Pharmacognosy Reviews

Vol 2, Issue 3, Jan-Jun, 2008 PHCOG REV.

An official Publication of Phcog.Net

Phcog Rev.: Plant Review

Olive: Native of Mediterranean region and Health benefits
Syed Haris Omar*
Pharmacy Department, Sebai Institute of Health Sciences, P.O.Box-54480, Jeddah-21514, Saudi Arabia
*Correspondence: Tel.: +966-2872009, Ext. 219. Email: syedharisomar@gmail.com

ABSTRACT
The Olive tree (Olea europaea) is native to the Mediterranean region, tropical & central Asia and various parts of Africa. It is an
integral ingredient of the diet in the form of whole fruit or oil in the countries surrounding the Mediterranean Sea. The
constituents of olive categorized into major and minor components. Major component of olive oil consist of oleic acid
(Triglycerides) and a large number of minor components includes phenolic constituents, squalene, α-tocopherol and sterols
having great importance and beneficial to human health. The main phenolics include hydroxytyrosol, tyrosol, and oleuropein,
which occur in highest levels in virgin olive oil and have demonstrated antioxidant activity. Many studies have been conducted to
prove its potential through oil, whole fruit and leaf extract as cardiovascular disorders and anti-oxidant, gastroprotective effect,
osteoprotective effect, endocrine effect, immunomodulatory effect, anti-cancer, anti-viral and anti-microbial effects.
KEY WORDS: Olive, Mediterranean diet, cardiovascular disorder, anti-cancer, antimicrobial.

INTRODUCTION AND HISTORY in the countries where olives are grown (2, 6), constitutes
Olive (Olea europaea) belongs to family Oleacea, have been part the commonly referred to “Mediterranean diet” of
used widely in folk medicine in European Mediterranean area, countries that surround the Mediterranean Sea and tend to
Arabia peninsula, India and other tropical and subtropical have a low incidence of chronic degenerative disease (7),
regions, as diuretic, hypotensive, emollient and for urinary particularly coronary heart disease (CHD) and cancers of the
and bladder infections (1). The olive can be consumed whole breast, skin, and colon (8, 9). This review will focus on the
as either the fully ripe black fruit or as the unripe green fruit. chemical constituents and health benefits of olive as olive oil,
Archeological evidence suggests that olives were being grown whole olive fruit and olive leaf extract.
in Crete as long ago as 2,500 B.C. From Crete and Syria olives CHEMICAL CONSTITUENTS
spread to Greece, Rome and other parts of the Mediterranean The composition of olive oil is complex; the major and minor
area and component of Mediterranean diet (2). Olives are also group of compounds thought to contribute to its observed
grown commercially in California, Australia and South Africa. health benefits includes small amounts of palmitate but is
There is some disagreement over when the trees first particularly by oleic acid as monoenoic acid oleate (5),
appeared in California. Some say they were introduced in phenolics, squalene (10), sterols about 0.2% phytosterol,
1769 when seeds brought from Mexico were planted. Others tocosterols, caffeic acid and Vitamin E (α-tocopherol) (11).
site the date 1785 when trees were brought in to make olive Oleic acid
oil. Edible olive was grown on the island of Crete around 3500 Olive oil is a triacylgylceride: three fatty acids attached to a
BC and may have been the source of the wealth of the Minoan glycerol backbone. Chemically it is a type of
kingdom. The Phoenicians spread the olive to the glycerolipid. Triacylglycerols (Triglycerides or Fats) are the
Mediterranean shores of Africa and southern Europe. Olives major energy reserve for plants and animals. Olive oil
have been found in Egyptian tombs from 2000 years BC. Olive contains approximately 72% oleic acid (Fig. 1), a
culture spread first to the early Greeks, then to the monounsaturated fatty acid (12). Llor and Pons (13)
Romans. As the Romans extended their domain, they brought conducted in vitro experiments on the effect of olive oil or
the olive with them. Some 1,400 years ago the Prophet of isolated oleic acid on colorectal neoplasia. They concluded
Islam, Muhammad (SAW), advised his followers to apply olive olive oil induces apoptosis and cell differentiation and down-
oil to their bodies; he himself used olive oil on his head. The regulates the expression of cyclooxygenase-2 (COX2) and Bcl-
use of oil is found in many religions and cultures. It has been 2. COX2 is believed to play an important role in colorectal
used during special ceremonies and also as a general health cancer development, while Bcl-2 is an intracellular protein
measure. It is also known as the symbol for peace, wisdom that inhibits apoptosis. Oleic acid alone exhibited cell-line
and victory. In the early Olympic Games the winners were specific apoptotic induction, since HT-29 cells were affected
crowned with wreaths made of olive branches. Holy people but not Caco-2 cells. Menendez et al (14) examined the effect
were anointed with olive oil, and Moses exempted men who of oleic acid on breast cancer cell lines. Oleic acid down-
would grow olives from military service. regulates the over-expression of Her-2/neu, an oncogene
Most plant oils of commercial value are accumulated in seeds over-expressed in approximately 20% of breast carcinomas.
(3). However, olive (Olea europaea L.) oil produced from fruit The gene, also know as erb-B2, encodes for the p185Her-
(4). Olive is one of the most significant oil crops in 2/neu oncoprotein, a transmembrane tyrosine kinase orphan
Mediterranean region and ranks sixth in the world production receptor that, under normal cellular conditions, is highly
of vegetable oils (5). Olive oil, the major source of dietary fat regulated because it controls many cell functions, such as

