The Coconut Oil Controversy
About this time last year, Coconut Oil came under the cross-hairs of a review from the American Heart Association, which advised against its use. This stirred lots of controversy between the professional nutrition community and proponents of its alleged health benefits - which is still ongoing today... So which is it - good and bad?
The review from the American Heart Association released in June of 2017, makes the point that coconut oil is 82 percent saturated fat and is as bad for your heart as other oils high in saturated fat, including butter, beef fat, and palm oil. The reviewers noted that 72 percent of the American public considers coconut oil a healthy food and that the AHA reviewers attributed this prevailing attitude to successful "marketing" by the coconut oil industry. The review cited seven clinical studies showing that coconut oil raises levels of LDL (“bad”) cholesterol as much as butter, beef fat and palm oil do. Despite what some people think about the connection between saturated fat, cholesterol and heart disease, there is very solid evidence that high LDL is a risk factor for cardiovascular disease.
The Dietary Fats and Cardiovascular Disease advisory reviewed existing data on saturated fat, showing coconut oil increased LDL ("bad") cholesterol in seven out of seven controlled trials. Researchers found coconut oil to have no difference from other oils high in saturated fat, like butter, beef fat and palm oil. In fact, the 82% saturated fat content in coconut oil, according to the data, is far beyond butter (63%), beef fat (50%) and pork lard (39%).
These findings are not new. We’ve long known that coconut oil can raise LDL cholesterol levels and therefore poses a threat to the heart. Many other health organizations advise against the consumption of coconut oil due to its high levels of saturated fat, including the United States Food and Drug Administration, World Health Organization, the United States Department of Health and Human Services, American Dietetic Association, British National Health Service, British Nutrition Foundation, and Dietitians of Canada.
So why did we get so excited about coconut oil in the first place? The reason coconut oil became so popular is partly due to research on medium chain triglycerides and weight loss by Marie-Pierre St-Onge, associate professor of nutritional medicine at Columbia University Medical Center. Her research suggested that eating medium-chain triglycerides (MCTs) may increase the rate of metabolism more than eating long-chain triglycerides, with the MCTs going from the intestinal tract directly to the liver where, it is believed, they are burned off as fuel rather than stored in body fat.
The problem is St-Onge's research used a "designer oil" packed with 100% true MCTs. Coconut oil only contains about 13 to 15% MCTs. The main fatty acid in coconut oil is Lauric acid (about 50%), and while technically considered a MCT with 12 carbons, behaves more like a long chain fatty acid (those with 14 or more carbons). So the leap from her research to the belief that coconut oil could assist with weight loss is unfounded.
The one study that carefully examined the effects of coconut oil on weight loss was a very small one, with only 40 women participating. Half of them used two tablespoons of coconut oil for cooking daily while the others used soybean oil. All the participants cut 200 calories from their daily diets and exercised four days a week. After three months, the women in both groups had each lost about two pounds. This is far from an impressive result, and the cut of calories with exercise would be the much more likely reason for the weight loss, not the MCTs. To date, no study has shown that using coconut oil leads to significant weight loss.
But what about the Pacific island populations who consume lots of coconut (though not necessarily coconut oil) and have low rates of heart disease? That may be true, but their traditional diet - rich in fish, fruit and vegetables and lacking in refined sugar, soft drinks and processed foods - is very different from the standard American diet, so a comparison is not really valid when it comes to the rates of heart disease.
You may have come across reports that coconut oil can help Alzheimer’s disease patients. However, there have been no studies of coconut oil as a treatment for Alzheimer’s disease and, as yet, no scientific evidence that it provides any benefit.
So, if you want to loose weight and/or lower your risk of heart disease, coconut oil is not a good choice. There’s no evidence that consuming coconut oil can lower the risk of heart disease. An article in the April 2016 Nutrition Reviews titled "Coconut Oil Consumption and Cardiovascular Risk Factors in Humans,” reviewed findings from 21 studies, most of which examined the effects of coconut oil or coconut products on cholesterol levels. Eight were clinical trials, in which volunteers consumed different types of fats, including coconut oil, butter, and unsaturated vegetable oils (such as olive, sunflower, safflower, and corn oil) for short periods of time. Compared with the unsaturated oils, coconut oil raised total, HDL, and LDL cholesterol levels, although not as much as butter did.
In contrast, there’s a wealth of data showing that diets rich in unsaturated fat, especially olive oil, lower the risk of cardiovascular disease. The evidence comes not only from many observational studies, but also a landmark clinical trial from Spain following over 7000 men and women for almost 5 years, found that people who ate a Mediterranean-style diet enhanced with extra-virgin olive oil or nuts had a significantly lower risk of heart attack, stroke, and death from heart disease than people who followed a low-fat diet.
A particular problem with the hype around coconut oil occurs when people eat them with refined grains (which turn into sugar) such as breads and pasta or sugary foods. This 'mixed meal' combination amplifies the inflammatory effects of sugar.
In essence, when it comes to your health, you need to look at the whole picture rather than an isolated ingredient. Coconut oil interacts differently in the human body depending on what else is being consumed. Supplementing a high-sugar, high-refined-carb diet with coconut oil will increase the bad type of cholesterol and contribute to inflammation. If you're not going to eat vegetables and avoid energy dense high-carb junk foods, then you should limit your saturated fat intake - coconut oil included.
Portion size also matters. The idea proposed by some so-called health authorities to add 1 to 2 tablespoons of coconut oil to every meal is not a good idea in my opinion. In many people, such a large load of fat will result in weight gain.
There’s no need to completely avoid coconut oil if you like the flavor, but it should be consumed in limited amounts in an otherwise generally healthy diet in order not to cause additional inflammation in the body. No credible studies support a carte blanche to eat tablespoons of it daily.