Doctors & Olive Oil — Conflict of Interest?
“How Much of a Good Thing?” is an article by Dr. Nemechek that was sent to me by a mother concerned about the doctor she once trusted to treat her child diagnosed with Autism. The article makes a broad disparaging statement about high phenolic olive oil, with “higher concentrations of phenolic comounds” than the one he sells. Despite this criticism, various brands of higher phenolic olive oils have proved helpful for many children.
What are the Facts?
My first reaction is: Too much of a good thing? It depends on what the “thing” is he is referring to. Secondly, in my opinion the title of Nemechek’s article does not reflect the professionalism expected from a medical doctor. And third, the ‘facts’ presented regarding potentially toxic levels of polyphenols and doses according to the health claim are misleading in the extreme because Nemechek does not seem to understand the different methods of measurement. He seems to equate using gallic equivalents, with the NMR method which is a direct quantitative measurement. For a medical professional to make such an error is highly unusual. Some insist on using these older methods of measurement like Folin (gallic equivalents) or HPLC (tyrosol equivalents). Not even the IOC International Olive Council has accepted the Folin method. But they have as their official method of measurement the HPLC method for 2 reasons:
1. Because they have no need for accuracy because they do not recognize any health claim for polyphenols.
2. They do not want to recognize a method whose equipment is expensive such as LC-MS/MS or NMR. $350k to $800K for each respectively. HPLC is less than $20K. The Spanish olive mills do not want a phenolic analytical method they cannot afford to have in their olive mills.
These outdated two methods (HPLC & Folin) do not have the capacity to measure the concentration or identify the type of phenolic compounds. This is why they use gallic acid or tyrosol equivalents. The fact is — no other phenolic compound or compound is equivalent to the phenolic compounds in olive oil. And there is no way to determine the concentration of phenolic compounds by averaging them out as tyrosol or gallic acid equivalents. It is equivalent to trying to measure the concentration of vitamins in oranges using B vitamin equivalents. Utter nonsense.
As positive research results from clinical trials escalate for phenolic compounds in olive oil, it is unfortunate that some professionals with trusted credentials are using these to promote their own questionable high phenolic olive oils. Here is an example of heart surgeon in Beverly Hills selling high phenolic olive oil with exaggerated claims and questionable scientific backup: https://www.oliveoiltimes.com/opinion/gundry-olive-oil-review/89570
This is Not an Attack This is in Defense
So, to level the playing field before we begin, let’s start with the baseline and let me make a declaration of my own:
This is not an attack on Dr. Nemechek, but clarification for the defence of the whole category of high phenolic extra virgin olive oil defined by the EU 432/2012 Health Claim Labelling regulation for polyphenols in extra virgin olive oil. It is also in defence of the honest producers who sacrifice quantity to ensure the increased phenolic concentrations.
They are being sickened to witness lower quality olive oils being marketed by doctors as high phenolic, or others who make disparaging remarks without even taking the time to study the research and catch up on the latest measuring methods for phenols. It is also in defence of the many distinguished researchers who continue to study the beneficial effects of olive oil rich in specific phenols on chronic illness — cardiovascular, neurodegenerative, autoimmune disease and many cancers.
Why I write
I presume the woman who contacted me did so because I am known to have dedicated my time, money and passion to the research and testing of high phenolic olive oil since 2012, first as a journalist on the emerging category of high phenolic olive oil and then as a participant in identifying and protecting this amazing food. I am either loved by buyers or hated by the olive oil industry for my advocacy and enthusiastic support of this distinct category of olive oil with proven health benefits for the potential prevention and/or treatment of chronic illness. The olive oil industry refuses to support this new category because it brings the much needed transparency to olive oil. We finally have a method to measure the quality of olive oil beyond the taste and the chemical analysis, or the acidity. We can now also measure with accuracy the healthfulness of olive oil based on its phenolic content as well. So far research is showing us the health benefits of olive oil are derived from the phenolic compounds and not the oil itself. This is shaking the olive oil industry built on selling the healthy fat content of olive oil.
“The health benefits of olive oil are 99 percent related to the presence of the phenolic compounds, not the oil itself,” said Nasir Malik, research plant physiologist at the U.S. Department of Agriculture (USDA)’s Agricultural Research Service.
Brief History
In 2012, following 8 years of intensive research, the health claim EU 432/2012 for polyphenols in olive oil was approved. This health claim created a new category of extra virgin olive oil with a specific type and minimum concentration of polyphenols.