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differentiation, proliferation, and apoptosis. sqalene (12). There is a slight difference observed between
Phenols the level of squalene in extra virgin and refined virgin olive
A Mediterranean diet rich in olive oil supplies ~10-20mg of oils (extra virgin having higher levels) (10).
phenols per day (15). Virgin olive oil is one of the few edible
vegetable oils that is consumed unrefined, which implies that
it contains a significant amount of minor bioactive
substances. Among them, phenolic compounds have received
a great deal of attention over recent years because of the
beneficial properties attributed to human health (16, 17, 18).
Levels of phenolic compounds in olive oil vary widely; one
consistent conclusion is that extra virgin olive oil has a higher
phenolic content than refined virgin olive oil (10, 17). Olive
oil phenols can be categorized into: simple phenols,
secoiridoids and lignans, all of which inhibit auto-oxidation.
Major phenols include hydroxytyrosol, tyrosol, oleuropein
(19), and ligstroside (10) (Figure 2). Percentages of individual Figure 3. Phenols present in olive oil, their degradation into
phenolic compounds present in the olive oils were ~6.5% aglycones during ripening, and hydrolysis of aglycones into tyrosol
hydroxytyrosol, 5.5% tyrosol, 40% oleuropein aglycones, 26% and hydroxytyrosol.
ligstrosids aglycones, 12% lutein, and 3% apigenine (20).
Hydroxytyrosol and tyrosol are simple phenols and oleuropein APPLICATION AND HEALTH BENEFITS
is a secoiridoid. The simple phenols hydroxytyrosol and Cardiovascular effect
tyrosol are formed from the hydrolysis of the secoiridoid Coronary heart disease (CHD) is the leading cause of death in
aglycones of oleuropein and ligstroside. Hydrolysis of the United States as well as in many developing and
oleuropein, which occurs during olive oil storage (21), results developed countries (25). Research has shown a strong
in the formation of hydroxytyrosol, tyrosol, and ethanol (22) connection between Mediterranean diets and lower rates of
(Figure. 3). A human study showed that tyrosol and heart disease (26-29). Most researchers believe that the most
hydroxytyrosol are excreted in urine (23). important health-promoting substance in olive oil is oleic
acid, which is a monounsaturated fatty acid. The natural
antioxidants, including oleuropein, from the olive tree may
play a role in the prevention of cardiovascular diseases
through a decreased formation of atherosclerotic plaques by
inhibiting LDL oxidation (30). An olive leaf extract was
reported in a laboratory study to have vasodilating effects,
seemingly independent of vascular endothelial integrity (31).
Figure 1. Structure of oleic acid Traditional uses support olive leaf and olive oil in
cardiovascular disease prevention (32, 33). Animal
experiments in rabbit and rat preparations found a
hypotensive effect of oleuropein, possibly via direct action on
smooth muscle. Oleuropeoside also may exert vasodilator
activity. Additionally, olive leaf extracts may possess
antispasmodic, vasodilator, and anti-arrhythmic properties
(31, 34).
Hypolipidemic and Anti-oxidant effect
Oxidation of LDL cholesterol has been identified as one of the
first steps in the development of atherosclerotic lesions by
promoting injury to the arterial wall through several
mechanisms, including growth factor and chemotactic protein
expression, inflammation, and increased local macrophages.
Figure 2. Olive oil phenols Macrophages bind to and engulf oxidized LDL -an innate
Squalene immune response to tissue damage. This engulfment produces
Kiritsakis (24) reported that olive oil contained the highest a fatty foam cell, which, when combined with other cells,
amounts of squalene among a range of seasoning oils. produces a fatty streak in the blood vessel (35). Oxidized LDL
Squalene, found in high amounts in the Mediterranean diet, is can also be taken up directly by endothelial and smooth
believed to be responsible for the chemoprotective effect muscles cells, leading to formation of fatty streaks, which is
(12) and lower incidence of skin cancer seen in the first sign of atherosclerosis. The lesions forming
epidemiological studies of populations consuming this diet. atherosclerotic plaques are made up of lipids, endothelial and
Olive oil contains very small amount approximately 0.7% of smooth muscle cells, and extracellular matrix. The plaque
environment is proinflammatory (7). Inflammation occurring

