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Coconut Oil and Heart Disease

Coconut Oil and Heart Disease
by Dr. Alexander J. Rinehart, DC, MS, CCN, CNS

The association between dietary saturated fat and coronary heart disease has been controversial, with reports consistently showing correlations between the two (1; 2). Dietary saturated fats have been correlated with hypercholesterolemia, and hypercholesterolemia has been correlated with increased cardiovascular mortality, but evidence directly linking dietary saturated fat and mortality has been less clear (2; 3; 4; 5; 6; 7; 8; 9; 10).

For instance, total dietary fat and saturated fat intake may have a protective relationship with stroke (11; 12); and, a 1994 article in Lancet demonstrated that the fatty acid composition of plaque associated with arteriosclerosis is comprised of mostly unsaturated fat (74%) (13).

Coconut oil is comprised of 64% medium chain saturated fatty acids, 28% long-chain saturated fatty acids, 6% monounsaturated fats, and 2% polyunsaturated fats. Despite its high saturated fat content, coconut oil has been shown to have little effect on total cholesterol, and may improve total cholesterol (TC):high density lipoprotein (HDL) and LDL:HDL (14; 15; 16; 17; 18). Authors attribute the positive cholesterol effect to a more pronounced lipid-raising effect on HDLs than TC and LDL alone. Lauric acid, the primary medium chain saturated fatty acid found in coconut oil has been proven to decrease TC:HDL more so than other fatty acids studied (19).

While both animal and human studies have failed to find a definitive relationship between coconut oil, saturated fats and abnormal lipids, the research suggests that the few studies which have linked coconut oil to hyperlipidemia and hypercholesterolemia, used hydrogenated coconut oil as the source of fat. When total fat as a percentage of diet is held the same, higher intakes of coconut oil and saturated fats will lead to a relative deficiency in essential fatty acids which may be the cause of high lipids and cholesterol seen in these few studies (3; 14; 20; 21; 22). Some of the studies also used coconut oil intakes that are unlikely to be consumed in everyday life (16; 17; 23). Additionally, the supportive effects of short, medium, and long-chain saturated fats on HDL and key ratios such as TC:HDL have been generally underappreciated in the research literature.

Positive changes in levels of other key risk factors for heart disease such as tissue plasminogen activator antigen (t-PA) concentration – affecting fibrinolysis and lp(a) have also been seen (24). Even though dietary intake of cholesterol has a small effect on systemic levels, coconut oil contains only trace amounts of cholesterol (0-14 ppm), compared to 3000 ppm cholesterol found in butter and lard (15). 2

Ultimately, consumption of coconut oil and/or MCTs may yield a net protective effect on overall risk of heart disease despite potential increases in total cholesterol and total LDL.

Coconut Oil Intake and Heart Disease

Sri Lanka, Polynesia, Philippines, Indonesia, and New Guinea have lower incidences of cardiovascular disease compared to more developed countries even though they have the highest consumption of coconut oil (1; 25; 26; 27).

While the prevalence of cardiovascular disease is rising in Sri Lanka and India (28; 29; 30), a 1998 review in the Journal of the Indian Medical Association suggests that the increase may be due to the recent dietary transition from ghee, coconut oil, and mustard oil to polyunsaturated fats such as corn, sunflower, or safflower oils (4). It is estimated that while total fat intake has remained the same in Sri Lanka, intake of fat from coconut decreased 25-30%. During this same period, deaths from cardiovascular disease increased (31). A similar trend is occurring in Indonesia yet a correlation between dietary coconut and heart disease has not been reported (32).

While controversy continues on the link between saturated fats (coconut-derived or otherwise) and heart disease, the effect of lifestyle factors such intake of refined carbohydrates (33), smoking and obesity may be more harmful and of more public concern (5; 34; 35).

Other Proposed Cardiovascular Benefits of Coconut Oil

Due to their unique metabolism, the MCTs in coconut oil may also offer an energy source that promotes general heart health, and may improve clinical symptoms of heart disease such as cardiomyopathy (36).

Coconut MCTs may help improve lipids (37), oxidized LDLs (38), fat deposition (39; 40; 41), triglycerides (42), and inflammation (43), while also raising HDLs as discussed previously (44).

Coconut oil constituents may offer anti-microbial properties and support the immune response to such infections. Low-grade bacterial and viral infections have also been associated with coronary heart disease, particularly Helicobacter pylori (45), Chlamydia pneumoniae and cytomegalovirus (46; 47) which may be inactivated by the medium chain triglycerides and monoglycerides in coconut oil (48; 49). 3

References:
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