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Canola oil and olive oil impact on lipid profile and blood
pressure in women with type 2 diabetes: a randomized,
controlled trial
Masoumeh Atefi1, Gholam Reza Pishdad2, Shiva Faghih1
1Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran -
Email: sh_faghih@sums.ac.ir; 2Endocrine and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Summary. Objective: A number of studies indicated that olive oil (OO) and canola oil (CO) have lipid-
lowering and blood pressure-lowering effects. is clinical trial was done to compare the effects of CO and
OO on serum lipids and blood pressure in women with type 2 diabetes. Methods: is randomized controlled
clinical trial was done on 77 type 2 diabetic women. 4 weeks before the intervention, lipid-lowering drugs
intakes were cut under the supervision of an endocrinologist. e participants were randomly allocated into
2 intervention groups (Balanced diet + 30 grams/day OO or CO) and one control group (Balanced diet
+ 30 grams/day of sunflower oil (SFO)). Dietary intakes were assessed using three 24-hour food records
at baseline and at weeks 4 and 8 of the interventions. At baseline and after 8 weeks, height, weight, waist
circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), serum total cholesterol (TC),
triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein (VLDL-C)
and high-density lipoprotein cholesterol (HDL-C) were measured and the data were statistically analyzed
by SPSS 19. Results: After treatment, SBP (p=0.02), TG (p=0.01) and VLDL-C (p=0.02) were significantly
decreased in OO group. None of the variables had significant changes in CO or SFO groups. ere were no
significant differences in the blood pressure and lipid profile among 3 groups. Conclusion: Although we found
no differences between the effects of CO, OO, and SFO, it seems that replacing CO and SFO by OO may
have some beneficial effects on SBP, TG and VLDL-C in women with type 2 diabetes.
Key words: canola oil, olive oil, lipid profile, blood pressure, type 2 diabetes
Progress in Nutrition 2018; Vol. 20, Supplement 1: 102-109 DOI: 10.23751/pn.v20i1-S.5854 © Mattioli 1885
Original article
Introduction
e global epidemic of type 2 diabetes is increas-
ing rapidly (1) and the number of people with diabetes
has doubled in the past decade (2). On the other hand,
cardiovascular diseases (CVD) are the major cause of
death in patients with type 2 diabetes, which covers
about 60 percent of the patients (3).
Diabetics with high blood pressure (BP) are at
high risk of CVD (4,5), also abnormal lipid metabo-
lism is common among people with type 2 diabetes,
which has significant effects on atherosclerosis and
CVD risk (5,6).
It has been shown that the type of dietary fats
has a more important role than the amount of it in
the blood lipids and BP regulations (7,8). It is clear
that the consumption of vegetable oils slows down
the progression of chronic heart diseases (CHD).
Accordingly, the consumption of vegetable oils are
recommended (9). Also, the type of fatty acids such as
Monounsaturated fatty acid (MUFA), Saturated fatty
acid (SFA), Polyunsaturated fatty acid (PUFA) affects
serum lipids and lipoproteins, which are related to the
development of atherosclerosis and CVDs (8,10).
In some studies, it is reported that MUFA intake
significantly decreases TG, TC and LDL-C levels, also
Canola oil and olive oil impact on lipid profile and blood pressure in women with Type 2 diabetes: a randomized, controlled trial 103
increases serum HDL-C (11, 12). Omega-3 fatty acids
are effective in the regulation of the genes which play a
role in controlling blood lipids (13). Animal model and
human studies have shown that omega-3 fatty acids
have beneficial effects on plasma lipids and lipopro-
teins (14,15). Besides, a meta-analysis has shown that
omega-3 fatty acid intake can significantly reduce BP
in hypertensive patients (16). Blood pressure-lowering
effect of OO consumption via its high oleic acid con-
tent has been shown; as such, OO increases the oleic
acid level of the membrane, regulating the membrane
lipid structure and decreasing BP (12).
OO and CO are good sources of MUFA (17). CO
contains 11% omega-3 PUFAs, 53-59% MUFA, 22%
omega-6 PUFAs and 7.1% saturated fatty acids (SFA)
(18–20) and its ratio of omega-6 to omega-3 is ap-
propriate (20,21). OO contains 1% omega-3 PUFAs,
73.3% oleic acid (a MUFA), 7.9% omega-6 PUFAs
and 13.5% SFA (21).
Studies have shown that consumption of diets
rich in OO, which contains important phenolic com-
pounds, has a remarkable ability in reducing cholester-
ol level and platelet aggregation and is inversely associ-
ated with risk of CHD (22). Given that the dysfunc-
tion of lipid metabolism is one of the most important
complications in patients with type 2 diabetes, and
that the impact of different type of oils and their com-
ponents on lipid profile and BP in diabetic patients,
this clinical trial was done to compare the effects of
OO and CO consumption on lipid profile and BP in
type 2 diabetic women.
