**9. Perspectives and future directions**

In summary, EVOO a key component of the Mediterranean diet contains a number of phenolics, one being oleocanthal. The unique sensory qualities and anti-inflammatory actions of oleocanthal, have prompted research to further verify its therapeutic potential. Oleocanthal has been shown, *in vitro*, to exert beneficial physiological effects in terms of neurodegenerative disease, joint-degenerative disease and cancer. Therefore, it has been postulated that the long term ingestion of this compound via EVOO consumption may have significant health promoting action over time, thereby reducing the development of chronic disease.

However, the studies conducted on the health promoting potential of oleocanthal have involved *in vitro* investigations and it is difficult to extrapolate data from *in vitro* studies to actual physiological benefits. *In vivo* research is therefore required to substantiate the *in vitro* findings. Furthermore, the bioavailability of oleocanthal has not been adequately investigated. To date, only one study has reported on the post-ingestive fate of oleocanthal, noting that it was readily metabolized however the mechanism was not investigated. The degree to which oleocanthal is metabolized is an important consideration when reviewing the health benefits associated with ingestion, and further research on this is warranted. The link between the perceptual aspects of oleocanthal and health benefits is the notion that variation in sensitivity to oleocanthal oro-pharyngeal irritation may relate to potential differences in sensitivity to the anti-inflammatory action of this compound and this is also worthy of future investigations.

Finally, it was not the purpose of this overview to attribute the health benefits of the Mediterranean diet solely to one component and we did not aim to credit oleocanthal as being the lone therapeutic agent contained in EVOO. Other constituents of the Mediterranean diet and EVOO will contribute, either with independent actions, or in a synergistic and complementary manner to impart beneficial health effects (Lucas et al., 2011, Fogliano and Sacchi, 2006). However, the studies conducted to date investigating the pharmacological actions of oleocanthal are encouraging and show that this compound possesses substantial health benefiting properties. Further research will no doubt provide new insight into the pharmacological potential of oleocanthal and assess the role that oleocanthal has in the clinical treatment of chronic disease.
