Benefits
Bone formation marker (osteocalcin) in women with low bone density
In a 12-month randomized trial in 64 postmenopausal women with low bone density, all taking calcium, adding 250 mg Bonolive raised the blood bone-building marker osteocalcin by about 32 percent, while it fell about 6 percent on calcium alone. The bone breakdown marker CTX did not differ between groups, spine bone density loss was not significantly smaller, and only 48 women finished.
Knee joint function: main goals not met
In a 6-month multicentre randomized trial in 124 older adults with knee pain, 125 mg Bonolive twice daily did no better than placebo on the co-primary measures, the overall KOOS knee score and the cartilage marker Coll2-1NO2, or on inflammation markers. An unplanned (post hoc) look found benefit only in people who started with high walking pain, which needs confirming.
Antioxidant activity (absorption study only)
In a single-dose absorption study in 16 women, 250 mg of this 40 percent oleuropein olive leaf extract was absorbed and appeared in blood as hydroxytyrosol and oleuropein metabolites. Blood malondialdehyde, a lipid oxidation marker, fell 32 percent in the 8 postmenopausal women, but there was no placebo group, so an antioxidant benefit is not shown.
Bone density readings: one small signal among many sites
In a 12-week trial in healthy postmenopausal women, right-arm bone density was slightly higher on 250 mg Bonolive than on placebo (p = 0.019), but it was one of many body sites scanned, right rib density only trended (p = 0.055) and the other sites did not differ. In the 6-month knee trial, the bone markers osteocalcin and CTX-1 did not differ from placebo.
Menopause-related quality of life
In a 12-week randomized trial in healthy postmenopausal women aged 47 to 70, 250 mg Bonolive daily improved the overall menopause quality-of-life (MENQoL) score slightly more than placebo (about 0.2 points on a 1 to 8 scale, p = 0.027). None of its four domains, including hot flashes and sweats, differed on its own, hot flash interference did not change, and the registered main outcome, body composition, did not differ.
Blood lipids (secondary outcomes in two trials)
In the 12-month trial, total and LDL cholesterol fell more on Bonolive than on calcium alone, and triglycerides dipped slightly instead of rising; HDL did not differ. In the 12-week trial, triglycerides and the triglyceride to HDL ratio fell compared with placebo, but total, LDL and HDL cholesterol did not change. Both were secondary outcomes in manufacturer-funded trials.
Post-meal blood sugar (single-meal studies)
In short crossover studies in healthy young adults, 125 mg Bonolive dissolved in water did not change blood sugar after bread, 50 g glucose or 50 g sucrose. A higher 400 mg dose lowered the blood sugar peak and area under the curve after a smaller 25 g sucrose drink in 10 people. These single-meal tests do not show a longer term blood sugar effect.
Mechanism of action
Osteoblast support
In laboratory work, oleuropein pushed human bone marrow stem cells toward bone-building osteoblasts rather than fat cells, and oleuropein limited bone loss in rat models. In people, the matching signal is a rise in the bone-formation marker osteocalcin in one 12-month trial; a 6-month trial saw no change in bone markers.
Anti-inflammatory polyphenol
Oleuropein is proposed to lower inflammatory signaling and oxidative stress. In people, inflammatory and cartilage markers did not improve more than placebo in the 6-month knee trial, and hs-CRP and IL-6 did not differ from calcium alone in the 12-month bone trial, so this mechanism is not confirmed in humans.
Absorbed as hydroxytyrosol and oleuropein metabolites
After a 250 mg dose, oleuropein from this extract appears in blood mainly as hydroxytyrosol and oleuropein aglycone conjugates, with higher levels in postmenopausal than premenopausal women in a 16-woman study.
Clinical trials
Exploratory 12-month double-blind randomized trial (NCT00789425). Both groups took a 1 g calcium supplement (400 mg elemental calcium) daily; the treatment group added one 250 mg Bonolive capsule (over 40 percent oleuropein) supplied by BioActor, which paid study site costs and employed two authors. Primary endpoints were the blood bone markers osteocalcin and CTX; bone density and lipids were secondary. (Filip et al. 2015, The Journal of Nutrition, Health and Aging)
64 postmenopausal women aged 49 to 68 with osteopenia (lumbar spine T-score between -1.5 and -2.5); 48 completed (27 on Bonolive, 21 on calcium alone).
Osteocalcin rose about 32 percent with Bonolive and fell about 6 percent with calcium alone, a significant difference at 3, 6 and 12 months. CTX rose in both groups (37 and 41 percent) with no difference between them, and BALP and PINP results were inconclusive. Lumbar spine density fell 0.9 percent on Bonolive and 1.9 percent on calcium alone, a difference the authors state was not statistically significant between groups; femoral neck density did not change. Total and LDL cholesterol fell more than on calcium alone, and triglycerides dipped about 4 mg/dL instead of rising about 19 mg/dL. No serious adverse events were related to treatment.
Multicentre randomized, double-blind, placebo-controlled trial (NCT03072108) at Belgian centres, run for 6 months. Participants took one 125 mg Bonolive capsule (50 mg oleuropein) or placebo twice daily. Co-primary endpoints were the KOOS knee score and the cartilage marker Coll2-1NO2. Nestlé funded the study and five authors were Nestlé employees. (Horcajada et al. 2022, Therapeutic Advances in Musculoskeletal Disease)
124 older adults with knee pain or mobility issues (118 in the full analysis set, 59 per group). Results describe people who already had knee pain, not what the product does for a healthy person.
