By Cliff Harvey
At a Glance:
The Bottom Line: Coconut oil is a healthy addition to a balanced diet.
Is Coconut Oil used traditionally?
The contention has been made in popular media (example: http://www.nzherald.co.nz/lifestyle/news/article.cfm?c_id=6&objectid=11347584b) that Coconut Oil (CO) has limited traditional use.
This is characterised by attention on Pacific populations using expressed coconut fluid (cream) from coconut flesh, and coconut flesh itself. Not withstanding that these traditional foods contain high amounts of coconut oils (14% and 33% by weight respectively) (USDA SR-27, 2014) thereby justifying their inclusion as a traditional food by proxy, there is also ample evidence for consistent, long term use of coconut oil as a traditional food.
Tribal authorities in outlying islands in Fiji (working with the New Zealand based company Pure Coco) have this to say: “Fijians like most other pacific islanders (and inhabitants of South east Asia) have used coconut for centuries. We use coconuts in all forms, both raw and cooked, as coconut flesh, coconut milk, coconut oil, coconut water, we even make sugar and alcohol from the coconut sap.”
They go on to elucidate the traditional extraction methods: “Traditionally, coconut oil was made from fresh coconut cream (i.e the fatty liquid squeezed from grated coconut flesh) in two different ways. You can heat the coconut cream until the milk solids and fats separate out (similar to making clarified butter or ghee from butter), you strain off the milk solids and what you are left with is coconut oil. Alternately you can leave the coconut cream in a cool dark place for about 48 hours, until it naturally ferments, and the coconut oil separates out.”
Coconut oil has also been used extensively in the Indian sub-continent. The traditional use of coconut and all it’s related products stretches back over 4000 years in Indian tradition and the coconut palm is often referred to in Sanskrit texts as the ‘Tree of Life’ due to the abundance of manufacturing, medicinal and culinary and edible uses for the plant. In traditional Indian medicine coconut oil is commonly used as a topical medicinal compound and base (Muthu, Ayyanar, Raja & Ignacimuthu, 2006; Jeeva, Jeeva & Kingston, 2007; Kumar, Ayyanar, Ignacimuthu, 2007; Gupta, Vairale, Deshmukh, Chaudhary & Wate, 2010; Rajakumar & Shivanna, 2010) and as an oral medicine (Revathi & Parimelazhagan, 2010) (Note: these are only a small selection of myriad relevant studies and texts showing the extensive use of coconut oil in traditional medicines in India).
Many other areas in South East Asia have a tradition and high use of Coconut Oil and Coconut food products.
Is Traditionally Used Coconut Oil Detrimental to Health?
In a comparison of Pacific peoples using differing amounts of CO, Prior and colleagues (1981) evaluated diets of atoll dwellers in Pukapuka and Tokelau in which coconut is the chief source of energy for both groups. Tokelauans exhibited higher saturated fat intake (63% of energy derived from coconut) than Pukapukans (34% energy derived from coconut) and had higher cholesterol levels. But in spite of this, cardiovascular diseases were uncommon in both groups, with no evidence that higher saturated fat intake, and higher coconut intake provide a harmful effect (Prior, Davidson, Salmond, & Czochanska, 1981).
According to Dr Sridhar Maddela, head of medical sciences at Auckland’s Wellpark College of Natural Therapies, Coconut Oil has been used extensively and traditionally as a cooking oil in the Southern Indian province of Kerala. In this province in particular the traditional and common use of CO has been implicated as a reason for high Coronary Heart Disease (CHD) rates. However a study comparing 16 age and sex matched controls performed in Kerala (Kumar, 1997) to explore this presumed link between coconut oil and heart disease risk found that CO consumption was similar in both groups (with and without CHD). The groups did not differ in fat, saturated fat nor cholesterol consumption, implying no specific role for coconut oil or coconut consumption in this population for CHD risk. It has been further noted (in this population) that the lipid composition of arterial plaques is not altered by either coconut oil or sunflower oil (which is often suggested as a replacement cooking medium) (Palazhy et al., 2012).
Indeed there has been an alarming rise in the prevalence of CHD and Type-2 Diabetes in India attributed in part to the replacement of traditional cooking fats condemned to be atherogenic, with refined vegetable oils—resulting in calls to switch ‘back’ to a combination of different types of fats including the traditional cooking fats like ghee, coconut oil and mustard oil to reduce the risk of CHD and diabetes (Sircar & Kansra, 1998).
