Olive oil is associated with better bone markers and fewer fractures in observational and trial data, but it has not been shown to stop bone loss at menopause. The most consistent evidence links Mediterranean-style eating, with olive oil as the main fat, to lower fracture risk in older women. Laboratory and animal studies suggest olive polyphenols such as oleuropein support bone-building cells. This article covers bone change at menopause, the human and animal evidence, hot flushes and the shift in heart health that menopause brings.
Why does menopause affect bone?
Oestrogen slows the breakdown of bone, so when oestrogen falls at menopause, bone is broken down faster than it is rebuilt.
Bone is living tissue. Cells called osteoclasts remove old bone and osteoblasts lay down new bone. Oestrogen keeps the two in balance. As levels drop, the balance tips toward loss.
The loss is fastest around the final menstrual period. In the Study of Women's Health Across the Nation, bone density at the lower spine fell by roughly 2.5% a year during the menopause transition, with smaller losses at the hip (Greendale et al., Journal of Bone and Mineral Research, 2012). Over several years that adds up, and it is the main reason osteoporosis is more common in older women than in men.
Diet cannot replace the role of oestrogen. Calcium, vitamin D, protein, weight-bearing exercise and avoiding smoking remain the foundations of bone health. The question is whether olive oil adds anything on top.
What does the Mediterranean diet show for bone and fractures?
Large cohort studies link Mediterranean-style eating to a modestly lower risk of hip fracture in older women.
The Women's Health Initiative followed more than 90,000 postmenopausal women in the United States. Those whose diets most closely matched a Mediterranean pattern had about a 20% lower risk of hip fracture than those with the lowest scores (Haring et al., JAMA Internal Medicine, 2016). The absolute difference was small, and the study was observational, so it shows an association rather than cause.
A European cohort found a similar pattern. Each step up in Mediterranean diet score was associated with a lower rate of hip fracture, and a higher ratio of unsaturated to saturated fat, largely from olive oil, was among the contributing parts (Benetou et al., Osteoporosis International, 2013).
These diets include olive oil alongside vegetables, legumes, fish and nuts. The effect of the oil alone is hard to separate. Our article on olive oil and the Mediterranean diet explains how the pattern fits together.
What did PREDIMED show about bone?
Two PREDIMED analyses link extra virgin olive oil to better bone markers in men and fewer osteoporotic fractures in older adults.
PREDIMED was a large Spanish trial that compared a Mediterranean diet supplemented with extra virgin olive oil, one supplemented with nuts, and a low-fat control diet. It was designed to study heart disease. Our guide to what PREDIMED really proved covers the main results.
- Osteocalcin in men. In a sub-study of 127 older men, two years on the olive oil diet raised blood osteocalcin, a marker of bone formation, while the other groups did not (Fernández-Real et al., Journal of Clinical Endocrinology and Metabolism, 2012). Bone density itself was not measured, and no women were included.
- Fractures. Participants in the top third of extra virgin olive oil intake had a lower risk of osteoporotic fractures than those in the bottom third (García-Gavilán et al., Clinical Nutrition, 2018). This compared intake levels within the trial rather than randomised groups, so it is closer to observational evidence. doi:10.1016/j.clnu.2016.12.030
These results are encouraging. They are not proof that olive oil protects bone through menopause.
How might oleuropein support bone-building cells?
In laboratory and animal studies, oleuropein encourages stem cells to become osteoblasts and limits bone loss after the ovaries are removed.
Oleuropein is the main bitter polyphenol of olive fruit and leaf. In human bone marrow stem cells, it pushed development toward bone-forming osteoblasts and away from fat cells (Santiago-Mora et al., Osteoporosis International, 2011, preclinical).
Removing the ovaries in rats mimics the oestrogen loss of menopause. In that model, olive oil and oleuropein both limited the bone loss that followed when inflammation was also present (Puel et al., British Journal of Nutrition, 2004, preclinical). Its breakdown product, hydroxytyrosol, has shown similar effects in cell studies.
One human trial tested an olive polyphenol extract directly. Postmenopausal women with low bone density took an olive extract or placebo for 12 months. The extract group had higher osteocalcin and better blood lipids, and spine bone density held steady while it declined in the placebo group (Filip et al., Journal of Nutrition, Health and Aging, 2015, small study). It needs repeating in a larger group.
Does olive oil help with hot flushes?
There is no direct trial evidence that olive oil reduces hot flushes, but Mediterranean-style eating is associated with fewer of them.
In the Australian Longitudinal Study on Women's Health, women whose diets were closer to a Mediterranean pattern were about 20% less likely to report hot flushes and night sweats over nine years (Herber-Gast and Mishra, American Journal of Clinical Nutrition, 2013). A diet high in fat and sugar was linked to more symptoms.
This was observational. It does not single out olive oil, and other factors such as weight change may explain part of the link. Anyone with troublesome symptoms should discuss options with a clinician.
Why does heart health change at menopause?
After menopause, LDL cholesterol tends to rise and cardiovascular risk climbs, which is where olive oil's evidence is strongest.
The American Heart Association describes the menopause transition as a time of faster change in cholesterol, body fat distribution and blood vessel health (El Khoudary et al., Circulation, 2020). It recommends paying early attention to these risk factors.
