Where nutrition is concerned, there is always great debate. What is good for you one day may be the worst thing ever imagined the next.
Lately, the greatest debate has centered around coconut oil. On the one hand, its proponents say it can do everything from increasing brain function to helping you lose weight to strengthening your heart. At the same time, on the other side of the debate, there are those who say the increase of LDL ( low-density lipoprotein) cholesterol increases the risk of heart disease.
Let’s take a look at the arguments. First, the anti-coconut oil side.
Arguments Made By Anti-Coconut Oil Supporters
The fatty acids in coconut oil can dramatically raise LDL (bad) cholesterol. This main fatty acid in coconut oil is lauric acid. Along with myristic and palmitic acids, it tends to raise LDL cholesterol. While these saturated fats are different from those found in meat and butter, researchers don’t know whether their effects on the body are different. The anti-coconut oil faction says it’s better to limit total saturated fat intake to 10% or less of your diet.
A study conducted several years ago on Pacific Ocean Islanders is often used to promote coconut oil. This study showed the islanders to consume a lot of coconuts, but to have very low incidence of heart problems. However, the study relied on one electrocardiogram (ECG) reading, which is not a good indicator of heart disease. In addition, factors such as genetics, high activity level, and consumption of other types of foods that lowered the risk of heart disease and increased overall health were not considered.
The claims that medium-chain triglycerides (MCTs) are found in coconut oil are not entirely true. Certainly, MCTs are utilized very effectively by the body for fuel and require fewer enzymes and bile acids in the digestion process. But the anti-coconut oil faction says the research used by the pro-coconut oil faction actually uses medical-grade MCTs not available in coconut oil.
Arguments Made By Pro-Coconut Oil Supporters
As in any debate, there is another side to the coconut oil question. Here are some of the points made by them.
The American Heart Association’s (AHA) recent finding regarding coconut oil and other saturated fat containing oils is flawed. The AHA strongly recommends against coconut oil because it tends to raise LDL cholesterol, a major contributor to cardiovascular disease. According to the AHA, there are no known offsetting favorable effects of coconut oil. According to the pro-coconut oil faction, the AHA is ignoring more current research that refutes the AHA’s long-standing stance that saturated fats are not good for you. The AHA advisory is based on a limited number of studies that have been published over the past several decades (some of which are 6 decades old). This has in the past, and continues to be, the basis for AHA saying polyunsaturated fats such as those found in more widely-used vegetable oils are better for you, health-wise.
This new advisory from the AHA was not published with a foundation of new research to support their contentions, rather, it was a reaction to studies that seem to refute their position. One study reported in the Annals of Internal Medicine in 2014 was a meta-analysis of a large number of research studies. This analysis showed the common finding that there simply isn’t enough evidence to recommend consuming larger amounts of polyunsaturated fats and low amounts of saturated fats.
While the research cited by the AHA showed saturated fats like those in coconut oil do raise LDL cholesterol levels, a closer look at all research shows coconut oil also increases HDL (high-density lipoproteins) or the “good” cholesterol as well. Many scientists are not positive that saturated fat raises LDL cholesterol anyway. But all are in agreement that increasing HDL cholesterol is a beneficial thing for cardiovascular health.
There may be bias among the members of the AHA’s nutrition advisory panel. Two members of the panel are also members of the U.S. Canola Association that supports canola oil, one of the recommended kinds of polyunsaturated oils. There are likewise other members of the panel who could be influenced by their corporate ties.
Much of the research utilized by the AHA to support its position are epidemiological studies. These types of studies have significant flaws in them that detract from their scientific rigor. Most of them follow groups of people over long periods of time, asking them to remember what they ate over periods of time that may span years. Such reliance on memory that can fade significantly over such long time periods leaves any results open to question. Even if the results are taken as accurate, the best this kind of research can provide is a correlation. This means it can show that one thing happened when another thing was present. There is no indication of any causation. Plus, most of the epidemiological studies ignore other variables that may have happened in people’s lives over those time periods.
Results from these epidemiological studies, even though conducted by Harvard’s School of Public Health, have not been supported in clinical trials and research. For example, a study reported in the 2006 Journal of the American Medical Association looked at over 48,000 women who made changes in their diets to be more in line with AHA recommendations. Their total fat consumption was lowered to 20% of total calories consumed and they ate more fruit, grains, and vegetables. After eight years of this diet, there was no lowering of risk factors for heart disease, stroke, or cardiovascular disease. The researchers concluded that more than just changes in diet is needed to decrease the risk of those illness conditions.
An earlier (1989) study divided 10,000 men and women into two groups. One group followed a diet with 9% saturated fat while the other group followed a diet with 18% saturated fat. The results after four and a half years showed the group who consumed more saturated fat to be healthier than the low-fat group. Those in the low-fat group showed no decrease in risk factors that damage the heart and no decrease in deaths compared to the high-fat group.
One study used to support the AHA stance was from Finland in 1972. The diets of patients in a mental hospital were changed to be lower in saturated fats. After 12 years, there was a decrease in coronary heart death among men, but not women. However, some of the patients involved in the study had been taking “cardiotoxic medications” that may have been the cause of some of the damage to their hearts before the dietary changes. This intervening factor may have been enough to lower the validity of the results.
Another study that the AHA used to support its assertions that saturated fat is unhealthy was from Norway, this one in the 1970s. A researcher asked local physicians to refer people who either were at increased risk for heart problems or had already had a heart attack. He divided the subjects into two groups, one of which ate a low saturated fat and high polyunsaturated fat diet. The other ate the regular Norwegian diet. Five years later, the low saturated fat group showed lower incidence of heart attacks.
This sounds good, but there was a problem. The group who ate the low saturated fat diet also got continuing counseling in nutrition and supervision in what they ate. The other group was unsupervised and received no nutrition counseling. This is a very good example of performance bias and poor research design. Nowhere would this kind of research be accepted, other than by the AHA.
While coconut oil does tend to raise LDL cholesterol, there is more to it than just that fact. LDL cholesterol particles come in two primary sizes. The small LDL particles are dense and will clump together and clog up arteries causing significant problems. The larger LDL particles have not been found by researchers to have a connection to increased risk of ischemic heart disease in men. On the other hand, small LDL particles at high levels have been associated with a high risk of cardiovascular disease. Research published in the Journal of the American Medical Association has shown LDL particles in cases of coronary artery disease to be small.
There is good evidence that saturated fats actually increase the size of LDL particles! This increases the possibility of them being safer.
So there you have it. Enough information for you to make your own decision regarding whether to use coconut oil.
It comes down to this: Do you believe a large, possibly biased organization that appears to use outdated and flawed research or do you believe current research from multiple sources that seems to indicate evidence is present that shows coconut oil to be beneficial to heart health and may have other beneficial properties as well?
The choice is yours. I know where I’ll put my money.