Since Ancel Keys introduced the Seven Country Study in the 1950s, the Mediterranean diet has been considered a model of a healthy eating pattern for its contribution to one favorable state of health and a better quality of life.1,2 Numerous studies conducted on different populations have indicated that the main components of the Mediterranean diet have a beneficial role in the prevention of cardiovascular diseases and chronic-degenerative diseases.2,3 Oil 'high oil content olive (not necessarily extra virgin olive oil) contributions are considered a distinctive feature of the traditional Mediterranean diet, along with a high consumption of monounsaturated fats, vegetable proteins, whole grains and fish; moderate consumption of wine; and low consumption of red meat and sweets.4 A study by Estruch, et al. found that a Mediterranean diet without energy restrictions, supplemented with extra virgin olive oil or nuts, substantially reduced the onset of cardiovascular disease.5 In short, the Prevención con Dieta Mediterránea (PREDIMED) study was a large study (7,447 participants), multicentre, randomized control trial conducted in Spain, which aimed to investigate the primary prevention of cardiovascular disease solely with diet. Participants at high risk for cardiovascular disease were assigned to one of three groups: those who received extra virgin olive oil, those who received nuts and those who were advised to reduce dietary fat. The primary endpoint was a composite of major cardiovascular events (myocardial infarction, stroke, and cardiovascular death). After a median follow-up of 4.8 years, the results of multivariate analyzes presented a protective effect of olive oil and dried fruit supplementation compared to the control diet by reducing cardiovascular risk. The Mediterranean diet has a higher total calorie intake from fat (about 35%) and specifically uses olive oil as the primary source of fat.3 There are still many unanswered questions about the benefits of the Mediterranean diet. The recent discovery by Estruch, et al. did not provide sufficient evidence that olive oil and nuts alone or the combination of a diet low in saturated fat and plant-based components are effective in reducing the risk of cardiovascular disease. Likewise, the long-term effect of olive oil supplementation, which provides a significant amount of empty calories, has not been documented. Given this limited information, a new recommendation on olive oil and nut supplementation is based on a future randomized control trial of the same size as the PREDIMED study, which tests the true Mediterranean diet as a whole and lasts more than five years.