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prior to the formation of fatty streaks and atherosclerotic Giliani et al (50) concluded that olive oil is a calcium channel
lesions causes alterations to the endothelial cell wall, which antagonist, closely mimicking the effects of the calcium
increases the adhesion of leukocytes, LDL cholesterol, and channel blocker drug verapamil. Another suggested
platelets. This contributes to the development of mechanism is via improved endothelial function (19, 52, 54).
atherosclerosis and cardiovascular disease (35). Phenols and oleic acid may contribute to improved
Olive leaf has been reported to inhibit platelet aggregation endothelial function by reducing ROS (19). Other potential
and production of thromboxane A2 (a stimulator of platelet mechanisms have been suggested, including decreasing
aggregation with vasodilatory effects) (36). Also of interest, is vascular tone and changes to the fatty acid and phospholipid
a recent study reporting that olive leaf extract inhibited both composition of the aorta (53).
angiotensin converting enzymes (37). In vitro studies have Gastro-intestinal protective effect
demonstrated hydroxytyrosol and oleuropein are capable of An early study detected that the substitution of animal fat for
inhibiting production of isoprostanes, a marker of LDL olive oil in the diet produced a significant reduction in the
oxidation (38). It has been suggested that phenols present in size of ulcers in patients (55) and another work related the
olive oil may act synergistically with these constituents to consumption of olive oil with a reduction in gastric acid
prevent LDL oxidation. secretion (56).
Studies in laboratory animals have reported hypoglycemic and Osteoprotective effect
hypolipidemic activity of olive leaf (39, 40). The active Ageing and oestrogen deficiency induce inflammatory and
constituent was reported to be oleuropein, with a proposed oxidant conditions that are involved in the development of
mechanism of action of potentiation of glucose-induced bone loss, osteoporosis and a higher likelihood of low-energy
insulin release, and an increase in peripheral blood glucose fractures. In this context, a sufficient load of antioxidants
uptake. supplied by a diet rich in olive oil may prevent bone loss
Antioxidant activity of olive has been attributed by phenols through the scavenging of free radicals. The anti-
content particularly to hydroxytyrosol, oleuropein and caffeic inflammatory components present in olive oil may also act by
acid. Caffeic acid was also reported to have antioxidant averting the increased plasma concentration of pro-
activity through the scavenging of superoxide anion (41). inflammatory cytokines (interleukin-6, tumour necrosis
Olive leaf has been reported to have anti-complement in factor-α) involved in bone resorption among postmenopausal
vitro, and is a proposed mechanism for its anti-inflammatory women (57).
effects (42). In-vitro and animal experiments have been A Mediterranean-type monounsaturated fatty acid MUFA-rich
conducted to demonstrate the antioxidant activity of olive diet can also affect bone metabolism because a MUFA-rich
leaf extracts. In rat epithelial cells stimulated with cytokines, diet might interfere with the actions of prostaglandins.
a concentrated polyphenol extract reduced nitrite Prostaglandins, especially PGE2, stimulate bone resorption by
concentration and free radical production (43). Rabbits with increasing the number and activity of osteoclasts (58). Most of
induced diabetes showed a decrease in oxidative stress the potent stimulators of bone resorption increase
markers when treated with oleuropein (44). Other prostaglandin production in bone by induction of COX2, and
experiments support the antioxidant activity of the phenols the ability of polyphenols present in olive oil to exert a dose-
oleuropein and hydroxytyrosol (6, 45, 46, 47). dependent inhibition of the enzyme COX2 has been recently
Anti-hypertensive effect shown (59). In addition, oleic acid is an inhibitor of
As with other aspects of cardiovascular diseases, there is a prostaglandin PGE2 synthesis, the major prostaglandin
reduced incidence of hypertension in populations that involved in bone metabolism (60). Normal or moderate levels
consume the Mediterranean diet (19, 48) and adherence to of PGE2 support bone formation, whereas greater quantities
the Mediterranean diet is inversely related to systolic and promote bone resorption (61).
diastolic blood pressure (49). Several studies have Puel et al (62) showed that olive oil consumption had had no
demonstrated the antihypertensive properties of olive oil (8, effect on plasma osteocalcin concentrations (marker of bone
50-53). Gilani et al found intravenous administration of olive formation) or on urinary deoxypyridinoline excretion (marker
oil extract reduced systolic, diastolic, and mean arterial of bone resorption) its feeding can prevent inflammation
blood pressures in normotensive rats (50). Epidemiological induced osteopenia in ovariectomised rats. His study (63)
data from studies in three Mediterranean countries-Italy, showed that every dose of oleuropein elicited protective
Greece and Spain as well as non-Mediterranean countries, effects on bone mass in this model of ovariectomy associated
suggest a protective effect for monounsaturated fatty acids or with inflammation, probably by modulating inflammatory
olive oil, while non-Mediterranean countries show little or no parameters. Black olives are able to prevent bone loss in an
positive effects (52). Ferrara et al (53) compared a diet rich experimental model of senile osteoporosis (oestrogen-
in polyunsaturated fatty acids (from sunflower oil) with a diet deficient rats in which a low-grade inflammation was induced
high in monounsaturated fatty acids (from olive oil) in by talc injection) (64).
patients taking antihypertensive medications and found Endocrine effect
individuals who consumed an olive oil-rich diet were able to Anti-diabetic effect
reduce the dosage of antihypertensive medication. Olive oil’s An early study, using ethanol leaf extracts (defatted with
precise mechanism of action for blood pressure reduction is petrol ether) given by gastric incubation to the rabbit (dose
unknown, although several theories have been proposed. not specified), showed a 17-23% decrease in blood sugar

