Is coconut oil healthy or not?

The bottom line is Coconut oil is 82% saturated fat (about half as lauric acid) and all saturated fats should be used in moderation. 

While coconut oil may increase LDL (bad) cholesterol which was discussed in the report, it also increases HDL (good) cholesterol which was not discussed in the report. 

For people who need to lower LDL, the AHA guideline to REDUCE total saturated fat intake to no more than 5 to 6 percent of total daily calories remains prudent. 

For healthy adults, the 2015-2020 Dietary Guidelines for Americans recommends no more than 10% total calories from saturated fat to reduce heart disease risk. Coconut oil can be safely used as part of these recommendations.

Further break down of the AHA report:

Recent headlines have coconut oil in the news, questioning its effect on heart health, based on an advisory report from the American Heart Association (AHA). The following may be helpful to better understand the limits of the report and how coconut oil can safely fit into an overall healthy diet plan for heart and total body health.

What is the AHA report?

The AHA report,  Dietary Fats and Cardiovascular Disease, summarizes information about fat intake and heart disease risk. In short, the report concludes that diets high in saturated fat increase blood levels of LDL (“bad”) cholesterol, which is a risk factor for heart disease. Reducing saturated fat intake and replacing it with unsaturated fats helps decrease LDL cholesterol as well as blood triglyceride levels, another risk factor for heart disease.

What was the basis for the report’s findings?

The reviewers based their conclusions on the ability of a fatty acid to reduce LDL cholesterol only. They specifically excluded any data about the ability of a fatty acid to raise HDL (“good”) cholesterol. Their rationale is a measure of HDL cholesterol alone has no value for directly assessing heart disease risk unless elevated LDL cholesterol (or triglycerides) is a concern.

Why is HDL cholesterol important?

HDL cholesterol continues to be an important measure in an overall risk profile for heart disease. HDL lipoproteins help remove cholesterol from cells and deliver it to the liver where it can be secreted in bile and excreted. A lower ratio of total-to-HDL cholesterol or LDL-to-HDL cholesterol equates to a lower heart disease risk.

Why is HDL cholesterol an important measure for coconut oil?

Coconut oil is 82% saturated fat (about half as lauric acid). While coconut oil may increase LDL cholesterol, it also increases HDL cholesterol. This is not captured in the AHA report because the reviewers did not include data related to changes in HDL cholesterol.

How does coconut oil raise HDL cholesterol?

In the meta-regression (Mensink 2016) used as the basis of the AHA report, the author notes that an increased intake of lauric, myristic or palmitic acid – the main saturated fats in coconut oil – raise both LDL and HDL cholesterol levels (as well as lower triglyceride levels) compared to carbohydrates. Lauric acid alone, which makes up 50% of the saturated fat in coconut oil, improves the total-to-HDL cholesterol and LDL:HDL cholesterol ratios compared to carbohydrates. Thus, while coconut oil may increase LDL cholesterol, it also raises beneficial HDL cholesterol, primarily mediated by its high content of lauric acid.

Has clinical research evaluated the blood lipid effects of coconut oil?

Yes, in one randomized crossover study (Harris 2017), 12 postmenopausal women were asked to follow their typical diet but add either 2 tablespoons of virgin coconut oil or safflower oil to their daily intake for a month. Each treatment period was separated by a month washout period. The safflower oil did not significantly change lipid values. Coconut oil raised both LDL and HDL cholesterol, resulting in a neutral effect on the ratio of total-to-HDL cholesterol. In addition, coconut oil reduced the blood level of IL-1-beta, a marker of inflammation. These findings suggest that individuals wishing to use coconut oil as part of an overall healthy diet can do so safely.

In another randomized, crossover, controlled study (Valente 2017), researchers asked 15 overweight women to eat a mixed breakfast with either coconut oil or olive oil to evaluate blood lipid, appetite and metabolic effects. On separate occasions, the women were asked to consume mixed breakfasts with similar calories, one containing about 1-1/2 tablespoons of virgin coconut oil and the other containing olive oil. Metabolic changes were measure up to 3 to 4 hours after intake. Results indicate the coconut oil had no adverse affect on blood lipids; however, it did significantly improved satiety and suppressed hunger after the meal.

What does the AHA report mean in practical terms?

For people who need to lower their blood cholesterol LDL, the AHA guideline to reduce total saturated fat intake to no more than 5 to 6 percent of total daily calories remains prudent. For healthy adults, the 2015-2020 Dietary Guidelines for Americans recommends no more than 10% total calories from saturated fat to reduce heart disease risk. Coconut oil can be safely used as part of these recommendations.

References

Harris M, Hutchins A, Fryda L. The impact of virgin coconut oil and high-oleic safflower oil on body composition, lipids, and inflammatory markers in postmenopausal women.  J Med Food. 2017;20(4):345-351. PMID: 28277823.

Mensink RP. Effects of Saturated Fatty Acids on Serum Lipids and Lipoproteins: A Systematic Review and Regression Analysis. Geneva, Switzerland: World Health Organization; 2016. Available at:  http://www.who.int/nutrition/publications/nutrientrequirements/sfa_systematic_review/en/

Valente FX, Cândido FG, Lopes LL, et al. Effects of coconut oil consumption on energy metabolism, cardiometabolic risk markers, and appetitive responses in women with excess body fat.  Eur J Nutr. 2017 Apr 12 [Epub ahead of print] PMID: 28405814.

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