olive oil for tomato sauces 85 5.7. References – For further knowledge 86 CHAPTER 6 OLIVE OIL AND THE CURRENT INSTITUTIONAL, SOCIOECONOMIC, AND ENVIRONMENTAL CONTEXT 87 Rosa Gallardo-Cobos, Pedro Sánchez-Zamora 6.1. Introduction 89 6.2. Context of olive oil production 89
27 Virgin Olive Oil Benefits 6.3. Olive oil in Spain 93 6.4. Conclusion 94 6.5. References – For further knowledge 95 UNIT B OLIVE OILS IN DIFFERENT STAGES OF LIFE AND IN PHYSICAL ACTIVITY CHAPTER 7 OLIVE OIL CONSUMPTION IN SPECIAL SITUATIONS SUCH AS PREGNANCY, CHILDHOOD, AND ADOLESCENCE 98 Jesús Vioque-López, Laura Torres-Collado, Leyre Notario-Barandiarán 7.1. Introduction 100 7.2. Olive oil consumption in pregnancy and lactation 101 7.3. Olive oil consumption in childhood and adolescence 103 7.4. References – For further knowledge 105 CHAPTER 8 VIRGIN OLIVE OIL AND AGEING 106 José L. Quiles, María D. Navarro-Hortal, José M. Romero-Márquez, Maurizio Battino, César L. Ramírez-Tortosa, Alfonso Varela-López 8.1. Introduction 108 8.2. Dietary fat, biological membranes, and oxidative stress 110 8.3. Experimental evidence of the benefits of olive oil on ageing and longevity 110 8.4. References – For further knowledge 116 CHAPTER 9 OLIVE OIL AND PHYSICAL ACTIVITY 117 Raquel Moral-Cabrera 9.1. Introduction 119 9.2. Exercise physiology 119 9.3. Nutrition and exercise: olive oil 121 - Cardiovascular action
OLIVE OILS AND HEALTH 28 - Oxidative stress - Inflammation -Others 9.4. Conclusions 124 9.5. References – For further knowledge 125 UNIT C BENEFITS OF VIRGIN AND EXTRA VIRGIN OLIVE OILS IN DISEASES CHAPTER 10 EXTRA VIRGIN OLIVE OIL AND CARDIOVASCULAR DISEASE 128 Ramon Estruch-Riba 10.1. Introduction 130 10.2. Extra virgin olive oil and cardiovascular risk factors 131 - Arterial hypertension - Effects on blood lipids - Olive oil and diabetes - Effects on other vascular risk factors 10.3. Olive oil, atherosclerosis, and cardiovascular disease 134 10.4. Conclusions 136 10.5. References – For further knowledge 137 CHAPTER 11 VIRGIN OLIVE OIL CONSUMPTION IN THE PREVENTION AND MANAGEMENT METABOLIC SYNDROME 138 Silvia de la Cruz-Ares, Francisco Miguel Gutiérrez-Mariscal, Elena M. Yubero-Serrano, José López-Miranda 11.1. What is metabolic syndrome? 140 11.2. Key role of diet on metabolic syndrome prevention 141 11.3. Virgin olive oil and metabolic syndrome 141 11.4. Virgin olive oil, oxidative stress, and inflammation 143 11.5. Virgin olive oil and HDL profile improvement 143 11.6. Virgin olive oil and blood pressure modulation 144 11.7. Virgin olive oil and type 2 diabetes 144
29 Virgin Olive Oil Benefits 11.8. Conclusion 145 11.9. References – For further knowledge 145 CHAPTER 12 EXTRA VIRGIN OLIVE OIL, OVERWEIGHT, AND OBESITY 146 José M Ordovás-Muñoz 12.1. Introduction 148 12.2. Epidemiological evidence on the association between olive oil consumption and overweight and/or obesity 149 12.3. Evidence from intervention studies on the association between olive oil consumption and overweight and/or obesity 150 12.4. Olive oil, microbiota, and overweight/obesity 151 12.5. Olive oil, obesity, and precision nutrition 152 12.6. Conclusions 155 12.7. References – For further knowledge 157 CHAPTER 13 EXTRA VIRGIN OLIVE OIL AND ITS BENEFICIAL EFFECTS ON HAEMOSTASIS AND COAGULATION 158 Francisco M Gutiérrez-Mariscal, Silvia de la Cruz-Ares, Fernando López-Segura, Elena M Yubero-Serrano, José López-Miranda 13.1. What is haemostasis? 160 13.2. The effect of olive oil on platelet aggregation 161 13.3. Blood clot formation and the effect of olive oil on coagulation 162 13.4. The influence of olive oil on thrombus formation 163 13.5. The effect of olive oil on clot dissolution by fibrinolysis 163 13.6. Conclusion 164 13.7. References – For further knowledge 165 CHAPTER 14 DIET AND CANCER: A PROLONGED RELATIONSHIP THAT CAN BE PREVENTED - OR EVENTUALLY ESTABLISHED - OVER TIME 166 Eduard Escrich-Escriche 14.1. Cancer 168
