Coconut Oil - A Good Choice? - May 2021

Coconut oil has gained popularity as a healthful choice with the public. A recent survey in the New York Times found that 72% of North Americans believe coconut oil was a “healthy food,” compared to only 37% of nutritionists.

What is coconut oil?
Coconut oil is made from pressed coconut extracted from the meat of the fruit. The saturated fat content is 82 percent, which is higher than beef or butter and 11 times the saturated fat in canola oil. It comes in both refined and unrefined versions.  The refined version is more processed and is better for cooking at high temperatures, while the unrefined version, also known as virgin coconut oil, has a stronger taste and richer flavour.  Some of the positive characteristics of coconut oil include having a shelf life of up to one year, a nutty flavour for baking, and a high smoke point. A negative is that coconut oil does not have the vitamins or the polyphenol antioxidant found in extra virgin olive oil.

Is coconut oil a healthy choice?
Evidence on the long-term health benefits of coconut oil is lacking, according to Walter Willett of Harvard University. While coconut oil is made up of medium-chained saturated fat (MCSF), which may increase the 'good' HDL cholesterol, EatRight Ontario reports that this has not been confirmed by research. It has also been pointed out that research is inconclusive regarding the total cholesterol to HDL ratio which is a more important predictor of cardiovascular disease risk.

The following claims made about coconut oil include:
Cardiovascular disease - there is currently a lack of agreement on the role of saturated fats in heart disease. A subset of researchers do not see saturated fats as being associated with heart disease and stroke but the American Heart Association (AHA) and other organizations disagree and promote limiting saturated fat. The AHA reports that coconut oil increases the bad LDL cholesterol in the same way as other foods high in saturated fat like butter, and “has no known offsetting effects.” The organization states that “Taking into consideration the totality of the scientific evidence, satisfying rigorous criteria for causality, we conclude strongly that lowering intake of saturated fat and replacing it with unsaturated fats, especially polyunsaturated fats, will lower the incidence of cardiovascular disease.” Saturated fat increases the body’s amount of 'bad cholesterol' or 'LDL cholesterol'.  Arteries can become blocked if there is too much LDL or bad cholesterol, and this blockage can lead to heart disease. With regards to coconut oil, the AHA cited seven controlled trials where coconut oil raised LDL cholesterol.

Weight loss  - Today’s Dietitian reports that there are few high-quality studies using humans. While some studies have found that taking coconut oil supplements with a low calorie-diet may reduce belly fat, there is not enough evidence to make the recommendation to take coconut oil supplements to help with weight loss. Since one tablespoon is 115 kcal, using a great deal of coconut oil is not a good way to reduce calories.

Other conditions - According to EatRight Ontario, no evidence supports the use of coconut oil for Alzheimer’s disease, diabetes, irritable bowel syndrome, Crohn’s disease or viral infections. 

Proponents of coconut oil 
Robin Foroutan, a spokesperson for the Academy of Nutrition and Dietetics, disagrees with the American Heart Association’s avoidance of coconut oil and highlights the benefits. While coconut oil is a saturated fat, she states that: 
It can be cardioprotective, reduce inflammation and contribute to brain health. 
A link between coconut oil and heart disease has not been shown. 
Because of genetic individuality, it is difficult to give generalized advice against coconut oil. 
Proponents of coconut oil cite studies of Indigenous populations from the Pacific Islands who consume a lot of coconuts yet have low rates of heart disease. These people, however, have a traditional diet rich in fish, fruits, and vegetables, which is not the typical Western diet. 

Proponents of using coconut oil occasionally: 
EatRight Ontario suggests using coconut oil once and a while in small amounts. Any type of oil, whether or not it is coconut oil, can cause weight gain. Instead, they advocate choosing oils with an evidence base such as canola and olive oils which are mostly heart healthy. 
Today’s Dietitian website quotes Libby Mills, spokesperson for the Academy of Nutrition and Dietetics, who states that coconut oil should not be used to excess. She also notes that high-heat damages oil. Coconut oil has a smoke point of 350 degrees, which is 50 degrees lower than extra-virgin olive oil. With damaged oil, the fat breaks down and free radicals are formed which can damage cell walls. This damage has been linked to cancer, can result in inflammation, and can be an underlying factor in cardiovascular disease. 
Walter Willett suggests using coconut oil occasionally e.g., for flavour in Thai food or in baking.  Willett ranks coconut oil in the middle when compared to other fats – above partially hydrogenated oils but not as good as the more unsaturated plant oils with proven benefits e.g., olive and canola oil. 

According to Assistant Professor Dr. Qi Sun of the Department of Nutrition at the Harvard T.H. Chan School of Public Health, coconut oil has unique qualities (half lauric acid which seems to raise HDL or good cholesterol more than other saturated fats), but he points out that the evidence is limited to support the health benefits of these unique qualities. Willett points out another complication is that there are many forms of HDL which have different health consequences, and the role of HDL is under debate. Willett says we don’t know for sure that higher HDL is better. 

The Dietitians Association of Australia suggests that people who use lots of coconut oil put a cap on the amount or try blending it with some monounsaturated oils such as olive, canola or avocado oil. 

Source: CNN website, The Globe and Mail website, EatRight Ontario website, Dietitians Association of Australia website, Harvard Health website, American Heart Association website, The Kitchn website