Material and methods
Patients
is study was held from July 2015 to November
2015. 81 females over 50 years old with type 2 dia-
betes and an average body mass index (BMI) of 28
kg/m2 were recruited. Participants were selected from
Motahhari clinic in Shiraz, according these inclusion
criteria:
Female gender, records of type 2 diabetes of at
least 6 months, and the routine use of SFO. Patients
who need insulin and/or lipid-lowering drugs; patients
with thyroid disorders, kidney and liver diseases, CVD;
participating in other studies in the past 6 months;
taking non-steroidal immunosuppressant, cyclospo-
rine and warfarin; smokers, alcohol consumption, and
who have TG > 400 (mg/dL) and/or LDL > 200 (mg/
dL) were not included to the study.
Study design
is is a single-center, parallel group, random-
ized controlled clinical trial. is study is approved
by the Ethics Committee of Shiraz University of
Medical Sciences (IR.SUMS.REC.1394.27) and
is recorded in the Iranian Registry of Clinical Trials
(IRCT2015062722818N1).
All study protocols were introduced into the
patients then written consents were taken. e sam-
ple size was estimated based on a previous study by
POWER SSC software (23) and with consideration
of the mean difference between independent groups by
assuming the probability of Type 1 error (α) equal to
0.05, the power of (β-1) equal to 80 %, the mean dif-
ference (μ1-μ2) equal to 0.35 and standard deviation
(σ) equal to 0.40. After adding 25% dropout rate, 25
persons per each group was considered.
Intakes of lipid-lowering drugs were discontin-
ued under the supervision of an endocrinologist 4
Table 1. Fatty acids composition of consumed oils
Sunflower oilCanola oilOlive oilFatty acids
7.86.511.2C16
4.92.52.9C18
0.40.20C20
0.900C22
27.659.472.5C18:1
5821.311C18:2
09.91C18:3
0.40.20C20:1
149.214.1SFA ∑
2859.672.5MUFA∑
5831.212PUFA∑
All values are % of total fatty acids, SFA: Saturated fatty acid, MUFA:
Monounsaturated fatty acid, PUFA: Polyunsaturated fatty acid
M. Atefi, G.R. Pishdad, S. Faghih
104
weeks before the intervention. en, by using balanced
block method patients were randomly allocated into 3
groups.
Using Estimated Energy Requirement (EER)
equation, weight maintenance (55% carbohydrate,
18% protein and 27% fat) diet was designated for each
participant. With Each diet contained 30 grams per
day of vegetable oils (SFO, CO and OO) and patients
were asked to add it to their salads or their boiled foods
by using a small measuring cup.
Anthropometric measurements and assessment of dietary
intake
At baseline and at the end of the intervention,
anthropometric indices were obtained by measuring
height, weight, and waist circumference.
Patients’ weights were measured in light clothes,
and without shoes with an accuracy of 100 grams by
a digital balance (BF11 OMRON made in France).
Height was measured with an accuracy of 0.5 centime-
ter by a non-stretchable tape measure. en BMI was
calculated as Weight (kg)/ (Height (m)* Height (m).
At baseline, week 4 and week 8 of the interven-
tion, 3 days 24-hour record and physical activity record
were filled by participants. Participants were asked not
to change the recommended diet, medications and
daily physical activity during the intervention.
Blood Pressure and Biochemical evaluation of blood
BP was measured by using a mercury manometer
after 10-15 minute relaxation in the sitting position
and away from any excitement before and after inter-
vention. BP was measured twice with an interval of
10 minutes, then the mean of 2 measurements was re-
corded.
Five milliliter blood sample was taken after 12 to
14 hours fasting and was held for 15 to 20 minutes at
room temperature, and then it was centrifuged for 5
minutes at 300 rpm. Serums were kept on -76°C un-
til further analysis. TC, TG, HDL-C, VLDL-C and
LDL-C were measured by the colorimetric methods
by Auto Analyzer Biochemical Model BT1500 device
(Pars Azmoon kit, Iran). Data were taken twice, before
and after intervention.
Statistical Analysis
24-hour food records were analyzed by Nutritionist IV
software. Data were analyzed by SPSS 19. P values less
than 0.05 considered significant.
Normal distribution of variables was assessed using
Kolmogorov-Smirnov test. Paired-Samples T-Test was
used to compare the anthropometric measurements,
energy, dietary intakes, lipid profile and BP at baseline
and week 8 of the intervention in each group. One-
way ANOVA was used to compare mean changes of
dietary intake, blood lipids and BP among the three
groups, and then Post-Hoc test was used for further
analysis.
