Surprisingly, a number of dietitians still cling to the 60-year old discredited theory that consuming saturated fats leads to atherosclerosis and heart attacks. Some of these well-meaning folks seem to have lost their way and apparently, their ability to analyze a scientific study.
Ironically, their anti-coconut oil rhetoric is at odds with statements published on the website of their own licensing organization, the Academy of Nutrition and Dietetics (AND), formerly known as the American Dietetic Association. The AND is a food industry sponsored (e.g., Coco Cola®, Kellogg®, McDonald’s®) private organization, which had this to say about coconut oil:
“Coconut oil, specifically virgin coconut oil, has some antioxidant properties, potentially because of plant nutrients called phenolic compounds. There’s some preliminary evidence — including both animal and human studies — suggesting that coconut oil intake may be associated with a neutral, if not beneficial, effect on cholesterol levels.”[i]
— Academy of Nutrition and Dietetics
The evidence presented in numerous preclinical and clinical studies on the health benefits of coconut oil helps explain why the AND took this favorable position: coconut oil has been shown to raise the level of heart-healthy HDL-cholesterol (PDF) and to lower lipid levels. Research also suggests that the unique saturated fatty acid profile of coconut oil helps create non-atherogenic lipid profiles and that phenolic compounds found in coconut oil may protect LDL-cholesterol from oxidation.
Despite the AND’s favorable position on coconut oil, one of their members, a spa dietitian at a well-known health resort, posted articles here, here, and here, warning about the dangers of consuming coconut oil. This dietitian claims that coconut oil contains only 10% medium-chain triglycerides (MCT).[ii] He believes that the saturated fats in coconut oil will adversely affect blood lipid profiles and thereby promote cardiovascular disease.
In addition, he labels as quacks those healthcare professionals who disagree with his beliefs about coconut oil’s dangers and further unabashedly states that he is an “expert at separating fact from fraud in the nutrition field.” Indeed.
This spa dietitian seems to be relying on older studies, which found that coconut oil supplementation increased LDL-cholesterol. These studies have been criticized for using hydrogenated coconut oils.
Why bother to hydrogenate coconut oil? Hydrogenation increases stability of coconut oil for cooking, but as a result, the oil will contain increased levels of trans-fatty acids (coconut oil contains about 8% unsaturated fatty acids that are vulnerable to conversion to trans fats). Studies have linked consumption of even very small amounts of trans fats to increased risk for cardiovascular disease.
Depending upon which authoritative source you use (see: here and here and here), coconut oil is composed of between 58-70% MCT, a stark contrast to the 10% figure the health spa dietitian claims. To be fair, some lauric acid, the main medium-chain fatty acid in coconut oil, is re-esterified to glycerol (the molecular backbone of the triglyceride molecule) and enters the lymph in chylomicrons in the same manner as long-chain fatty acids.
It appears that approximately 35% of the total saturated fats in coconut oil behave as beneficial MCTs — 350% higher than this spa dietitian claims. Since he works for an organization with a strong financial interest in promoting the discredited lipid-heart disease theory, there’s an potential conflict of interest between profit motive and the facts. Perhaps this explains why this spa dietitian personally attacks healthcare professionals with whom he disagrees by labeling them as quacks.
I’d like to examine what the science tells us about this dietitian’s questionable statements regarding coconut oil. This is important because they reflect the same confirmation bias of other others who promote the lipid-heart disease theory at a time when millions of those in the ancestral/Paleo/primal communities are discovering the weight-control and health benefits of coconut oil.
How Coconut Oil Got Its “Heart Unhealthy” Reputation
In 1994, the scariest thing in the movies wasn’t vampires.
It was popcorn.
The food police, aka, CSPI—the Center For Science In the Public Interest—took aim at movie theater popcorn because it was popped in coconut oil. Jacobsen is a self-professed vegetarian and cholesterolphobe. It’s therefore not surprising that he and CSPI could have overlooked published studies that suggest coconut oil provides numerous health benefits to users, including reducing the risk of cardiovascular disease.