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levels which reached a minimum within 6 hours and rose to has focused on possible mechanisms to explain this
normal after 48 hours (65). Aqueous extracts of dried leaf phenomenon. Oxidation of proteins, DNA, and lipids has been
from Italy, administered intragastrically (IG) to male rats in a shown to contribute to cancer development, and consumption
dosage of 500mg/kg, reduced the blood glucose levels of of antioxidants is believed to reduce the risk of mutagenesis
normal or alloxan induced diabetic rats (66). Aqueous and carcinogenesis (76). Antioxidants are present in olive oil,
decoctions of Spanish leaf, administered IG to the rat at a fruits, and vegetables that constitute a large part of the
dose of 32.0mg/kg, showed activity against alloxan-induced Mediterranean diet. Owen et al (9) showed that anti cancer
hyperglycaemia (40). The hypoglycemic activity of olive leaf activity of olive oil because of its high content of antioxidants
has been demonstrated in animals. In rabbits with induced (such as hydroxytyrosol, tyrosol, secoiridoids and lignans) and
diabetes, an ethanol extract of olive leaf decreased blood compounds deemed to be anticancer agents (such as squalene
glucose. Suggested mechanisms include potentiation of and terpenoids). The exact contribution olive oil makes to the
glucose induced insulin release and increased peripheral apparent dietary chemoprotection is debatable; in vitro
uptake of glucose (40, 44). studies have found olive oil phenols are potent antioxidants,
Thyroid inducers which may provide potential chemoprotective properties,
An aqueous extract of olive leaf administered to rats for 14 although in vivo data are lacking. Research examining
days increased T3 levels and reduced circulating thyroid individual phenolic compounds has found hydroxytyrosol is
stimulating hormone levels, possibly via a feedback capable of protecting cells from hydrogen peroxide damage
mechanism (67). and DNA from peroxynitrite-induced damage, blocking cell
Immunomodulatory effect cycle progression at the G1 phase, and inducing apoptosis
Olive oil intake also has been shown to modulate immune (77). In vivo and in vitro studies on the activity of oleuropein
function, particularly the inflammatory processes (10, 68, have found, in addition to antioxidant properties, it has
69). Rheumatoid arthritis (RA) is an autoimmune disease antiangiogenic action and inhibits cell growth, motility, and
characterized by chronic joint inflammation and damage. The invasiveness (78). Oleuropein has also been found to cause
initiation of RA is believed to result in an increase in the cell rounding, which disrupts the cell actin cytoskeleton.
concentration of macrophages and neutrophils in the synovial Oleuropein also affects and disrupts purified actin filaments,
fluid and free-radical-producing enzymes. This leads to high providing direct antitumor effects due to cell disruption (78).
levels of ROS in the joints, which increases and prolongs In in-vivo animal studies, rapid tumor regression was observed
inflammation and damage (70). The antioxidant effect of when mice were given one-percent oleuropein in drinking
olive oil has been found to reduce inflammation. In addition, water (78). Saturated animal fats and polyunsaturated plant
dietary omega-9 monounsaturated fatty acids, such as oleic fats in the diet have been implicated in colon, breast,
acid, have been found to replace omega-6 polyunsaturated prostate, and ovarian cancers (79). The substitution of olive
fatty acids (PUFAs) in several aspects of cell metabolism. oil in the Mediterranean diet may explain its apparent cancer-
Reducing the competition between omega-6 and omega-3- protective effect and accentuate the importance of the type,
PUFAs can lead to an increased use and incorporation of rather than the amount, of fat consumed.
omega-3-PUFAs (70). A number of studies that examined the Colon Cancer
benefits of fish oils in RA used an olive oil placebo for the The HCAs produced when protein-containing food is fried
control groups (71-73). Although results highlighted the have been found to induce breast, colon, and pancreatic
benefits of fish oils, unexpected significant improvements cancer in rats (80). Based on this evidence, Galeone et al (81)
were also seen in the control groups. Benefits including pain used data from a multinational, case control study to examine
reduction, reduced morning stiffness, and improved patient the relationship between fried foods and colorectal cancer.
evaluation of global disease were reported by patients When olive oil was compared to other oils, it was found that
receiving olive oil only. No explanation of the improvements fried olive oil has a protective effect against colon cancer.
shown by the olive oil groups were proposed, although This agrees with data that unheated olive oil is beneficial in
changes in immune function may be responsible (73). As a protecting against colon cancer (80). As described previously,
result of these data, Berbert et al (74) conducted research to when olive oil is used for frying, fewer HCAs are produced
establish whether olive oil improved RA symptoms in patients than when oils high in polyunsaturated fatty acids are used.
already receiving fish oil. Olive oil appears to act Later in vitro research by Gill et al (82) looked at the effect
synergistically with omega-3 fish oils to improve the of virgin olive oil phenols on colorectal carcinogenesis. Using
symptoms of RA; the benefits are thought to be exerted specific cell lines, they investigated processes involved in
through the oleic acid component. Oleic acid is converted to cancer initiation, promotion, and metastasis-the three main
eicosatrienoic acid (ETA) and then leukotriene A3 (LTA3). LTA3 stages in cancer development and concluded olive oil phenols
is a potent inhibitor of proinflammatory leukotriene B4 exert beneficial effects in all three stages. The oil extract
synthesis (74). It has also been shown that olive oil was shown to reduce DNA damage (initiation), increase
consumption decreases the risk of developing RA (75). barrier function (promotion), and reduce cell invasion of
Anti-Cancer effect surrounding tissue (metastasis) (82).
Epidemiological evidence suggested that people who consume Breast Cancer
the Mediterranean diet have a lower incidence of certain Most of the active compounds in olive oil are lipid soluble;
cancers, including breast, skin, and colon (7, 10), research however, even though the phenolic glycosides are less so,