Result
Of 81 participants, one in the OO group (not
following the dietary regimen), one in the CO group
(need for Insulin) and two in the SFO group (need
for blood lipids lowering drugs) were excluded, and 77
of them completed the study (Figure 1). Participants
reported no side effects associated with the consump-
tion of the oils.
General characteristics, anthropometric status,
and the dietary intake of participants at baseline are
shown in Table 2. No significant differences in ener-
gy, macronutrients distribution, and fatty acid intake,
weight, waist circumference, BMI and physical activ-
Figure 1. Participants flow diagram throughout the study
Canola oil and olive oil impact on lipid profile and blood pressure in women with Type 2 diabetes: a randomized, controlled trial 105
ity were observed in the control and the intervention
groups.
Dietary intakes of participants during the inter-
vention are given in Table 3. No significant differences
were observed in energy and fiber intakes, macronutri-
ent distributions and physical activities of three groups.
MUFA (P=0.001) and PUFA (P=0.001), intakes had
significant differences among the three groups.
Comparisons of the mean changes in blood lip-
ids and BP among the three groups are illustrated in
Table 4. ere were no significant differences in TG,
TC, LDL-C, VLDL-C, HDL-C, SBP and DBP lev-
els of the three groups. In the inter-group analysis, re-
duction of TG (P=0.01) and VLDL-C (P=0.02) were
significant just in OO group. Reduction of serum TC,
LDL-C, HDL-C, and BP were not significant in all
groups.
Discussion
e results of our study showed that there were no sig-
nificant differences among the effects of OO, CO or
SFO consumption on lipid profile or BP in women
with diabetes, however OO consumption led to sig-
nificant reduction of serum TG and VLDL-C.
Based on the previous studies, effects of different
kind of oils on blood lipids are controversial. TG and
VLDL-C levels increased by consumption of OO in-
stead of CO and SFO (24) while the opposite results
(25,26) and no TG level changes were also observed
(11). In Gustafsson and Nigam studies, consumption
of CO led to significant serum TG and VLDL-C re-
ductions (27,28). In Jones study, DHA-enriched high–
oleic acid canola oil improves TG (29). OO and CO are
rich sources of MUFA (17). Consumption of MUFA
Table 2. General characteristics, anthropometric status, physical activity and dietary intake of participants at baseline.
p-Value*Sunflower OilCanola OilOlive OilVariables
0.6357±558±659±7Age (Year)
0.67155±4156±4155±5Height (cm)
0.6868±9.970.7±7.869.8±14Weight (kg)
0.7628.1±3.828.9±3.628.7±4.8BMI (kg/m2)
0.3195.6±9.798.8±6.895.2±10.5Waist Circumference (cm)
0.2028.6±2.227.5±227.7±2Physical Activity (ME/day)
0.3928.9±5.427.7±4.529.4±3.6Fat (%Energy)
0.5817±2.117.5±2.916.8±2.4Protein (%Energy)
0.8955.2±7.156.1±6.555.7±5.4Carbohydrate (%Energy)
0.501542.6±262.41642.3±299.01586.6±337.3Energy (kcal/day)
0.46231.6±83.7206.3±72.1211.2±71.0Cholesterol (mg/day)
0.8513.0±4.213.4±3.113.6±3.6SFA (% of total energy)
0.0812.1±2.610.0±3.89.6±3.8MUFA (% of total energy)
0.0618.3±1.522.4±8.522.7±3.9PUFA (% of total energy)
0.0713.99±3.918.0±5.814.9±5.6Dietary fiber (% of total energy)
0.540.39±0.30.4±0.20.4±0.3Soluble fiber (% of total energy)
BMI: body mass index, SFAs: saturated fatty acids, MUFAs: monounsaturated fatty acids, PUFAs: polyunsaturated fatty acids. All values are
mean ± Standard deviation. * One way ANOVA.
M. Atefi, G.R. Pishdad, S. Faghih
106
increases TG entrance into the bloodstream, also makes
its clearance faster (30) which in our study probably it is
the reason of significant TG reduction after consump-
tion of OO and moderate TG reduction in CO.
Although we found no significant differences
in serum TC and LDL-C among the OO, CO and
SFO groups. TC and LDL-C levels increased in
OO and decreased in CO non-significantly. It is re-
ported that compared to SFO, consumption of OO
did not make significant reductions in serum TC and
LDL-C (11,25), while opposite results are also report-
ed (26,31). In Lichtensten study, serum TC decreased
after consumption of OO or CO enriched diet (32).