CSPI’s questionable condemnation of coconut oil severely tarnished coconut oil’s reputation, a reputation that persisted until ancestral/primal/Paleo diet bloggers began to discuss the health benefits of coconut oil as supported by the scientific data culled from multiple peer-reviewed studies.
Human Studies Support The Health Benefits of Coconut Oil
Before I dismantle the spa dietitian’s coconut oil fiction, here’s a fun fact to ponder: Throughout evolution, the mammalian mammary gland has conserved the means to synthesize butyric, caproic, caprylic, capric, lauric, myristic, palmitic, and stearic acids — the same saturated fatty acids found in coconut oil. These are the very fats that have provided optimal nourishment to promote the healthy development, growth and survival of newborn humans and other mammals.
I recommend that all anti-coconut oil health professionals and those not yet familiar with the oil’s multimodal health benefits consider the following research findings:
- The Pukapukans, who consume 35 percent of their daily calories as fat—75 percent of which comes from coconut oil—have total cholesterol levels averaging 170 mg/dL for men and 176 mg/dL for women. The Tokelauans, who consume 50 percent of their calories from fat—with 90 percent of their daily fat ration coming from coconut oil — have average cholesterol levels of 208 mg/dL for men, 216 mg/dL for women. Their LDL:HDL ratios are healthier than those seen in the US and other industrialized countries. Blood triglyceride levels, a widely recognized cardiovascular disease risk factor, were very low, averaging less than 50 mg/dL for both tribes.
- A controlled study of female college students compared the effects of a coconut oil-rich diet on postprandial t-PA and Lp(a) – two established risk factors for cardiovascular disease – with a low-saturated fat diet without changing the polyunsaturated/saturated fatty acid ratio of either diet. Investigators found that the coconut oil–based diet lowered postprandial (after-meal) t-PA antigen concentration. This showed that coconut oil use could favorably affect the blood clotting system and lower the Lp(a) concentration, thereby reducing cardiovascular disease risk when compared to a diet rich in unsaturated vegetable oils.
- A randomized, double-blind study in women found that when coconut oil replaced other fats in the diet, it led to a reduction in waist circumference and abdominal obesity. This weight-loss effect has been confirmed and has been linked to healthy modifications to cardiovascular risk profiles.
- In an Indian study of 32 patients diagnosed with ischemic heart disease and 16 age- and sex-matched healthy controls (both groups had similar intakes of coconut, coconut oil, total fat, saturated fat, and cholesterol), researchers could find“no specific role for coconut or coconut oil in the causation of CHD.”
- Researchers who reviewed studies on the effects of feeding MCT-rich oil to humans concluded: “MCT increase energy expenditure, may result in faster satiety, and facilitate weight control when included in the diet as a replacement for fats containing LCT [long-chain triglycerides].”
- Investigators found that Filipinos living in the Bicol region of Luzon consume the most fat from coconut oil in the Philippines — 26 g daily on average — had the highest serum cholesterol among all Filipinos, yet it was still below 200 mg/dl. Importantly, Bicolanos were found to enjoy the lowest mortality from heart disease and strokes among all Filipinos (PDF).
- A case-control study conducted among the Minangkabau, in West Sumatra, Indonesia, who consume large amounts of coconut and coconut oil, found that consumption of total fat or saturated fat, including that from coconut, was not a predictor for CHD in this population.
- A controlled human study found that a coconut oil–based diet (high in saturated fats) lowers postprandial t-PA antigen concentration (which favorably affects the blood clotting system) and Lp(a) concentration (which reduced cardiovascular disease risk) compared with a low-saturated fat diet. Importantly, the unique proportions of saturated fatty acids in coconut oil rather than the percentage of saturated fat energy were responsible for the beneficial influence on Lp(a) levels.
