Written by Marsha Seidelman, M.D.
August 22, 2017
There had been so much advertising and new product development around coconut oil – and all things coconut – that I thought I would let you in on what the medical literature says. Looks like it should be a short-lived fad if science has anything to do with it!
Despite the fact that there are no good data on health benefits related to coconut oil, 72% of the American public (but only 37% of nutritionists) rate it as a ‘healthy food.’ That shows the power of good marketing!
Here’s a quick overview of fat facts to put the coconut oil controversy in context. All the oils we use are a mix of saturated fats and unsaturated fats. The unsaturated ones can be divided into MONOunsaturated fats (MUFAs) and POLYunsaturated fats (PUFAs). ‘Good oils’ like canola and olive oil, are rich in UNsaturated fats, especially MUFAs. Beef, butter and coconut oil, on the other hand, are much more heavily weighted toward ‘bad’ saturated fats.
Saturated fat, in fact, makes up about 82% of coconut oil. Proponents of the oil say that even though it’s saturated, it contains MCTs, or medium chain triglycerides, which are not bad for you. Yes, coconut oil contains MCTs, but only 10% – the remainder of the saturated fat components are longer chain triglycerides, that are simply BAD. They raise LDL, which is a major risk factor for heart disease.
Studies suggest that coconut oil increases ‘bad’ cholesterol (LDL) in your blood, and might increase ‘good’ cholesterol (HDL) as well. Studies in humans DO show that LDL is increased by consuming coconut oil. The evidence for increasing HDL is not as clearcut, and comes from animal studies and small, nonrandomized studies of virgin coconut oil. There are no standards for what virgin oil is, but it is prepared in a way to retain the beneficial active plant contents – phytosterols, tocopherols and the like.
Further complicating the situation, is that although higher HDL is associated with lower incidence of heart disease, we have NOT been able to show that by forcing the HDL to increase, that we can decrease heart disease. Unfortunately, increasing HDL with foods or medications, does NOT seem to be helpful in decreasing heart attacks. Our past attempts at using niacin and the like to raise HDL levels did not improve cardiac risk, so those meds have fallen out of favor. The LDL or non-HDL cholesterol (Total cholesterol minus HDL) is the real risk determinant for cardiovascular disease, and one we can modify to alter risk.
I recommend the website nutrition facts.org with presentations by Dr. Michael Greger. Here’s the analogy he uses regarding HDL and heart disease, showing how there can be an association, without the HDL actually being responsible for heart protection, i.e., association, not causation. He states that it would be easy to prove that the number of ashtrays someone owns is an excellent predictor of lung cancer risk. Makes sense, right? But tossing out the ashtrays doesn’t lower your cancer risk — unless you also stop smoking! Ashtrays and lung cancer are associated, but one doesn’t cause the other.
In summary then, raising the LDL by sat fat intake is definitely bad, raising the HDL is probably not beneficial. Net effect then, even if HDL does go up a little with coconut, is thumbs down for coconut oil.
We know for sure that we should replace saturated fats with unsaturated fats. That’s well documented, and a major tenet of the July, 2017 statement from the American Heart Association. Official recommendation of the AHA on coconut oil: AVOID.
What about coconut itself? The non-fat part of coconuts is good – it’s plant fiber. However non-fat coconut flakes are not available commercially. In plain old coconut flakes, the fat part is probably more bad than the fiber is good, if that makes sense.
So think of coconut products like butter, but a little worse – the saturated fat content and subsequent LDL increase are in the same range. If you like coconut in whatever form, use it sparingly, but don’t fool yourself into thinking it will improve your health! And have some admiration for the marketing folks who managed to build an industry around coconut products and their health benefits!
REFERENCES:
Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association; Circulation. July 18, 2017. Frank M. Sacks, et.al.
http://circ.ahajournals.org/content/early/2017/06/15/CIR.0000000000000510
https://nutritionfacts.org/video/coconut-oil-and-the-boost-in-hdl-good-cholesterol/
https://nutritionfacts.org/video/is-coconut-milk-good-for-you/