Nydahl and coworkers reported that TC, LDL-C and
LDL-C to HDL-C ratio, reduced after the consump-
tion of OO and CO (33), while we found different
results because of using different methodologies and/
or low concentration of blood lipids at baseline.
After substitution of omega 6 PUFAs with
MUFAs Griffin et al found no changes in serum TG,
TC and LDL-C, but LDL-C was rich in oleic acid
and subsequently its linoleic acid content was reduced,
which could reduce cholesterol ester to free choles-
terol ratio in LDL-C, so helps to regulate the cellular
cholesterol synthesis De Novo as an important fac-
tor against atherosclerosis (34). ese results prob-
ably happened in the current study; however, LDL-C
structures were not analyzed because of the financial
limitations.
HDL-C had no significant differences among
the OO, CO and SFO groups in the current study.
In agreement with our finding several studies reported
that compared to SFO, OO and CO made no signifi-
cant changes in HDL-C levels (11,31,33) while some
others reported a significant increase in HDL-C after
consumption of OO (24,34). And also, In Jones study,
DHA-enriched high–oleic acid canola oil improves
HDL-C (29).
In low-fat diet, PUFA has not adversely effected
on HDL-C (35). So the energy of fat can be one of the
Table 3. Anthropometric status, physical activity and dietary intake of participants during the intervention.
p-Value*Sunflower OilCanola OilOlive OilVariables
0.6367.8±9.870.7±869.5±14.1Weight (kg)
0.7128±3.728.9±3.728.6±4.9BMI (kg/m2)
0.2395.2±9.398.9±7.394.9±10.6Waist Circumference (cm)
0.6728.2±1.927.6±1.827.7±2.1Physical Activity (ME/day)
0.9128±4.527.8±2.928.3±3.9Fat (%Energy)
0.8216.8±1.716.5±1.416.8±2.1Protein (%Energy)
0.8956.6±5.657.3±4.256.9±5.6Carbohydrate (%Energy)
1.001614.9±316.71620.8±252.01614.8±267.0Energy (kcal/day)
0.56178.5±65.5183.1±49.8197.3±76.4Cholesterol (mg/day))
0.2012.9±3.112.0±2.313.4±2.9SFA (% of total energy)
0.0012.3±2.321.7±3.024.57±2.6MUFA (% of total energy)
0.0019.0±1.411.3±2.06.8±2.1PUFA (% of total energy)
0.2816.3±4.217.7±4.718.5±5.5Dietary fiber (% of total energy)
0.280.4±0.20.53±0.20.5±0.2Soluble fiber (% of total energy)
BMI: body mass index, SFAs: saturated fatty acids, MUFAs: monounsaturated fatty acids, PUFAs: polyunsaturated fatty acids. All values are
mean ± Standard deviation. * One way ANOVA
Canola oil and olive oil impact on lipid profile and blood pressure in women with Type 2 diabetes: a randomized, controlled trial 107
factors that affect HDL-C. In this study, the average
amount of energy derived from fats was 28.6 percent.
So, MUFA increase and PUFA decrease in OO and
CO groups compare to SFO group were not enough
for a significant increase in HDL-C during 8 weeks
of the treatment. So, by considering low-fat and low-
energy dietaries and normal amount of HDL-C at
the beginning of the treatment, no sensible effect on
HDL-C had happened.
Besides, SBP and DBP did not differe signifi-
cantly among the three groups, but SBP reduced sig-
nificantly in OO group. Based on the previous stud-
ies, the following results were made; long-term con-
sumption of OO reduced SBP and DBP (4,36) also
positive effects of CO consumption on SBP and DBP
were reported (29,37), while neutral results were also
observed (38). Probably, length of study, methodology,
amount of consumed oils and participants’ health sta-
tus are the reasons that the results of the current study
is not exactly similar to the previous studies.
In conclusion, although we found no differences
between the effects of CO, OO, and SFO on BP and
the lipid profile of the participants, it seems that re-
placing of SFO by OO may have some trivial benefi-
cial effects on SBP, TG and VLDL-C in women with
type 2 diabetes.
Acknowledgment
is article was extracted from MSc thesis written by
Masoumeh Atefi which was funded by Shiraz University of
Medical Sciences (SUMS) with the grant number of “94-7493”.
We wish to thank SUMS for their support. Also, we thank our
participants for their cooperation.
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Table 4. Comparison of serum lipids and BP changes among the three groups before and after intervention.
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Correspondence:
Shiva Faghih
Nutrition Research Center, School of Nutrition
and Food Sciences, Shiraz University of Medical Sciences,
Shiraz, Iran
Tel. +989126305829,
Fax +987137257288
E-mail: sh_faghih@sums.ac.ir
