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Is Coconut Oil Going to Kill You?

August 7, 2017  |  By: Whitney E. RD

The American Heart Association says coconut oil is bad for heart health, others say it cures everything from obesity to Alzheimer’s. Today we’re dissecting the science on this greasy debate.

*This is a long, science-heavy article – if you want the gist, scroll to the bottom to watch the video!

I apologize for the dramatic headline, but I wanted to ensure your attention because I have something very important to tell you:

Coconut oil is not going to kill you.

Neither will gluten (unless you have Celiac disease), or soy, or any other single ingredient that the fear-mongering media repeatedly warns you about on a daily basis.

The relentless ranting occurring online since the release of the American Heart Association’s (AHA) recent review on Dietary Fats and Cardiovascular Disease and their demonization of coconut oil is getting out of cocontrol.

Food is powerful, but single ingredients are not that powerful. Food works synergistically. Disease prevention is the result of the totality of your daily intake, combined with your other health habits – sleep, hydration, stress management, movement, and avoidance of harmful behaviors like smoking, excessive drinking, etc.

Chronic illness occurs due to a combination of factors.

Not one. Not just coconut oil.

With that said, studies have not yet proven that coconut oil is the panacea for chronic disease that people make it out to be. And with experts on both sides of the coconut oil debate doing their best to convince you that its consumption will either cure or kill you, it’s hard to know whom to believe. That’s where today’s post comes in.

Today we’re going to dissect the recent AHA study, a 2010 meta-analysis that supporters argue vindicates saturated fat (and therefore coconut oil), and all the other research in between to get to the truth about this sweet, unique, saturated oil.

First up, let’s talk about the American Heart Association study.

Saturated Fat and Cardiovascular Disease

The AHA recently released a review of evidence on the connection between saturated fat (which makes up ~85-90% of coconut oil) and cardiovascular disease, reiterating what they’ve said for years – excessive consumption of saturated fat is bad for you, and you should dramatically reduce it from your diet.

They performed a meta-analysis (a study that weighs the results of groups of studies) and showed that replacing saturated fat with polyunsaturated fat, the kind found in nuts and seeds, results in a 29% reduction in heart disease.

Some people criticized this analysis because the studies used were all from the 1960s. However, the AHA researchers explained that these particular studies were chosen for very specific reasons:

1. They each lasted longer two years.

2. They had large sample sizes (number of people in the study).

3. They were all randomized controlled trials.

4. They all replaced saturated fat with polyunsaturated fat.

These last two points are key.

The opposing studies on the health effects of saturated fat have been “epidemiological studies.” Meaning they are observational. Observational studies look at a population of people and their habits and try to draw conclusions about correlations – they do not prove causation.

Randomized controlled trials, on the other hand, are interventional – they directly test a hypothesis.

Secondly, these observational studies looked at what happens when you lower all fat in the diet (including polyunsaturated fat) or replace saturated fat with carbohydrates, both of which result in dramatically different effects than what the AHA study looked at: replacing saturated fat with polyunsaturated fat.

The AHA also focused on another study in their report, a 2015 meta-analysis conducted by the American College of Cardiology which also supported their findings, showing that replacing 5% of sat fat with polyunsaturated, monounsaturated (found in olive oil and avocado), or whole grains resulted in a decrease of heart disease of 25%, 15%, and 9%, respectively.

This same study showed that replacing saturated fat with refined carbohydrates (you know, the white stuff – sugar, processed food, cakes, cookies, etc) resulted in a 1% higher incidence of heart disease.

And that’s the main takeaway right there – replace saturated fat with polyunsaturated fat, good things happen. Replace saturated fat with refined carbs, bad things happen. 

The AHA researchers explained that since coconut oil is predominately made up of saturated fat, it carries the same risk for heart disease as any other food high in saturated fat, like butter, cheese, and other animal products and therefore should be avoided. But that’s not a fair conclusion… more on that shortly.

So why do some people say that saturated fat is good for you?

The “Pro-Saturated Fat Studies”

In 2010, Siri-Tarino et al. released a large meta-analysis showing no correlation between the consumption of saturated fat and heart disease.

