On June 15, 2017 the American Heart Association (AHA) published a presidential advisory entitled “Dietary Fats and Cardiovascular Disease” advising the public to lower intake of saturated fats and replace them with unsaturated fats, particularly polyunsaturated fats.
This resulted in an article published the very next day by USA Today entitled “Coconut oil isn’t healthy. It’s never been healthy” and a number of other equally ‘scary’ articles (coconut oil is about 80% saturated fat, which is one of the reasons the articles targeted it).
In turn these articles, rather inevitably and understandably, resulted in a number of concerned clients asking if they should still consume coconut oil.
My quick answer? Yes! Absolutely!
The long answer is yes, absolutely – and here’s why:
1. The evidence to avoid saturated fats is NOT compelling.
This statement is in direct contrast to the AHA’s report, but the truth is the evidence hasn’t been compelling for many years now. The AHA did not come up with any new studies or evidence to (re)draw their (50-year old) conclusion. Instead, they looked at “several” reviews and meta-analyses and chose only 4 trials in which to base their conclusions off of. Yes, you read that right – out of dozens, just four (and all 4 were done in the 1960’s) met their ‘criteria’. Of course, these 4 studies drew the conclusion they wanted to hear, while many that were left out in fact concluded the exact opposite.
For example, they left out the 1970s Sydney Diet Heart Study, which ultimately would lead to headlines reading “Omega-6 Fats Linked to Increased Risk of Heart Disease”. This study concluded those who used polyunsaturated oils had a higher risk of death.
They also left out the 1968-73 Minnesota Coronary Experiment (republished with recovered data in 2016), which ultimately concluded that switching out saturated fats for polyunsaturated fats did lower cholesterol but this did NOT translate to a lower risk of death from heart disease – in fact there was a 22% higher risk of death for each 30 mg/dL reduction in serum cholesterol.
They appear to have missed including this 1994 study of 997 subjects over 70 years old that concluded high cholesterol was not associated with a higher rate of heart disease. As well as this 2009 systematic review finding no correlation between saturated fats and coronary heart disease.
They didn’t include this 2010 meta-analysis of 21 studies concluding there is no significant evidence for concluding that saturated fat is associated with an increased risk of coronary heart disease, stroke or cardiovascular disease.
Nor did they they include this 2011 study of 12,334 healthy adults that concluded low cholesterol was related to high morality, and high cholesterol was NOT a risk factor for mortality.
Then of course there’s the Pukapuka and Tokelau island studies, which investigated the diets of the Tokelauans (who ate 63% of their energy from coconuts) and Pukapukans (who derived 34% of their calories from saturated fat rich coconut). Heart disease was found to be uncommon in both populations, and the researchers concluded there is no evidence of high saturated fat intake being harmful to these groups. You guessed it – these studies didn’t make it into the AHA report either.
In their presidential advisory, the AHA state, “Replacement of saturated with unsaturated fats lowers low-density lipoprotein cholesterol, a cause of atherosclerosis, linking biological evidence with incidence of CVD in populations and in clinical trials.”
While it’s true that replacement of saturated with unsaturated fats lowers low-density lipoprotein (LDL – often called bad cholesterol), the studies above indicate that lowered LDL (or lowered cholesterol) does NOT reduce the incidence of cardiovascular disease. Clearly, had the AHA included the above studies there’d have been no need for the presidential advisory.
Of the 4 studies the AHA did include (again, all dating back to over 50 years ago), one, the Oslo Diet-Heart study, is a blatantly uncontrolled study (this is direct contradiction to the AHA’s assertion their 4 chosen studies are controlled trials), as pointed out by Gary Taubes, an investigative science and health journalist who wrote this excellent response to the AHA’s report. It also included only men – in fact, all 4 of the AHA’s chosen studies include only men. And it’s also interesting to note this study left out the fact sugar was drastically reduced in the diet group also, adding to the many factors (not just the switch to polyunsaturated oils) that clearly played into its “favourable” results.
Of the other 3 studies included, this one carried out between 1959-71 was conducted on middle aged men living in mental hospitals… And this one published in 1968 included 846 men who were living in an institution (interesting to note that total mortality rates were similar for both the control and the experimental group).
Essentially, the AHA managed to construct their criteria for inclusion of studies in their latest report in such a way that any study or review that challenged their diet-heart hypothesis (which is unfortunately still generally a widely accepted hypothesis) was left out.
I don’t know about you, but I call that deliberate cherry-picking.
2. The AHA is biased in doling out dietary advise (money trumps all).
Not only did the AHA report advise the public to reduce saturated fat, perhaps more importantly (and somewhat frighteningly) they direct us to use unsaturated fats instead. Unsaturated fats include sunflower oil, safflower oil, soy oil, corn oil and canola oil.