OLIVE OILS AND HEALTH 30 14.2. Diet and cancer 170 14.3. Extra virgin olive oil in the prevention and fight against cancer 173 14.4. Health recommendations and final considerations on olive oil in cancer prevention 177 14.5. References – For further knowledge 179 CHAPTER 15 EXTRA VIRGIN OLIVE OIL, THE IMMUNE SYSTEM, INFLAMMATION: ANTI-INFLAMMATORIES AND IMMUNOMODULATORS 180 Gerardo Álvarez de Cienfuegos-López 15.1. The immune system. A short description 182 15.2. Inflammation 182 15.3. Anti-inflammatories and immunomodulators 183 15.4. Effect of fats on the immune system 184 15.5. The particular case of extra virgin olive oil 185 15.6. Implications of olive oil for CoViD-19 development 185 15.7. References – For further knowledge 186 CHAPTER 16 EXTRA VIRGIN OLIVE OIL PROTECTS AGAINST COGNITIVE DECLINE 187 Elena H Martinez-Lapiscina, Miguel Ángel Martínez-González 16.1. Cognitive decline associated with age, cognitive decline, and dementia 189 16.2. What alternatives do we currently have for cognitive decline and dementia treatment? 189 16.3. How can extra virgin olive oil prevent cognitive decline? 191 16.4. What evidence is available regarding the benefits of extra virgin olive oil to improve cognitive function and reducing cognitive decline, and dementia risk? 191 16.5. References – For further knowledge 195
31 Virgin Olive Oil Benefits CHAPTER 17 OTHER PATHOLOGIES IN WHICH EXTRA VIRGIN OLIVE OIL HAS SHOWN HEALTHY EFFECTS 196 José M Ordovás-Muñoz 17.1. Introduction 198 17.2. Extra virgin olive oil and pain 199 17.3. Extra virgin olive oil and bone health 201 17.4. Extra virgin olive oil and inflammatory bowel disease 202 17.5. References – For further knowledge 203 UNIT D OLIVE OIL WITHIN THE FRAMEWORK OF THE MEDITERRANEAN DIET AND A HEALTHY LIFESTYLE CHAPTER 18 EXTRA VIRGIN OLIVE OIL, MEDITERRANEAN DIET, LIFESTYLE, AND HEALTH 205 Lluís Serra-Majem, Ana Luisa Álvarez-Falcón 18.1. What is the Mediterranean Diet? 208 18.2. Extra virgin olive oil, Mediterranean Diet, and health 209 18.3. Mediterranean Diet, culture, and lifestyle 210 18.4. Food sustainability: the new Mediterranean Diet pyramid 211 18.5. References – For further knowledge 213 GLOSSARY Presentation 215 Glossary structure 217 Glossary: definitions of technical term 220 NUTRITION AND HEALTH CLAIMS AUTHORISED BY THE EUROPEAN COMMISSION APPLICABLE TO OLIVE OILS 339
1 1 1 1
33
1.1. Animal and vegetable fats - Aspects and general concepts - Classification - The function of fat in human nutrition 1.2. Nutritional and dietetic properties of extra virgin olive oil - Characteristics and types of olive oil - Biological properties of extra virgin oil: nutritional and dietetic aspects 1.3. The olive tree and olive oil within the Mediterranean cultural and dietary framework 1.4. References – For further knowledge 34 ■ OILASNOFATS /lti/l,,r;,-,' ABEMLARINÉ-FONT
35 Virgin Olive Oil Benefits The nature of fats and oils, their classification according to various criteria, and their role in human nutrition are described. Special attention is paid to extra virgin olive oil and its biological and nutritional properties. The role of olive oil within the Mediterranean cultural and nutritional framework is also outlined. KEYWORDS: Oils, Fats, Virgin olive oil, Mediterranean diet ABBREVIATIONS: DHA: Docosahexaenoic acid EPA: Eicosapentaenoic acid. HDL: High density lipoproteins LDL: Low density lipoproteins abstract
OLIVE OILS AND HEALTH 36 1.1 ANIMAL AND VEGETABLE FATS General aspects and concepts Fats are non-soluble substances in water of differing nature which have the fatty acids as a common pattern. Most fatty acids are attached to glycerin forming triglycerides or triacylglycerides. They are made up of a molecule of glycerin (or glycerol) and three molecules of fatty acids, the major components of fat. They also have minor compounds such as phospholipids and sterols (Figure 1.1). The biochemical term lipids, a synonym of fats, is often used when describing their metabolism in the body. Figura 1.1: Clasificación de lípidos SIMPLE LIPIDS: Triglycerides COMPOUND LIPIDS: Phospholipids DERIVEDLIPIDS: Those released during the hydrolysis of simple and compound lipids Figure 1.1: Lipid Classification. Classification According to their characteristics at room temperature (around 20ºC), fats can be classified as liquid or solid. Liquid fats are called oils and the