Coconut Conundrum

The American Heart Association (AHA) Presidential Advisory Board recently published new recommendations for dietary fat intake, including a recommendation against the consumption of coconut oil. This has lead to newspaper articles with headlines such as “Coconut oil worse for you than butter and beef dripping” (The Independent).

I agree that most oils of any kind on the market are highly processed and therefore oxidized and unhealthy compared to oils the way they were produced hundred of years ago (and still are in traditional environments). So I agree that oil in general reduces health, unless artisanal such as those consumed in Mediterranean villages with no supermarkets in sight, or from small olive farms purchased at your local Farmer’s market.

Separately from this point, and more generally, the AHA is not taking into account all of the evidence when concluding that replacing animal fats with vegetable oils increases health; there is significant evidence going back half a century that the opposite is true.

Eggs were taken off of the “bad food list” in 2015 by the US Government, reported by the press (again The Indpendent) as “Cholesterol U-turn as research shows fatty foods might not be bad for us after all.” The shift in consensus by the scientific and medical community from viewing blood cholesterol as causative to seeing it as coorelated is not reflected in this latest AHA promulgation. Unfortunate since this outdated view is leading to confusing and conflicting recommendations to the public.

It is usually counter-productive to combine three separate issues into one debate, as is occuring in this coconut conundrum. First, overeating in general accelerates aging and disease risk to some extent, no matter how healthy the food, which makes the over-consumption of fats (or anything else) an issue. Fats are calorie dense, so overeating them can occur easier without realizing it than other macronutrients. Second, processed carbs reduce health even when consumed in relatively small amounts, so replacing them with fats or anything else (protein, vegetables) is a good idea, making fats (by comparison with “carbs”) “healthy.” Third, most oils on the modern market are oxidized and therefore unhealthy, so any food (olives, coconut) is healthier than its extracted oil.

Since coconut oil is the highest in saturated fats of any concentrated fat source (butter, animal fat, or other plant fats), it is the most resistant to oxidation and therefore the best for cooking, particularly at high temperature e.g. stir frying. This does NOT mean that coconut fat is “healthy” but that it is not hurting you as much as other oils when exposed to high temperature. This is like saying riding a motorcycle is not healthy but having a helmet on at least reduces how much you might get hurt.

It is an entirely separate and unrelated issue as to whether raw, fresh coconut (the food, not the oil squeezed out of it) is healthy. Several years ago I did a literature search on the health effects of coconut and could not find any evidence for a negative health outcome. This is in spite of a clear increase in blood cholesterol levels (see below references). This argues for blood cholesterol levels being correlated to disease (when oxidized, such as when you eat processed oil, smoke, or avoid fats altogether), but argues against blood cholesterol levels causing disease.

The bottom line is that health is driven by eating natural food. The natural world is nicely matched to our natural bodies. If you eat something processed such as olive oil or milk, get the least-processed version such as the artisanal oil or the cream top milk (which has undergone just a bit of pasteurization to avoid food poisoning). If you cannot afford higher-quality fats, focus your diet on vegetables and protein instead of large amounts of fats. And if you want to cook with fat, use a bit of butter or, even better, coconut, ground up as opposed to just the oil. Even more preferably, don’t cook with fat at all: use a bit of water or a watery vegetable (e.g. tomato) and cook at low heat, then add patience and take your time so nothing gets burned. Eating like your Great-Grandparents did is really just a bit of common sense in the end.

The complexity and back-and-forth on these nutrition topics stems from the necessary loss in health value with any form of food processing, which has reached caricature levels in modern society where soda is consumed like water and fast “food” is considered food. Coconut has become yet another victim of that contrived modern complexity.

References showing coconut is in fact (based on scientific evidence) healthy:

1. “Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials”, Mensink RP et al., Am J Clin Nutr 77 2003 1146

2. “Coconut oil: Atherogenic or not?”, Dayrit CS, Philippine J Cardiology 31 2003 97

3. “The role of coconut and coconut oil in coronary heart disease in Kerala, south India”, Kumar PD, Trop Doct 27 1997 215.

4. “Dietary intake and the risk of coronary heart disease among the coconut-consuming Minangkabau in West Sumatra, Indonesia”, Lipoeto NI et al., Asia Pac J Clin Nutr 13 2004 377

5. “Effect of fish oil and coconut oil diet on the LDL receptor activity of rat liver plasma membranes”, Tripodi A et al., Biochim Biophys Acta 1083 1991 298

6. “Dipyridamole prevents the coconut oil-induced hypercholesterolemia”, Garcia-Fuentes E et al., Int J Biochem Cell Biol 34 2002 269

7. “Effect of coconut oil on plasma apo A-I levels in WHHL and NZW rabbits”, Carlson TL and Kottke BA, Biochim Biophys Acta 1083 1991 221

8. “Effects of dietary coconut oil on apolipoprotein B synthesis and VLDL secretion by calf liver slices”, Gruffat-Mouty D et al., Br J Nutr 86 2001 13

9. “Synergism between the effects of dietary cholesterol and coconut oil on plasma, liver and lipoprotein composition of neonatal chick”, Castillo M et al., 30 1998 707

10. “The serum LDL/HDL cholesterol ratio is influenced more favorably by exchanging saturated with unsaturated fat than by reducing saturated fat in the diet of women”, Muller H et al., J Nutr 133 2003 78

11. “Plasma lipid and lipoprotein response of humans to beef fat, coconut oil and safflower oil”, Reiser R et al., Am J Clin Nutr 42 1985 190. Critical comment by Jacobs DR in a subsequent issue.