By coincidence in 2012, Dr. Magiatis of the University of Athens developed the method to measure individual phenolic compounds in olive oil. This Quantitative Nuclear Magnetic Resonance method (qNMR) has been verified by a circle test in comparison with LC-MS/MS method. This was part of the recently completed EU funded 3-year, 5-country ARISTOIL Interred MED Programme to study best practices in the production of high phenolic olive oil. The LC-MS/MS is a method of measuring phenolic compounds quantitatively. It was used by researchers for the EU health claim. The qNMR was found to be comparable in measuring phenolic concentrations in a variety of olive oils with different phenolic profiles.
Troubling Numbers
What’s troubling about this article is that Dr. Nemechek extols the virtues of phenolic-rich olive oil which he himself sells. Then he proceeds to offer up numbers to back an argument that phenolic compounds in olive oil can be toxic. The numbers start tumbling across the page, making anyone dizzy with calculations, which unbeknownst to the reader, represent varying methods of measurements uniformly and erroneously referred to in the article as Gallic Equivalents, which I will explain shortly is like comparing 10 inches to 10 centimeters and calling both “10”.
Quotes from “How Much of a Good Thing” by Nemechek:
https://www.nemechekconsultativemedicine.com/blog/how-much-of-a-good-thing/
Quote by Nemechek:
The European Food Safety Authority (EFSA) regulations state that EVOO will reduce oxidative stress for blood of an individual when the oil contains about 5 mg of phenols per 20 grams of EVOO.
In layman’s terms, this mean you want to include in your diet 2 tablespoons per day of extra virgin olive oil that has an approximate total phenol count of 200 mg/kg (gallic eq mg/kg). The total phenol count is often listed on the oil producer’s web site.
Response:
The specific wording of the EFSA Health Claim is:
Olive oil polyphenols contribute to the protection of blood lipids from oxidative stress. The claim may be used only for olive oil, containing at least 5 mg of hydroxytyrosol and its derivatives (e.g. oleuropein complex and tyrosol) per 20 g of olive oil. In order to bear the claim information shall be given to the consumer that the beneficial effect is obtained with a daily intake of 20 g of olive oil.
In reference to “layman’s terms” above,
1. The health claim was declared at 5mg/20 g or 250 mg/kg based on the LC-MS/MS quantitative method of measurement.
2. The gallic equivalent measurement is not accepted by the EU as a means to measure polyphenols in olive oil or any food.*
3. 20 grams of olive oil is not 30 ml or 2 tablespoons, but 22 ml or 1 ½ tablespoons.
4. The minimum per day of 20 g to protect blood lipids from oxidative stress is based on 250mg/kg of total phenolic content.
5. Nowhere in the health claim do they use equivalents to measure the phenolic concentration.
Quote by Nemechek:
There are a wide range of studies showing improvements in health with the consumption of olive oil containing high levels of phenols. The important point is that there is no significant evidence that consuming an olive oil with a phenol count of 600 mg/kg, 800 mg/kg or even 1000 mg/kg produces any more health of an olive oil containing only 200 mg/kg.
https://www.nemechekconsultativemedicine.com/blog/how-much-of-a-good-thing/
Response:
Research has shown the polyphenols are indeed dose dependent. The reason olive oils with higher concentrations of phenolic compounds were not used is because the purpose of the health claim was to identify the minimum required dose per day to have a positive effect and not the maximum. Although experiments were conducted with a much higher concentrations and that is how they determined the health benefit is indeed dose dependent. The purpose of the research was not to determine how much better a higher concentration of phenolic compounds impact on health.
Since then in vitro and animal and human trials have proven the type of polyphenols in olive oil have different physiological responses. To promote the use of high phenolic olive oils to autistic children or in response to other chronic illness, you really need to be informed on the physiological effects of each phenolic compound.
So far, the effect of certain individual phenolic compounds like Oleocanthal and Oleacein have shown to have the most profound effect and these presently are the most rigorously tested.
Current Oleocanthal clinical trial:
https://clinicaltrials.gov/ct2/show/NCT03528603?term=oleocanthal&draw=2&rank=1
Previous clinical trial with Oleocanthal & Oleacein
https://clinicaltrials.gov/ct2/show/NCT02902913?term=oleocanthal&draw=2&rank=2
Chronic Lymphocytic Leukemia
https://clinicaltrials.gov/ct2/show/NCT04215367?term=oleocanthal&draw=2&rank=4
Alzheimers Clinical Trial Greece
https://clinicaltrials.gov/ct2/show/NCT03362996?term=oleocanthal&draw=2&rank=6
Alzheimers Clinical Trial USA
https://clinicaltrials.gov/ct2/show/NCT03824197?term=oleocanthal&draw=2&rank=5
Most trials use total phenolic compounds of 500–800 mg/kg based on qNMR calculations. Controls back up the effect of Oleocanthal and that low levels of phenolic compounds have negligible or no therapeutic effect. (Alzheimer’s Aristotle University).