I know what you’re thinking, this is totally contradictory to the AHA study!

The problem with this study, and others like it, is what I stated before: these studies are observational, and they do not differentiate between which nutrients replace saturated fat in the diet.

In these studies, saturated fat was usually replaced by refined carbohydrates, which we learned earlier, will actually increase the risk of heart disease.

Critics of the AHA study and supporters of diets high in saturated fat use this as evidence that saturated fat is not harmful and that carbohydrates are the dietary culprits. However, the only thing that this study proves is that saturated fat is no more harmful than refined carbohydrates.

The truth is, neither are a good choice in excess — especially when they crowd out polyunsaturated fat from the diet.

What saturated fat supporters also missed about this study is that the authors actually agree with the AHA and state that replacing saturated fat with polyunsaturated fat decreases chronic disease risk: 

“Inverse associations of polyunsaturated fat and CVD risk have previously been reported. Replacement of 5% of total energy from saturated fat with polyunsaturated fat has been estimated to reduce CHD risk by 42%.” – Siri-Tarino et al., 2010

They also note, in agreement with the AHA, that the type of carbohydrate is important:

“With respect to dietary carbohydrate, the type of carbohydrate that replaces saturated fat is likely important in influencing dietary effects on CVD risk,” Siri-Tarino et al., 2010

This supports the notion that refined carbs increase heart disease risk, whole grains reduce heart disease.

Conspiracy Theories About Heart Disease Research

The biggest irony in the debate over saturated fat is that critics are claiming the AHA, the nation’s oldest and largest nonprofit organization, is not to be trusted. In fact, the studies supporting saturated fat have their own greasy history.

The study from Siri-Tarino et al. that we’ve been discussing was actually funded by the National Dairy Council.

Dairy = saturated fat. I’ll let you make of that what you will.

Lastly, the authors of this same study (which Melissa Hartwig of Whole 30 cited to support her position that saturated fat is good and polyunsaturated fat is bad) released another review article in 2015 where they again stated that replacing saturated fat with polyunsaturated fat is associated with reduced risk of heart disease and concluded:

“Overall dietary patterns emphasizing vegetables, fish, nuts, and whole versus processed grains form the basis of heart-healthy eating and should supersede a focus on macronutrient composition.” – Siri-Tarino et al., 2015.

Hmmmm, this sounds like pretty similar advice to what the AHA is recommending, with not a saturated fat containing food item in sight…

Is Saturated Fat “Bad”?

Given the conclusions from these studies, we know that diets high in saturated fat are associated with higher levels of cholesterol, and we know that replacing some saturated fat in the diet with polyunsaturated fat reduces your risk of heart disease.

However, there is an ongoing debate as to whether cholesterol levels are actually an accurate measure of heart disease risk, and if so, which measures (LDL/HDL ratio, LDL particle size, TC/HDL ratio) are the best. That’s an issue for another post though.

Therefore, the jury is still out on whether saturated fat itself is the culprit and cholesterol levels even matter, or if food items containing saturated fat may be driving the association between saturated fat and heart disease due to other factors.

Finally, not all saturated fat is created equal. There are different types of dietary saturated fat: medium and long chain saturated fatty acids, and these behave differently in the body – which brings us back to the coconut oil.

The Research on Coconut Oil

We’ve established that coconut oil is high in saturated fat. However, there are no studies in humans directly testing coconut oil and heart disease outcomes.

What we have is a handful of small, short studies showing that coconut oil raises LDL cholesterol levels (aka “bad” cholesterol) compared to monounsaturated and polyunsaturated fats. However, these same studies show that coconut oil also raises HDL cholesterol levels (aka “good” cholesterol) to a greater degree than unsaturated fat. Additionally, the studies show that the coconut oil does not increase LDL as much as butter or other sources of animal fat.

One study showed that compared to olive oil, coconut oil did not increase a person’s susceptibility to blood clots. However, it did increase a proinflammatory response in the body.