This is where olive oil has its firmest support. PREDIMED found that a Mediterranean diet with extra virgin olive oil was associated with fewer major cardiovascular events in adults at high risk. Olive polyphenols also help protect blood lipids from oxidation, a benefit recognised by the European Union for qualifying oils. See our cholesterol page and our article on olive oil and heart health.
Bone and heart health also share a thread. Both are influenced by low-grade inflammation, which rises with age, as discussed in our article on olive oil and longevity.
How Pomoni fits: Making Pomoni high-phenolic Greek olive oil your main cooking and finishing fat is a practical way to follow the Mediterranean pattern studied above. Pomoni High-Phenolic Olive Oil provides oleuropein derivatives and hydroxytyrosol, compounds associated with healthy blood lipids and with bone-cell activity in laboratory research. For a measured daily amount, Phenolia Daily combines olive fruit extract, olive leaf extract and Greek Mountain Tea in two vegan, zero-calorie capsules taken with a meal, with polyphenols verified by HPLC. It supports cardiovascular and bone health alongside calcium, vitamin D and regular exercise. Most people judge it after 8 to 12 weeks.
Frequently asked questions
Can olive oil stop bone loss after menopause?
No study has shown that. Higher olive oil intake is associated with better bone markers and fewer fractures, and one small trial of an olive extract found spine density held steady over a year. Calcium, vitamin D, exercise and medical advice remain the basis of bone care.
What is oleuropein's role in bone health?
In laboratory studies, oleuropein encourages stem cells to become bone-building osteoblasts. In rats with oestrogen loss, it limited bone loss. Human evidence is limited to small trials.
Does olive oil help with hot flushes?
There is no direct trial evidence. A large Australian study found women following a Mediterranean-style diet were about 20% less likely to report hot flushes and night sweats.
How much olive oil was used in the PREDIMED study?
Participants in the olive oil group received about one litre of extra virgin olive oil a week for the household and were encouraged to use at least four tablespoons a day.
These statements have not been evaluated by the Food and Drug Administration. Pomoni products are not intended to diagnose, treat, cure or prevent any disease.
Sources
- Greendale GA, Sowers M, Han W, et al. Bone mineral density loss in relation to the final menstrual period in a multiethnic cohort: results from the Study of Women's Health Across the Nation (SWAN). Journal of Bone and Mineral Research. 2012;27(1):111-118. PubMed doi:10.1002/jbmr.534
- Haring B, Crandall CJ, Wu C, et al. Dietary patterns and fractures in postmenopausal women: results from the Women's Health Initiative. JAMA Internal Medicine. 2016;176(5):645-652. PubMed doi:10.1001/jamainternmed.2016.0482
- Benetou V, Orfanos P, Pettersson-Kymmer U, et al. Mediterranean diet and incidence of hip fractures in a European cohort. Osteoporosis International. 2013;24(5):1587-1598. PubMed doi:10.1007/s00198-012-2187-3
- Fernández-Real JM, Bulló M, Moreno-Navarrete JM, et al. A Mediterranean diet enriched with olive oil is associated with higher serum total osteocalcin levels in elderly men at high cardiovascular risk. Journal of Clinical Endocrinology and Metabolism. 2012;97(10):3792-3798. PubMed doi:10.1210/jc.2012-2221
- García-Gavilán JF, Bulló M, Canudas S, et al. Extra virgin olive oil consumption reduces the risk of osteoporotic fractures in the PREDIMED trial. Clinical Nutrition. 2018;37(1):329-335. PubMed doi:10.1016/j.clnu.2016.12.030
- Santiago-Mora R, Casado-Díaz A, De Castro MD, Quesada-Gómez JM. Oleuropein enhances osteoblastogenesis and inhibits adipogenesis: the effect on differentiation in stem cells derived from bone marrow. Osteoporosis International. 2011;22(2):675-684. PubMed doi:10.1007/s00198-010-1270-x
- Puel C, Quintin A, Agalias A, et al. Olive oil and its main phenolic micronutrient (oleuropein) prevent inflammation-induced bone loss in the ovariectomised rat. British Journal of Nutrition. 2004;92(1):119-127. PubMed doi:10.1079/bjn20041181
- Filip R, Possemiers S, Heyerick A, et al. Twelve-month consumption of a polyphenol extract from olive (Olea europaea) in a double blind, randomized trial increases serum total osteocalcin levels and improves serum lipid profiles in postmenopausal women with osteopenia. Journal of Nutrition, Health and Aging. 2015;19(1):77-86. PubMed doi:10.1007/s12603-014-0480-x
- Herber-Gast GC, Mishra GD. Fruit, Mediterranean-style, and high-fat and -sugar diets are associated with the risk of night sweats and hot flushes in midlife: results from a prospective cohort study. American Journal of Clinical Nutrition. 2013;97(5):1092-1099. PubMed doi:10.3945/ajcn.112.049965
- El Khoudary SR, Aggarwal B, Beckie TM, et al. Menopause transition and cardiovascular disease risk: implications for timing of early prevention. A scientific statement from the American Heart Association. Circulation. 2020;142(25):e506-e532. PubMed doi:10.1161/cir.0000000000000912