Similarly, a human trial at UC Davis showed that oleocanthal-rich olive oil had anti-inflammatory effects comparable to Ibuprofen, while the control extra virgin olive oil with low phenolic content or other phenols in high concentrations had little or no effect on blood platelet aggregation.
Quote by Nemechek:
The ultra-high phenol content provided antioxidative protective effects in muscle, brain and small intestine tissues but caused an unhealthy effect in tissues of the spleen, pancreas, liver and heart. The ultra-high phenol level increased oxidative stress within the mitochondria of the cells causing them not to function as well.https://www.sciencedirect.com/science/article/pii/S2214750020300044#bib0305
Increased mitochondrial oxidative stress is one of the ways in which chronic inflammation impairs cellular function and is the exact opposite effect we are trying to achieve with The Nemechek Protocol.
Response:
This is a misquote from a recent Greek study that had no control group, nor was it a large sampling. Notwithstanding the questionable veracity of this experiment entitled, Olive oil with high polyphenolic content induces both beneficial and harmful alterations on rat redox status depending on the tissue.
This research was not conclusive and is contrary to other research on the toxicity of phenolic compounds that did not find any hint of toxicity at such low concentrations. Another more reputable research on the toxicity of phenolic compounds using better species of mice found the opposite. No hint of toxicity. See the next example after this one.
What Dr. Nemechek failed to add to his quote was the final conclusion of that study which states:
“However, according to the real life exposure scenario that was analyzed above it is believed that the negative role of Oleocanthal in the redox status of some tissues is actually an adaptive response that is anticipated to reinforce their redox profile”.
It should further be noted here that in conducting in vivo testing (mice) there are types of mice (swiss albino mice) which more accurately resemble the human response to pharmaceuticals than the ones used (wister rats) by the Greek study.
In contrast to the Greek study is the following opinion of Dr. Amal Kaddoumi of Auburn University who has dedicated the past 37 years to research in toxicological evaluations as well as the study of oleocanthal in olive oil and pure extraction in clinical trials. Here is a significantly more scientifically rigorous research on the toxicity of oleocanthal. This research was conducted on specially bred Swiss albino mice. Dr Amal concludes:
Although the species and inter-individual sensitivity will significantly vary and results extension should only be applicable after careful clinical testing, hypothetical assumption of the oral Oleocanthal LD50 of 500 mg/kg in Swiss albino mice is to be applicable to humans, with the average human bodyweight of 70 kg, knowing that Oleocanthal average natural occurrence in EVOO range from 10–1200 mg/L, the toxic dose of Oleocanthal tentatively translate to 35,000 mg of pure Oleocanthal or 29.2–3500 Litres of EVOO. https://pubmed.ncbi.nlm.nih.gov/31991771/
Let me repeat that last sentence: “knowing that Oleocanthal average natural occurrence in EVOO range from 10–1200 mg/L, the toxic dose of Oleocanthal tentatively translate to 35,000 mg of pure Oleocanthal or 29.2–3500 Litres of EVOO.”
Quote by Nemechek:
Historically, most individuals within the Mediterranean are consuming an average of 4 tablespoons of olive oil per day or more over their lifetime. If the average EVOO phenol level is about 150–200 mg/kg per 2 tablespoons, the daily average Mediterranean intake is approximately 300–400 mg/kg per day, far lower that the potentially toxic range cited in this study.
While this study does not constitute “proof” that high phenol counts are toxic it should provide a bit of caution that if ultra-high phenolic olive oil is being consumed on a regular basis over the long term, it may in fact start having a negative effect on certain aspects of an individual’s health.
Response:
What can I say — this is certainly not “proof” of anything but a bias and a clear conflict of interest on Dr. Nemechek’s part. But here is where it gets really confusing.
Dr. Nemechek, based on a non specific measurement method, recommends:
Buy olive oils with phenol counts in the 300–400 mg/kg range.
Last year Nemechek Gold was listed at two levels, 359mg/kg and 610mg/kg. This year only 610mg/kg is listed. Does this mean he is selling high phenolic olive oil he considers to be of a toxic level?
Not to put too fine a point on it, Dr. Nemechek’s actual measurement of polyphenols by Gallic equivalents may be much higher or lower if analysed by either of the two methods accepted by the EU Commission for the health claim. If it is by Folin*, often referred to as Gallic Equivalents was the method used, it is not accepted for measuring the health claim due to its limitations.
*NOTE:
The Folin Coilteau method uses Gallic equivalents but Dr. Nemechek does not refer to the full name or mention the method using Gallic equivalents. If it is the Folin Coilteau method of measuring phenolic compounds, it has been rejected by the European Food Safety Agency for measuring total polyphenols in food.