It’s worth mentioning here that the Sydney Diet Heart Study mentioned above specifically found that sunflower and safflower oils are directly correlated with an increased risk of death.
It should come as no surprise that some of the largest contributors to the AHA have a direct investment in the success of the sale of unsaturated oils (the AHA’s 2011-2012 financial statements reported donations in the amount of $521 million from non-government and non-memberships sources).
Bayer (one of the biggest pharmaceutical companies in the world) is one of these supporters and sponsors. Monsanto, who owns exclusive rights to GMO corn, soy and canola of which is used to make the majority of polyunsaturated oils available in the marketplace (if it doesn’t say organic, it’s undoubtedly GMO), is in the process of being acquired by Bayer for $66 billion.
In general, it’s no secret where the AHA’s funding is coming from – for example it’s listed on the AHA website that Bayer has committed to donating 5 cents for each bag of a soybean seed they sell, up to $500,000 to one particular AHA initiative.
There are many other big pharmaceutical companies financially supporting the AHA in one way or another including Merck and Pfizer, as well as many big food companies including California Walnut Commission (walnut oil is an unsaturated fat), Ag Canada and Canola Oil Council (canola oil is an unsaturated fat), and the National Cattlemen’s Beef Association (who has every reason to want to demonize coconut oil in the face of this report!).
3. There’s so many great things about coconut oil the AHA forgot to mention!
In fact, based on 7 trials pertinent to coconut oil the AHA focused on (of which I’ll argue again are clearly cherry-picked), they point-blank conclude that the public should completely avoid the use of coconut oil.
Here’s what they missed:
ONE: As a saturated fat, coconut oil is resistant to oxidization (and according to the USDA National Nutrient Database, coconut oil is just over 82% saturated fat – with the rest being 6% monounsaturated and only less than 2% polyunsaturated).
Being resistant to oxidization is valuable because consuming oxidized fats are a risk to human health. As detailed in numerous studies and reports including this one, an oxidized fat creates a cascade of undesirable cellular responses ultimately resulting in the damage and death of healthy cells (inflammation and eventually, chronic inflammatory disease such as heart disease or arthritis). In fact, coconut oil has even been shown to help prevent oxidation of fats in our cells, essentially preventing the damage that can lead to heart disease.
Oxidation happens when a susceptible fat is exposed to oxygen, light and/or heat, which is likely to happen during processing. Fats that are susceptible to oxidation are all unsaturated fats: monounsaturated fats and especially polyunsaturated fats. Here’s a breakdown of commonly used unsaturated oils (all values taken from the USDA National Nutrient Database):
- olive: 12% saturated – 72% monounsaturated – 10% polyunsaturated
- avocado: 12% saturated – 71% monounsaturated – 13% polyunsaturated
- corn: 13% saturated – 28% monounsaturated – 55% polyunsaturated
- soy: 16% saturated – 38% monounsaturated – 22% polyunsaturated
- canola: 7% saturated – 63% monounsaturated – 28% polyunsaturated
- high oleic canola: 7% saturated – 73% monounsaturated – 16% polyunsaturated
- linoleic safflower: 8% saturated – 14% monounsaturated – 75% polyunsaturated
- high oleic safflower: 8% saturated – 75% monounsaturated – 13% polyunsaturated
- linoleic sunflower: 10% saturated – 45% monounsaturated – 40% polyunsaturated
- high oleic sunflower: 10% saturated – 84% monounsaturated – 4% polyunsaturated
- grapeseed: 10% saturated – 17% monounsaturated – 70% polyunsaturated
- walnut: 9% saturated – 23% monounsaturated – 63% polyunsaturated
- sesame seed: 14% saturated – 39% monounsaturated – 41% polyunsaturated
You can see these oils are made up predominately of monounsaturated or polyunsaturated fats, making them highly susceptible to oxidation. Therefore if we consume any of these oils, we need to ensure they are cold-pressed (extra-virgin), contain a good amount of polyphenols which help prevent oxidation, and are organic (as stated above, if a corn, soy or canola oil is not labelled organic it is almost certainly GMO). Most oils on the market are processed with chemical solvents and/or heat, oxidizing the fat – we want to avoid these oils.
Olive oil can be a good choice as long as it’s extra virgin because it’s rich in vitamin E (an antioxidant that protects against oxidation) and it’s also very high in polyphenols (also protecting against oxidation). Just be sure to purchase a reputable brand as unfortunately some brands have mixed soy or canola oil into it (creating olive oil blends that are no longer healthy).
Of note – some coconut oils on the market are highly processed, and while that might not result in an oxidized oil, it removes valuable polyphenols and possibly introduces chemicals used for processing into the oil. Therefore, it’s best to reach only for virgin coconut oil packed ideally in glass jars.