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they are likely to be stored in fat tissue. This may explain the agent against a variety of pathogens, including Salmonella
chemoprotective effect against breast cancer and the low typhi, Vibrio parahaemolyticus, and Staphylococcus aureus
incidence of breast cancer in Mediterranean countries. In (including penicillin-resistant strains); and Klebsiella
addition, oleic acid is incorporated into the phospholipid pneumonia, and Escherichia coli, causal agents of intestinal
membrane of breast tissue cells, resulting in a reduction in or respiratory tract infections in humans (92). Olive leaf could
lipid peroxidation (82). Although in developed countries be considered a potentially effective antimicrobial agent for
breast cancer is the most common cancer seen in women, the treatment of intestinal or respiratory tract infections. The
there is vastgeographical variation in its incidence (82, 83). component usually associated with olive leaf’s antimicrobial
Epidemiological data show women in the Mediterranean basin properties is oleuropein (93, 94). Oleuropein has also been
have a lower incidence of breast cancer than women in other reported to directly stimulate macrophage activation in
“Western” countries (8, 10). Case control studies that looked laboratory studies (68). Hydroxytyrosol demonstrated broader
at women in several Mediterranean countries have shown an antimicrobial activity than oleuropein and is comparable to
inverse correlation between olive oil consumption and the ampicillin and erythromycin in spectrum and potency (92). In
incidence of breast cancer (83, 84). High mammographic vitro studies have demonstrated the antimicrobial activity of
breast density (H-MBD) is associated with greater breast hydroxytyrosol, tyrosol, and oleuropein against several strains
cancer risk (84).Using volunteers from the European of bacteria implicated in intestinal and respiratory infections.
Prospective Investigation into Cancer and Nutrition (EPIC) Hydroxytyrosol and oleuropein have antimicrobial action
study, Masala et al (84) examined the effect of diet and against both American Type Culture Collection (ATCC) and
lifestyle on MBD and concluded consumption of olive oil is patient-derived clinical bacterial strains, with slightly greater
inversely related to the risk of H-MBD. Women who reported activity against ATCC strains. It has been proposed that this
olive oil intake of ≥30.5 g/day were 30% less likely to be action is due to the two ortho-positioned phenolic groups in
classified into the H-MBD group. Using data from the their structure (Figure 2) (17). A recent study found virgin
European Community Multicenter Study on Antioxidants, olive oil has bactericidal action against Helicobacter pylori
Myocardial Infarction and Breast Cancer (EURAMIC), Simonsen (21), the primary cause of gastric ulcers and linked to gastric
et al (79) looked at the relationship between cancers. In recent years some strains have shown resistance
monounsaturated fat intake, the storage of monounsaturated to the typical antibiotics used to eradicate the infection and
fatty acids in breast tissue, and postmenopausal breast aid ulcer healing, spurring research on other compounds to
cancer. They found a strong inverse relationship between treat the infection. Because phenolic compounds have been