Studies in Pacific Island populations that consume large amounts of coconut products have shown lower levels of heart disease. However, these populations typically ate the coconut in whole foods forms (coconut meat and cream as opposed to oil) and as a part of a traditional diet comprised of health-promoting foods like seafood (which has omega-3 fatty acids), fruit, and root vegetables. These diets are also low in processed foods and very different than a typical Western diet.

Coconut oil is different from other saturated fats in that it has a high composition of phenolic acids, phytochemicals in plants that possess antioxidant and anti-inflammatory properties. For this reason, some have suggested that coconut oil may be beneficial for people with cognitive disorders like Alzheimer’s disease.

Additionally, there is mixed research showing that virgin coconut oil may help with weight loss by increasing satiety and energy expenditure due to the fact that its saturated fat comes mainly from medium chain fatty acids.

Medium Chain Fatty Acids in Coconut Oil

Medium-chain fatty acids may be less “adipogenic” (prone to being deposited as fat), as they are metabolized differently in the body than long-chain fatty acids. Instead of being incorporated into what are called “chylomicrons” after digestion and entering the lymphatic system to be distributed to the body’s tissues like long-chain fatty acids, medium-chain fatty acids are absorbed directly into the blood stream and go straight to the liver to be used as energy.

However, the major medium-chain fatty acid in coconut oil, lauric acid, actually isn’t fully absorbed and metabolized the same way as the other medium-chain acids, caprylic and capric acid, and tends to behave more like a long-chain fatty acid in the body, which may reduce the purported benefits.

In summary, the evidence supporting coconut oil for weight loss is slim.

But let’s get back to our original question…

Is Coconut Oil Going to Kill You?

Is coconut oil going to kill you? Of course not.

While the bulk of research shows a link between saturated fat and heart disease, we don’t know what is driving that association. Is it actually the saturated fat or is it other components of foods that are high in saturated fat? If it is other factors, you cannot simply lump coconut oil (a plant-derived product, high in medium-chain saturated fatty acids) with foods like meat, milk, eggs, and cheese (animal-derived foods that are high in long-chain saturated fatty acids). They’re fundamentally different.

Or is it a dietary pattern that emphasizes one type of fat over another? As I said before, food works synergistically. All nutrients have a place in the diet, including saturated fat.

While the research on coconut oil is sparse, it appears that consuming it as a part of a balanced, whole-foods-based diet is appropriate. But letting it crowd out other sources of healthy fat like monounsaturated and polyunsaturated, omega-3 fatty acids is probably not a good idea.

The best advice is to consume it in moderation, as with all foods. It’s all about BALANCE. I wouldn’t encourage eating coconut oil (or any other oil) by the spoonful, but I also wouldn’t cut it out.

Here in #whitskitch, we use a variety of oils and fats – avocado, olive, algae, and yes, coconut oil.

If you’re going to eat coconut oil, I recommend using virgin coconut oil. This means the oil has been produced without chemical refining (bleaching and deodorizing), which helps retain phytochemicals.

The Takeaways:

• Coconut oil is high in saturated fat and diets high in saturated fat are associated with heart disease — though there may be confounding factors driving that association.
• The majority of saturated fat in the diet comes from animal products. Coconut oil and palm oil are the main non-animal sources of saturated fat.
• Coconut oil is made predominately of medium-chain fatty acids that are metabolized differently than the long-chain fatty acids found in meat, eggs, and dairy. However, it is mostly made of lauric acid, which behaves more like a long-chain fatty acid.
• Coconut oil raises LDL cholesterol, but it also raises HDL cholesterol.
• Coconut oil may possess health-promoting properties related to cognitive functioning due to its high level of phenolic acids, phytochemicals with antioxidant and anti-inflammatory properties.
• The research on coconut oil and weight loss is inconclusive.
• More research is needed to determine the effects of coconut oil on heart disease outcomes.
• Food acts synergistically. Eat a variety of whole foods, with a variety of fats to optimize your health!

Weigh In: Do you eat coconut oil? Do you think coconut oil is a healthy component of the diet? What did you think of the American Heart Association study? Do you enjoy these long form articles on nutritional issues or would you prefer more condensed summaries of the issues? Let me know!