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Coconut Oil: Good for Some, Bad for Others?

The American Heart Association says coconut oil is bad for your health.

But some commentators, such as Chris Kresser, vehemently disagree. I left this comment on Chris’ blog post Coconut Oil is Still Healthy, Despite AHA Claims.

I use coconut oil, mainly in homemade toothpaste and as a mouthwash, because as Chris points out, lauric and caprylic acid are both powerful antimicrobial agents that can enhance dental health. I do find the saturated fat and heart disease debate tiresome though as I think it’s likely that genetic polymorphisms are a major driver of how dietary fat affects us.

Another reader, Mike Torres from Seattle, left this comment:

I’m concerned that the current debate is focused on whether coconut oil is healthy vs. not healthy, and not focused on the individual variations that might make something that’s healthy for one person, unhealthy for another – or vice versa.

Saturated fat – especially coconut oil – absolutely spikes my LDL-P (more than doubled) and Small LDL (more than tripled!) Could be because of the ACE gene (G/G) or some other gene associated with fat metabolism. But it’s testable and repeatable. So regardless of the AHA’s motivations, I don’t think it’s accurate to say any one thing is healthy or not on a broad scale vs. speaking in individual terms.

We couldn’t agree more with Mike!

This post is offered as a middle road to the black and white discussions surrounding coconut oil. The reality is that Coconut Oil is probably good for some people using it for targeted reasons, and probably very bad for the heart health of others.

Recent controlled trials teach us that some people see an uptick in markers associated with poor cardiovascular health, such as LDL-C, when eating a high saturated fat diet. However, the response to dietary fat is not uniform. One recent study saw variation of between 5-107% increase in LDL-C when subjects followed a high fat diet. 1 If you’re someone who sees a large change in cholesterol numbers when eating coconut oil in large quantities, coconut oil probably isn’t a great choice as a staple. Conversely, if eating coconut oil doesn’t spike cholesterol and LDL-C (the 5% group referenced above) you may be able to keep coconut oil in your diet and be just fine.

In our scoring matrix, diet types like Mosaic and Urban Grazer are more likely to be in the 5% camp, whereas Wayoan and Okinawan are more likely closer to the 107% group.

Passing the mic over to Aaron for the rest of this post.

Breaking down coconut oil health claims

Alongside the flavor benefits of coconuts as a delicious food, and yes they are delicious, no one is disputing that, the raft of specific health claims attributed to coconuts in recent years have been on the rise. Bulletproof Coffee and its MCT oil is a great example.

Whilst some, such as claims of more efficient hydration, are relatively harmless, other claims have potentially wider reaching implications for individual and population health; hence the recent American Heart Association report.

Below, I’ll run down the various uses for coconut oil and weigh in on whether there is reason to say it is healthy.

Oral hygiene

Our call: definitely healthy 

Coconut oil has been used for generations in Ayurvedic traditions as tool for maintaining oral health. The practice, known as “oil pulling,” involves swirling coconut oil in the mouth, sometime for as long as 30 minutes. Pulling is usually done in the mornings. Turns out there is a science based reason for using coconut oil in this way as the lauric acid found in coconut oil has been proven in multiple studies to have a potent antimicrobial effect.

Mental acuity

Our call: possibly healthy for some, efficacy questionable

Coconut oil contains a form of fat known as medium chain triglyceride or “MCT.” The two major benefits attributed to MCTs, and therefore coconut oils and fats, are:

  1. the promotion of fat burning and;
  2. mental sharpness.

MCTs have been shown to increase energy expenditure and decrease weight gain (or promote weight loss) when compared to long chain triglycerides (LCT) such as olive oil. 2 3

The increase in mental sharpness is thought to occur through the increase of ketone bodies. By eating a high fat, adequate protein and low carbohydrate diet, fats rather than carbohydrates are preferentially used to provide energy. When your body burns fat instead of glucose, you are in a state of ketosis. By preferentially burning fats, it is claimed that the sleepy feeling generated following eating a meal rich in carbohydrates is avoided, allowing greater focus as well as myriad other health benefits.

