Coconut Oil: Fact or Fiction?

Coconut Oil: Fact or Fiction?

Quick facts that you might already know:

  • Coconut oil is trending in the United States
  • Coconut oil is made by pressing the fat from the white “meat” inside the giant nut. About 84% of its calories come from saturated fat (14% of olive oil’s calories are from saturated fat and 63% of butter’s are)
  • Coconut oil fans point out that people in places like Polynesia and Sri Lanka eat high amounts of coconut products daily but don’t seem to have high rates of heart disease
  • Coconut oil does have antioxidants, compounds that may help reduce the risk of disease

Coconut oil is being promoted as a healthy oil. This is DIFFERENT than consumption of coconut flesh or squeezed coconut in the context of traditional dietary patterns, which does not lead to adverse cardiovascular outcomes. Coronary artery disease (CAD) and the atherosclerotic (buildup of plaque in the blood vessels) process are closely related to lipids/fats and the consumption of them in our diet (depending on what kind we are consuming).

For example, saturated fatty acids increase the risk for atherosclerosis by increasing the cholesterol level (HDL and LDL). This kind of fat is what is found in butter and lard. BUT, people proclaim that coconut oil is different because it has medium chain triglycerides, which are not absorbed using chylomicrons (a precursor to cholesterol). Basically, it won't raise cholesterol like butter or other bad things, and as such it must be the holy grail. But does coconut oil really have MCTs (these shorter fatty acids that avoid raising cholesterol)? Or are we all just eating gobs of saturated fat because the food industry has duped us? Let’s examine a recent study.

Goal/Aim: Investigate the impact of cooking oil media (coconut oil and sunflower oil) on lipid profile, antioxidant mechanism, and endothelial function in patients with established CAD

  • Single-center randomized study conducted in India

  • Patients with stable CAD (coronary artery disease) on standard medical care were assigned to receive coconut oil or sunflower oil as cooking medium for 2 years (+ family)

  • Anthropometric measurements, serum lipids, lipoprotein a, apo B/A-1 ratio, antioxidants, flow-mediated vasodilation, and cardiovascular events were assessed at 3 months, 6 months, 1 year, and 2 years

  • Provided with oil, instructed to use the assigned oil for cooking

100 patients in each group completed 2 years with 98% follow up (all on statin drugs)
7 day recall and diet diary were used to monitor adherence (but do we ever really know? not really, that's the big downside with nutrition studies, unless you're providing all the food and asking them to return what they didn't eat and even then...)

What happened?

Lpa slightly higher in group II (sunflower)*
Reduction in CRP in group I (coconut)*

*No statistically significant difference in anthropometric, biochemical, vascular function, and in cardiovascular events found after two years of follow-up

So what does it really mean?

MCTs in coconut oil do not seem to increase lipids when compared to PUFAs in sunflower oil when consumed alongside statins. The unsaturated fatty acids in sunflower oil are comparable to the same kinds of fatty acids found in olive oil, which has been proven to have a variety of health benefits and is generally considered a “heart healthy” fat.

Weaknesses of this study:
Outcome likely influenced by medication
Results can’t extend to general population
Sponsored by coconut development board
Within group significance not assessed
Did not use virgin coconut oil (has a beneficial effect in DM patients)

Strengths of this study:
Higher N than many other studies in this area
Relevant Topic
Longer follow-up than most studies

Conclusion:

Coconut oil, though rich in SFAs, in comparison to sunflower oil, when used as a cooking medium over a period of 2 years, did not change the lipid-related cardiovascular risk factors and events in those receiving standard medical care.

but wait there's more!! 

Lit Review: MCTs are focused on synthesized esters of C:8 and C:10. Coconut oil contains primarily lauric acid (C12:0), which behaves more like a  LCT because the majority of it (70%) is absorbed with chylomicrons. As such, it’s cholesterol-raising potential is higher than pure MCT oil.

Lauric acid raises total and LDL cholesterol concentrations compared with oleic acid, but is not as potent for increasing cholesterol concentrations as is palmitic acid (palm oil). This means that coconut oil is not as good for you as olive oil or other sources of unsaturated fats (avocados and nuts fit in this category too), but coconut oil is not as bad for you as butter or palm oil.

Healthy -> Unhealthy
Olive oil > coconut oil > butter/lard

Aside from the fat sources, coconut oil has been shown to have anti-inflammatory properties, so unless you have something that would counter-indicate usage (i.e. heart problems), it is certainly safe, and even healthy, in small amounts. Be careful when using it for cooking--it has a lower smoke point than olive oil.

 

Gratitude

November Jams