oleic acid consumption and breast cancer only in the Spanish identified as having antibacterial properties, olive oil, with its
group (82), possibly due to the reported high consumption of high phenolic content, has been studied for H. pylori. Romero
olive oil in Spain. Animal studies using et al (21) concluded phenols inhibited bacterial growth at low
dimethylbenz(α)anthracene-induced cancer have shown a diet concentration and were stable for several hours in the highly
rich in olive oil has a non-promoting effect on carcinogenesis. acidic environment of the stomach. They found the
This effect is backed up by histopathological and secoiridoid aglycones, particularly the dialdehydic form of
morphological features (85, 86). decarboxymethyl ligstroside, have the greatest anti-H. pylori
Anti-viral effect activity and are not hydrolyzed in the stomach (21);
Early evidences reported the antiviral activity of olive leaf hydrolysis, if it occurs, produces the less active
extract through the constituent calcium elenolate, a hydroxytyrosol and tyrosol. As the concentration of phenolics
derivative of elenolic acid (87, 88). The isolated calcium salt needed to kill H. pyloricells is higher than that for antibiotics,
of elenolic acid was tested as a broad-spectrum antiviral the researchers suggest virgin olive oil should be considered
agent active against all viruses tested (89). Some viruses as preventive rather than a treatment agent. Because the
inhibited by calcium elenolate in vitro include rhinovirus, research was conducted in vitro, the researchers also suggest
myxoviruses, Herpes simplex type I, Herpes simplex type II, in vivo testing is needed to confirm or reject the conclusions,
Herpes zoster, Encephalomyocarditis, Polio 1, 2, and 3, two an especially important note since other foods that
strains of leukemia virus, many strains of influenza and para- demonstrate good activity against H. pylori in vitro do not
influenza viruses (89-91). The mechanism of action of the appear to have any action in vivo. The exact mechanism by
antiviral activity is reported to include an ability to interfere which phenolic compounds affect H. pylori is unknown at
with critical amino acid production, inactivating viruses or by present (21) but different theories have been proposed, for
preventing virus shedding, budding, or assembly at the cell example, inhibition of the urease activity (95), adhesion to
membrane, directly penetrate infected cells and stop viral human gastric mucus (96), disintegration of the outer
replication, neutralize the production of reverse transcriptase membrane (97), and inhibition of VacA citotoxin activity
and protease (in Retroviruses) and stimulation of phagocytosis which causes the development of inflammation and ulceration
(87). in patients (98, 99).
Antimicrobial effects Passive smoking and olive
Olive leaves are known to resist insect and microbial attack, Epidemiological studies have shown that the intake of
and in-vitro studies have been conducted to establish the antioxidants results in a reduced risk for several degenerative
range of activity of olive leaf extracts (47, 92). Olive leaf disorders such as cancer and atherosclerosis. Olive mill waste
extract has been reported to be an effective antimicrobial water is a byproduct of olive oil production and is phenols,

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