Numbers for total phenolic content vary widely depending on the method used and the ratio of phenols in the olive oil itself, which vary according to variety, location, climate, topography, olive mill settings such as temperature and many other factors. And this begs the question, how does Dr. Nemechek have consistent readings of 610mg/kg from last year to this. Being a natural product, this is highly unusual.
COOC Certified — but is it Organic?
And that brings up the question of the Nemechek olive oil being organic or having chemical residue from such chemicals as Round Up residue such as Glyphosate. COOC certification uses chemical analysis and organoleptic analysis to ascertain that the olive oil is extra virgin and it is made from California olives. Period.
Right now the COOC certificate on Nemechek’s website is out of date. https://nemechekgold.shop/pages/cooc-certification
Quote from FAQs on Website:
Is Nemechek Gold Organic?
No, it is not. Most olive oil is not organic because of the methods used to protect the olive trees from gophers, not because chemicals were sprayed on the trees.
https://nemechekgold.shop/pages/nemechek-gold-faqs
Response:
Gophers are poisoned. Where does that go? Where is the chemical analysis for insecticide or toxic chemical residue?
How do they get rid of gophers? If it is not an organic farm, poison is the way to go!
How to get rid of gophers: “Place proper amount [of poison] at the entrance to a gopher burrow. Most poisons are made of zinc phosphide or strychnine. Both will cause physiological and neurological reactions in gophers and other wildlife before they die, which is why they aren’t considered a humane option.”
https://www.pests.org/get-rid-of-gophers/
No they do not spray the trees, poison is placed on the ground where it kills not only gophers but other animals in a very unhumane way and contaminates the soil. Contrary to Dr. Nemechek’s statement of organic olive oil not being available, the fact is organic olive oils are available to purchase in California but they are more expensive because they receive lower yields and more labor intensive. They are also more expensive to produce and must be accompanied by costly and comprehensive chemical analyses.
“Organic” is a major criteria for any olive oil used in the treatment of illness. However, there are traditional olive oils that are not organic that were used in clinical trials, but they do publish their chemical analysis and phenolic concentration certificates. Dr. Nemechek has done neither.
Mediterranean High Phenolic Olives Oils, of which I am most familiar, in contrast, are measured by qNMR or LC-MS/MS to comply with the EU Health Claim. Most of the high phenolic olive oils produced in Greece particularly, are either certified Organic or are produced using regenerative agricultural methods and in some cases traditional methods. Chemical analysis for pesticides, fertilizer or plasticizers are available and can be requested along with the phenolic analysis.
This is not the first time I have witnessed a person in “authority” in one profession posing as an expert in another profession and confusing his clients. When it comes to health and especially that of children, already compromised, I find it egregious that respected doctors are expressing negative misinformed opinions on real science and criticizing the good work of so many dedicated scientists and producers without basis.
If Nemechek was up to date with the latest research on best methods to use for the accurate characterization of polyphenols in olive oil he would have known the truth instead of spreading confused and misleading information.
He would have also known of the many clinical studies done using high phenolic olive oils with specific phenolic ratios. Not all phenolic compounds are equal in their effectiveness.
If he had talked to the mothers that had very positive experiences with other olive oils than his own he would have learned something. In fact, in this article mothers came forward and answered a questionnaire and the positive results were overwhelming.
https://aristoleo.com/when-a-child-stops-playing-autism-and-high-phenolic-olive-oil/
Why would Dr. Nemechek not take a serious look at the clinical trials? Or the latest methods of accurately measuring the phenolic concentrations in olive oil?
When the mothers purchase high phenolic they are not just buying it based on total phenolic content. They are buying the olive oils that contain high levels of Oleocanthal. Oleocanthal and the second most prolific phenolic compound Oleacein in the olive oils the mothers are purchasing seems to be the what makes the huge difference. They are also not giving their children 2 tablespoons (30ml), but usually it is closer to 1 teaspoon (5ml).
These mothers are dedicated and ultra-cautious, monitoring every minute response of their child to change of diet or in this case, addition of various olive oil brands with high levels of phenolic compounds.
In Conclusion:
Everyone has a right to make a living and use their professional credentials in support of that — EXCEPT — if, in the case of the health and wellbeing of those trusting them, that authority is used to misdirect or misinform — by commission or omission — in service to their own marketing objectives. Dr. Nemechek’s attack on the high phenolic olive oils sector is, in my opinion, a misuse of his medical authority, and as such, a clear conflict of interest.
Stay tuned: Soon we will have certified high phenolic olive oils displayed in temperature controlled coolers. https://aristoleo.com/6th-annual-aristoleo-awards-2021-en/
This article has been sent to Dr. Nemechek for his response. I will update the article when I receive it. I am hoping he will take the time to study this more deeply.