- A study of two free-living South Pacific populations that consume a natural diet extraordinarily high in coconut and coconut oil, found that these people enjoy an a healthy existence with no evidence of harmful effects. Researchers who studied the South Pacific Pukapukan and Tokelau Islanders found no evidence that their coconut-rich diet dangerously elevated their blood cholesterol levels, promoted atherosclerosis, or increased their risk of heart attack. The study’s authors concluded: “Vascular disease is uncommon in both populations and there is no evidence of high saturated fat intake having a harmful effect in these populations … Certainly, there is no reason based on this report, to alter the diet patterns of coconut eating groups in order to reduce coronary risk.”
- One study showed improved quality of life of breast cancer patients given virgin coconut oil (VCO) during the chemotherapy treatment. This study also suggests that VCO consumption can improve body image, future perspective and sexual function.
- One review study found that as a result of an ‘anti-saturated fat’ campaign in 1978, Sri Lankans switched from using coconut, the primary source of dietary oil for thousand of years, to using corn oil and other polyunsaturated vegetable oils. As a result, heart disease rates dramatically soared. Until that time, only one out of every 100,000 deaths was attributed to heart disease. Compare that to the United States, where the heart disease death rate during the same time was at least 280 times higher).
Phytonutrients In Coconut and Coconut Oil
Virgin coconut oil (manufactured by wet process) has been shown to reduce cholesterol and triglyceride levels in the blood.
One study showed it reduced total cholesterol, triglycerides, phospholipids, LDL- and VLDL-cholesterol levels and increased HDL-cholesterol in serum and tissues. Study investigators also found that a phytonutrient-rich fraction of virgin coconut oil was capable of preventing in vitro LDL oxidation.
A major phenolic compound in coconut, 4-hydroxybenzoic, exerts anti-tumor activity against breast cancer cells. Other health-promoting coconut phenolic acids include:
- Ferulic acid, which has been shown to protect against beta-amyloid toxicity linked to Alzheimer’s disease
- 4-coumaric acid (also found in raw honey), can activate immunity genes,
- 4-hydroxybenzaldehyde, an antimicrobial, antiviral and anti-inflammatory compound
- Vanillic acid, which has been shown to reduce the severity of ulcerative colitis
Monolaurin, a metabolite of coconut’s main MCT, lauric acid, is an anti-microbial agent that protects the immune system from a range of infectious bacteria and viruses. It has been shown to exert broad-spectrum sensitivity against Gram-positive and Gram-negative bacteria and protect against Respiratory Syncytial Virus (RSV) and other respiratory tract viruses by disintegrating the fat envelope coat of viruses. Monolaurin is also used into total parenteral nutrition (TPN)-lipid emulsions due to its insulinotropic (anabolic) property.
“Most of the studies involving coconut oil were done with partially hydrogenated coconut oil, which researchers used because they needed to raise the cholesterol levels of their rabbits in order to collect certain data,” Dr. Brenna said. “Virgin coconut oil, which has not been chemically treated, is a different thing in terms of a health risk perspective.”
Dr. George Blackburn, (Harvard Medical School, New England Deaconess Hospital, Laboratory of Nutrition/Infection, Nutrition/Metabolism Laboratory, Cancer Research Institute, Boston), a highly respected nutrition authority, reviewed the published scientific literature on coconut oil and concluded that coconut oil is a neutral fat with respect to its atherogenic (heart disease) potential.
The bulk of the published evidence suggests that consuming coconut and coconut products will not add plaque to your arteries. It might, however, help you lose some belly fat and reduce your risk of cardiovascular disease, prevent osteoporosis and hypertension, and possibly help thwart Alzheimer’s disease.
i) I originally accessed the official Academy of Nutrition and Dietetics position statement on coconut oil in 2014 from their website: www.eatright.org at this URL. Since that time, the page has disappeared from the website.
ii) Food scientists (see here, here, and here) disagree with this spa dietitian’s claim that coconut oil contains only 10% MCTs. The reason is that they classify triglycerides with saturated fatty acids of between 6–12 carbons in length as “medium-chain triglycerides” (MCTs). This means that coconut oils MCT content is many times higher than the spa dietitian claims. MCTs are either neutral or cholesterol-lowering fats.
☆ Disclaimer: This is my informed opinion. I could be wrong. What do you think?