12. “Beneficial effects of virgin coconut oil on lipid parameters and in vitro LDL oxidation”, Nevin KG and Rajamohan T, Clin Biochem 37 2004 830

13. “The effect of dietary menhaden, olive, and coconut oil fed with three levels of vitamin E on plasma and liver lipids and plasma fatty acid composition in rats”, Mohamed AI et al., J Nutr Biochem 13 2002 435

14. “Coconut kernel protein modifies the effect of coconut oil on serum lipids”, Padmakumarannair KG et al, Plant Foods Hum Nutr 53 1998 133

15. “Effects of coconut oil, butter, and safflower oil on lipids and lipoproteins in persons with moderately elevated cholesterol levels”, Cox C et al., J Lipid Res 36 1995 1787

16. “Lipoprotein lipases, lipoproteins and tissue lipids in rats fed fish oil or coconut oil”, Haug A and Hostmark AT, J Nutr 117 1987 1011

17. “Coconut fat and serum lipoproteins: effects of partial replacement with unsaturated fats”, Mendis S et al., Br J Nutr 85 2001 583

18. “Lipoprotein responses to fish, coconut and soybean oil diets with and without cholesterol in the Syrian hamster”, Lin MH et al., J Formos Med Assoc 94 1995 724

19. “Effects of dietary coconut oil, butter and safflower oil on plasma lipids, lipoproteins and lathosterol levels”, Cox C a al., Eur J Clin Nutr 52 1998 650

20. “Oxidative susceptibility of low density lipoprotein from rabbits fed atherogenic diets containing coconut, palm, or soybean oils”, Yap SC et al., Lipids 30 1995 1145

21. “Coconut fats”, Amarasiri WA and Dissanayake AS, Ceylon Med J 51 2006 47

22. “Hypolipidemic and antiperoxidative effect of coconut protein in hypercholesterolemic rats”, Salil G and Rajamohan T, Indian J Exp Biol 39 2001 1028

23. “The effect of daily consumption of coconut fat and soya-bean fat on plasma lipids and lipoproteins of young normolipidaemic men”, Mendis S and Kumarasunderam R, Br J Nutr 63 1990 547

24. “Modulation of the regression of atherosclerosis in the hamster by dietary lipids: comparison of coconut and olive oil”, Mangiapane EH et al., Br J Nutr 82 1999 401

25. “Effect of corn and coconut oil-containing diets with and without cholesterol on high density lipoprotein apoprotein A-I metabolism and hepatic apoprotein A-I mRNA levels in cebus monkeys”, Stucchi AF et al., Arterioscler Thromb 11 1991 1719

26. “Dietary coconut oil increases conjugated linoleic acid-induced body fat loss in mice independent of essential fatty acid deficiency”, Hargrave KM et al., Biochim Biophys Acta 1737 2005 52

27. “Effects of dietary coconut oil on fatty acid oxidation capacity of the liver, the heart and skeletal muscles in the preruminant calf”, Pilot C et al., Br J Nutr 82 1999 299

28. “Differential effects of coconut oil- and fish oil-enriched diets on tricarboxylate carrier in rat liver mitochondria”, Giudetti AM et al., J Lipid Res 44 2003 2135

29. “Effects of milk diets containing beef tallow or coconut oil on the fatty acid metabolism of liver slices from preruminant calves”, Graulet B et al., Br J Nutr 84 2000 309

30. “Coconut oil induces short-term changes in lipid composition and enzyme activity of chick hepatic mitochondria”, Gil-Villarino A et al., J Nutr Biochem 10 1999 325

31. “Inclusion of coconut oil in diets for turkey breeders and its effects on embryonic and liver fatty acids”, Ding ST and Lilburn MS, Poultry Science 76 1997 1714

32. “Dietary coconut oil affects more lipoprotein lipase activity than the mitochondria oxidative capacities in muscles of preruminant calves”, Pilot C et al., J Nutr Biochem 11 2000 231

33. “A diet rich in coconut oil reduces diurnal postprandial variations in circulating tissue plasminogen activator antigen antigen and fasting lipoprotein(a) compared with a diet rich in unsaturated fat in women”, Muller H et al., J Nutr 133 2003 3422

34. “Plasma platelet factor 4 response in rhesus monkeys fed coconut oil”, Podbielski FJ et al., Appl Pathol 7 1989 241

35. “An antifungal peptide from the coconut”, Wang HX and Ng TB, Peptides 26 2005 2392

36. “In vitro antimicrobial properties of coconut oil on Candida species in Ibadan, Nigeria”, Ogbolu DO et al., J Med Food 10 2007 384

37. “Histopathological and lipid changes in experimental colon cancer: effect of coconut kernal (Cocos nucifera Linn.) and (Capsicum annum Linn.) red chilli powder”, Nalini N et al., Indian J Exp Biol 35 1997 964

38. “Menhaden, coconut, and corn oils and mammary tumor incidence in BALB/c virgin female mice treated with DMBA”, Craig-Schmidt M et al., Nutr Cancer 20 1993 99

39. “Tumour necrosis factor-alpha and endotoxin induce less prostaglandin E2 production from hypothalami of rats fed coconut oil than from hypothalami of rats fed maize oil”, Bibby DC and Grimble RF, Clin Sci (London) 79 1990 657

40. “Protective effect of coconut oil on renal necrosis occurring in rats fed a methyl-deficient diet”, Monserrat AJ et al., Ren Fail 17 1995 525

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