The trial did not meet its main goals: after 6 months Bonolive was no better than placebo on the overall KOOS score, Coll2-1NO2, or inflammatory and cartilage remodeling markers. The bone markers osteocalcin and CTX-1 also did not differ from placebo. An unplanned post hoc analysis found a significant effect only in the subgroup with high walking pain at baseline (p = 0.03). The extract was well tolerated.
Randomized, double-blind, placebo-controlled parallel trial (FEMMED, NCT05744453) at Maastricht University. Participants took one 250 mg Bonolive capsule (100 mg oleuropein) or a cellulose placebo daily for 12 weeks. The registered primary outcome was body composition by DXA; menopause symptoms, strength and other measures were secondary. BioActor funded the study and employed two authors. (Imperatrice et al. 2024, Nutrients)
62 healthy postmenopausal women aged 47 to 70 started and 60 were analyzed; their vasomotor symptoms were mostly mild to moderate.
Fat mass and fat-free mass, the registered main outcome, did not differ from placebo. The overall MENQoL menopause quality-of-life score improved slightly compared with placebo (about 0.2 points on a 1 to 8 scale, p = 0.027), but none of its four domains differed on its own and hot flash interference did not change. Right-arm bone density was slightly higher than placebo (p = 0.019) and right rib density trended (p = 0.055), with no difference at other sites. Triglycerides and the triglyceride to HDL ratio fell compared with placebo; total, LDL and HDL cholesterol did not change, and handgrip strength showed no significant effect. No serious adverse events were reported.
Second report from the same 12-week randomized, double-blind, placebo-controlled FEMMED trial (NCT05744453), covering blood markers of connective tissue aging and an exploratory skin substudy. Participants took 250 mg Bonolive or placebo daily. Solabia BV, which now supplies Bonolive (the Solabia group took a majority stake in BioActor in 2023), funded the study and employed four authors. (Lasfar et al. 2025, Frontiers in Nutrition)
65 healthy postmenopausal women aged 45 to 70 were randomized and 60 were analyzed for blood markers; skin was assessed in a subgroup of 26 (10 on Bonolive, 16 on placebo).
No blood marker of tissue aging changed significantly after correction for multiple testing: elastin (p = 0.033, adjusted p = 0.0825) and pentosidine (p = 0.022, adjusted p = 0.088) were only nominally significant, and collagen, hydroxyproline, MMP-2 and glucose were unchanged. In the exploratory skin subgroup, pore number was lower than placebo at 12 weeks (p = 0.034).
Series of randomized, crossover, controlled single-meal studies at the University of Leeds (NCT03093753). Bonolive powder (41.8 percent oleuropein, supplied by BioActor) was dissolved in water and taken with bread, glucose or sucrose; earlier capsule studies in the same paper used a different BioActor extract. One author was a BioActor employee; funding came from EU and UK research grants. (Kerimi et al. 2019, European Journal of Nutrition)
Healthy young adults, 10 per study.
125 mg Bonolive (50 mg oleuropein) did not change blood sugar after white bread, wholemeal bread, 50 g glucose or 50 g sucrose. A higher 400 mg dose (160 mg oleuropein) lowered peak blood sugar (p < 0.0002) and the area under the curve (p = 0.025) after 25 g sucrose. Single-meal results do not show longer term effects.
Single-dose absorption study: participants took 250 mg of an olive leaf extract with 40 percent oleuropein, and blood and urine were collected over 24 hours. Later research from the manufacturer's group identifies this extract as Bonolive. There was no placebo group. (García-Villalba et al. 2014, European Journal of Nutrition)
16 healthy women: 8 premenopausal and 8 postmenopausal.
Oleuropein was absorbed and appeared in blood mainly as hydroxytyrosol and oleuropein aglycone metabolites, at higher levels in postmenopausal women. Plasma malondialdehyde, a lipid oxidation marker, fell 32 percent in postmenopausal women. With no control group, this shows absorption, not a proven antioxidant benefit.
Randomized, double-blind, placebo-controlled trial (NCT05217433) at Maastricht University, sponsored by Nestlé. Participants took 250 mg olive leaf extract providing 100 mg oleuropein, or placebo, daily for 36 days. The abstract and registration do not name the brand; a later Nestlé-linked paper cites this trial when describing its extract as Solabia's 40 percent oleuropein extract, the Bonolive specification. (Pinckaers et al. 2025, The Journal of Nutrition)
40 healthy older men, average age 60.
After 36 days, resting muscle fractional pyruvate dehydrogenase (PDH) activity was about 25 percent higher than on placebo (p = 0.016), and LDL cholesterol was lower (p = 0.043). Muscle mitochondrial respiration, leg strength, fatigue resistance and whole-body fuel use did not differ from placebo.
Double-blind, placebo-controlled crossover study (NCT05350566) at the University of Lausanne with Nestlé co-authors. Participants took one 250 mg capsule of olive leaf extract standardized to 40 percent oleuropein (100 mg), supplied by Solabia, or placebo with a single exercise session. The paper does not use the Bonolive name, but Solabia now supplies Bonolive and the specification matches. (Lanfranchi et al. 2026, The Journal of Physiology)
Healthy young men: 11 did moderate continuous cycling and 10 did sprint intervals.
With the extract, heart rate was lower during moderate exercise and the fatigue index in the first sprint was 25.5 percent lower (p = 0.013), but knee extensor fatigue after exercise did not differ from placebo. Muscle PDH activity rose with the extract only after moderate exercise. These are single-session results in a small study.