TWO: Coconut oil is a great source of medium chain triglycerides (MCTs) – one of the only sources in fact (they are also found in palm oil and to a small extent in dairy products). MCTs include C6:0 Caprioic acid, C8:0 Caprylic acid, C10:0 Capric acid and C12:0 Lauric acid. Apologies… I included the lipid number, which is how many carbon atoms that fatty acid has, and this makes it all look a bit confusing – but it’s important to know the carbon number when you then look up coconut oil and its composition in the USDA national nutrient database.
Of the 82g per 100g of saturated fat coconut oil is made up of, more than half of that are MCTs:
- C6:0 (caprioic acid) = 0.5g
- C8:0 (caprylic acid) = 6.8g
- C10:0 (capris acid) = 5.4g
- C12:0 (lauric acid) = 41.8g
Total MCTs equal 54.5 grams per 100 grams of coconut oil.
Now here’s a little issue: some experts believe that medium chain triglycerides are made up of only saturated fatty acids with 6 to 10 carbons, such as this study claims, arguing the extra carbons in the C12 tail make it behave more like a long chain fatty acid. However, this study, this review and this study agree that MCTs include fatty acids with 6 to 12 carbons. My huge Staying Healthy with Nutrition textbook includes all four (C6 to C12), while my Clinical Sports Nutrition textbook includes only three (C6 to C10). This understandably creates some confusion.
So technically, 54% of coconut oil is comprised of the beneficial MCTs – although one could argue only 13% of coconut oil is MCTs.
All that said, regardless of whether MCTs are made up of C6 through C12 or only C6 through C10, the fact is they do contain C6, C8, C10 and C12 – and each are valuable.
Why are MCTs found to be valuable? Two reasons. First, they are known to have antiviral, antibacterial and antimicrobial (and more antimicrobial) effects. Those are only a few of the many studies showing MCTs to be valuable in this regard. Interestingly, it’s C12 (lauric acid) that exerts the strongest healing power of all the MCTs.
And second, MCTs are processed by the body differently than long chain or short chain fatty acids. They are passively diffused from the GI tract to the liver where they are processed quickly for energy. Therefore there is a much lower chance of storing MCTs as fat on our body and a higher likelihood it’ll be used immediately for energy. It’s also been found to be useful for those who wish to become more metabolically efficient, helping their bodies to use their own body fat more predominately as a fuel source. This helps to promote weight loss, such as this 2001 study pointed out – in fact the MCT group showed a significantly greater decrease in body weight in only 2 weeks than the low fat high carb group.
(Interesting fact – specially formulated MCT oils don’t use C6, C10 or C12 – they focus on only C8. This is because too much C6 causes GI distress and C10 and C12 do take a bit longer to be processed by the liver, thus making C8 ideal as an energy source.)
THREE: Unrefined coconut oil may actually be GOOD for your heart!
Yes, I know claiming coconut oil is good for your heart is exactly the opposite message the AHA just put out. I’m certainly not the only one making this argument – among the many well known and respected medical experts doing so, Dr. Mark Hyman also argues for coconut oils heart healthy benefits (as part of a well rounded diet) in his well written response Coconut Oil – Are you Coco-Nuts to Eat it?.
In brief, this 2004 study demonstrated that virgin coconut oil reduced total and LDL cholesterol and increased HDL cholesterol (aka good cholesterol). And this 2008 study concluded virgin coconut oil was rich in antioxidants and polyphenols that helped to prevent oxidation of cholesterol – and it’s the oxidation of cholesterol that causes heart disease. Then there’s this 2009 study what was done on women with abdominal obesity. It compared soy oil to coconut oil and showed soy oil decreased HDL (good cholesterol) while the coconut oil increased HDL. Bonus, the coconut oil group ended up losing weight around the waist (the soy group didn’t budge).
Essentially, coconut oil has been found to raise good cholesterol, prevent oxidation of cholesterol and lower the total cholesterol to HDL ratio (a low ratio means a low risk of heart disease – this ratio is a better indicator of heart disease than LDL levels).
FOUR: And this one just might be my favourite – coconut oil was recently found to help counter the effects of stress (you may recall I recently blogged about stress as I’ve had a keen interest in it lately). This 2015 study showed that virgin coconut oil reduced stress hormone levels, making coconut oil a useful anti-stress oil. Well sign me up! Oh wait, I’m already signed up, haha – in fact I’ve been cooking and baking with aaaaaall the coconut oil for years now.
So should you continue to reach for coconut oil as a healthy choice? Yes absolutely – and I, for one, will continue consuming my 2-4 Tbsp of coconut oil daily with, honestly? Zero worries.
To deliciously healthy food and stronger faster running… Cheers,
Sarah J Cuff, RHN