Ketogenic diets have evidence of health benefits

There is a lot of evidence that ketogenic diets can have a beneficial effect, having historically been used in the treatment of childhood epilepsy. 4 There is even evidence that ketone bodies can be protective against radiation.

More recently MCTs have been proposed as an aid to achieving a state of ketosis. They are marketed as an ideal source of fat energy due to their easier absorption and use than other dietary fat sources. 5 6

As coconuts are rich in MCT’s, they have become a preferred source of fat for this type of diet. It is therefore easy to see how a link towards improved mental acuity could be attributed to coconut oil.

Coconut oil is not MCT oil

However, the evidence for some of these claims is less than stellar. A series of papers from researchers at Cornell UMS are frequently cited to demonstrate the fat burning benefits of MCTs and therefore coconuts. 7 These studies do indeed show a marked effect on weight loss in overweight populations when LCTs such as olive oil were replaced with 100% pure MCT oils. 7 8

While MCT oil is made by refining coconut oil, they are not the same product. Coconut oil does not contain 100% MCTs, rather it is thought to comprise of approximately 14% MCTs with the rest made up more traditional LCTs and carbohydrates. 8 One of the authors of the papers themselves have even gone on record to state that:

“From what I can tell, my research is being used to say that coconut oil is healthy, but this is a very liberal extrapolation of what we’ve actually studied… We don’t know if the amount in coconut oil is sufficient to have similar effects as pure MCT oil in releasing energy expenditure and improving satiety and weight management.”

Image From St-Onge et al. Medium-Chain Triglycerides Increase Energy Expenditure and Decrease Adiposity in Overweight Men. Obesity Research. 2003. Figure one shows an increase in energy expenditure when an MCT rich diet (black squares) is used compared to a normal olive oil rich diet (white squares), at both 2 and 28 days. A similar increase in fat oxidation is shown in figure 2 at both 2 and 28 days.

Bottom line here is that MCT oil was found to have health benefits that cannot, and should not be extended to coconut oil. And before you run off and include MCT supplements in your diet, remember they are even higher in saturated fat content than is coconut oil.

Coconut oil and heart health

Our call: unhealthy for some 

For those using coconut oil as stable cooking oil, or taking a few tablespoons with their coffee, whether their coconut oil usage can be said to be healthy depends on the state of their lipid profile. As Mike from Seattle points out above, certain people experience dangerous spikes in LDL and other heart disease markers whilst on a diet high in saturated fat, and coconut oil is high in saturated fat. 9

Coconut oil increases HDL, but also LDL and Triglycerides

Coconut oil diets have been shown to increase the levels of triglycerides, HDL cholesterol and LDL cholesterol in the blood (R).

See also: Citrus bergamot: the all natural statin?

For those with a heightened cardiovascular risk, the presence of increased blood triglycerides and LDL, through either genetic or environmental factors, then this is less than desirable. Indeed, the British Nutrition Foundation state that there are no health benefits associated with a dietary intake of coconut oil, when compared to other healthier oils such as olive oil.

Take home message

So, bearing in mind the AHA report what should you do?

Well it’s important to re-state that coconuts are not a miracle food, but nor are they a food villain. As for dietary or supplement advice it depends on your current lifestyle, diet and underlying genetics.

It’s best to discuss with your doctor once your baseline lipid markers are known. The message here is that there are many variables that go into whether coconut products are healthy for a given individual. If you’re genetically predisposed to elevated LDL levels, coconut oil supplements probably aren’t a great choice for your longterm heart health.

If you have healthy LDL levels and testing shows you maintain them with ease, coconut oil or MCT oil in moderation could provide a nice mental boost without impacting heart health.

We encourage readers to test and experiment. Know your numbers and know your genetic risk. Then make the decision that is right for you based on all the evidence.

Dr. Aaron Gardner, BSc, MRes, PhD

Dr. Aaron Gardner, BSc, MRes, PhD is a life-scientist with a strong background in genetics and medical research, and the developing fields of personalized medicine and nutrition. Read his full bio here.

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