solid ones butters, lard, or tallows. Butters is soft and melts around 37ºC whilst lard or tallow has both more consistency and a higher melting temperature. Oils and lard are composed almost totally of fat whilst butter contains around 80%, the rest being mainly water. Margarine and other fat products for spreading or for different applications may present a lower fat content. According to their origin, fats are classified as vegetable, animal, or transformed. The fat content of vegetables is generally low with the exception of those defined as oily (e.g., olives, nuts, soy, avocado), and cocoa and its derivatives. The oth-
er clietary fats are of animal ongm: meat, milk and its derivatives, and eggs. The content of fats in the e foods, particularly meat and derivatives (e.g., sau age ), is variable but could be high. Fish also has a variable quantity of interesting fat and is consequently classified as white or lean (e.g., hake, cod, monkfish, sole) and blue or oily (e.g., sarcline, herring, tuna). Shellfish has lowfat.Transformed and industrially manufacturedfat iseither consumed as such (margarine) or as ingredients of other products (e.g., pastries, biscuits) and present a diverse fat content (Table 1.1). TYPE OF FOOD - TYPE OF FOOD Olive oíl 99,9 � Semí-cured, Manchego cheese 29 Palm oíl 99,9 Serrano ham 20 Sunflower oíl 99,9 Chicken egg 12 Soy oíl 99,9 Cooked ham 10 Lard 99 Lean pork 8 Butter, Margarine 80 �Sardíne 8 Industrial mayonnaíse 75 �f' Beef chop 7 � Bacon 71 Tuna 6 Nuts (wíthout husk) 65 1,4- 5 • Sobrasada 61 Full cream cow's mílk 3,7 Cream 48 Chicken 3 Díet margaríne 41 �Hake 2 � Cured Sausage 37 Bread 1,5 -,,. Pork chop " 30 Fruít and Vegetables 0,1-1,3 Table 1.1: Average fat content (per 100 grarns) of different foods. According to their chemical nature, fattY acids are clivided into saturated (without double bonds in their molecules) and unsaturated (with one or more double bonds). (Figure 1.2). A fat with a main content of unsaturat,ed fatry acids i an oil whilst one with a main content of saturatedfatry acids is a solid product. Taking in account the relationship between fats and cardiovascular health, the predominant fats in the cliet hould be the unsaturated ones (oil ). Whilst the quantity of saturatedfat in the cliet
OLIVE OILS AND HEALTH 38 needs to be controlled it should be noted that the negative effects of saturated fats, whose main source is meat and its derivatives and dairy products, are lesser than previously thought. Palmitic and stearic acids are the most abundant saturated fatty acids, in addition, there are the butyric, caproic, caprylic, capric, lauric, and myristic fatty acids. Unsaturated fatty acids are divided into monounsaturated (with only one double bond, for instance, oleic acid, predominant in olive oil), and polyunsaturated ones (with more than one double bond, such as linoleic and linolenic acids). The function of fats in human nutrition Animal and human fats are structural or “regular” and for storage or “variable”. The latter particularly increase in overweight and obesity. From a nutritional point of view, fats and oils have fallen into disrepute given that they are associated with excess weight and high cholesterol levels (Fig 1.4a). This, however, is due to an over-consumption of fats within the framework of a nonhealthy diet and/or metabolic or genetic problems. A varied, complete, and balanced diet should provide fats given that they: 1) provide slow disposal energy (9 kilocalories per gram); 2) protect the body’s tissues and organs (structural function); 3) contribute to isolating the body from temperature changes (too high or too low); 4) contain liposoluble vitamins (vitamins which are soluble in fats such as A, D, E, and K); and 5) provide essential biochemical functions for the body. Whilst the non-consumption of Figure 1.2: Types of fatty acids (according to the number of double bonds). Figura 1.2: Tipos de ácidos grasos (según el número de dobles enlaces) SATURATED (without double bonds) MONOUNSATURATED (with one double bond) POLYUNSATURATED (with more than one double bond) NVV\ /VV\ ./V\J\
RkJQdWJsaXNoZXIy Njg1MjYx