A community based longitudinal study in Cebu, Phillipines found a positive, albeit small correlation between CO and HDL cholesterol, with no worseing of HDL-Total Cholesterol ratio or triglycerides (Feranil, Duazo, Kuzawa, & Adair, 2011).
The Food and Agriculture Organisation of the United Nations has stated: “All available population studies show that dietary coconut oil does not lead to high serum cholesterol nor to high coronary heart disease mortality or morbidity rate.”(Kaunitz, N.D)
Do the Fats in Coconut Oil Increase Risk of Heart Disease?
A meta-analysis of 60 selected trials calculated the effects of the amount and type of fat on total:HDL cholesterol and on other lipids suggests that lauric acid (the primary fatty acid found in coconut oil) does increase total cholesterol, but much of the effect is on HDL cholesterol, favourably influencing HDL to Total Cholesterol ratios (Mensink, Zock, Kester, & Katan, 2003). The antiartherogenic acitivities of HDL-C are a function not just of quanitity but quality of HDL (Sviridov, Mukhamedova, Remaley, Chin-Dusting, & Nestel, 2008) in which glycation, oxidation and other nutritional factors (influenced for example by excessive sugar and n-6 fatty acid intake) may also play critical roles .
A randomised, double-blind, clinical trial involving 40 women aged 20–40 years, over a 12 week intervention period compared supplementation of 30 mL of either coconut oil or soy bean oil. There were no differences in biochemical or anthropometric markers at the beginning of the study. After 12 weeks the coconut oil treated group exhibited higher levels of HDL (48.7 ± 2.4 vs. 45.00 ± 5.6; P = 0.01) and a lower LDL:HDL ratio (2.41 ± 0.8 vs. 3.1 ± 0.8; P = 0.04). Reductions in BMI were observed in both groups but only the group taking coconut oil reduced waist circumference, The soybean oil treated group demonstrated reduced HDL, increased cholesterol and LDL cholesterol. This suggests coconut oil does not cause dyslipidemia and may promote reduced abdominal obesity (Assunção, Ferreira, dos Santos, Cabral, & Florêncio, 2009). Further, it has been indicated that that a coconut oil-based, high saturated fatty-acid diet may favourbaly affect post-prandial lipoprotein-a concentration compared with a high polyunsaturated fat diet (Müller, Lindman, Blomfeldt, Seljeflot, & Pedersen, 2003).
A study was performed to investigate effects of coconut milk and soya milk supplementation on the lipid profile of free living healthy subjects. In this trial sixty volunteers aged 18–57 years were given coconut milk porridge (CMP) for 5 days of the week for 8 weeks, followed by a 2-week washout period, subsequent to which they received isoenergetic soya milk porridge (SMP) for 8 weeks. LDL levels decreased with CMP whilst HDL rose. They study authors concluded that “coconut fat in the form of CM does not cause a detrimental effect on the lipid profile in the general population and in fact is beneficial due to the decrease in LDL and rise in HDL” (Ekanayaka, Ekanayaka, Perera, & De Silva, 2013).
In rat studies Virgin Coconut Oil (VCO) reduces total cholesterol, triglycerides, LDL, VLDL and increased HDL. It also appears to reduce or prevent oxidation of LDL and reduce carbonyl formation. These properties are thought to result at least partially from the antioxidant polyphenols present in CO (Nevin & Rajamohan, 2004). Virgin coconut oil appears to be superior in its antioxidant action, including increased antioxidant status of animals treated with VCO, and provides a greater reduction in lipid peroxidation when compared to both Copra oil and groundnut oil treated animals (Nevin & Rajamohan, 2006, 2008). It also exhibits significant antithrombotic effects (Nevin & Rajamohan, 2008).
Arunima, S., & Rajamohan, T. (2014). Influence of virgin coconut oil-enriched diet on the transcriptional regulation of fatty acid synthesis and oxidation in rats – a comparative study. British Journal of Nutrition, 111(10), 1782-1790. doi: doi:10.1017/S000711451400004X
Assunção, M., Ferreira, H., dos Santos, A., Cabral, C., Jr., & Florêncio, T. M. T. (2009). Effects of Dietary Coconut Oil on the Biochemical and Anthropometric Profiles of Women Presenting Abdominal Obesity. Lipids, 44(7), 593-601. doi: 10.1007/s11745-009-3306-6
Ekanayaka, R. A. I., Ekanayaka, N. K., Perera, B., & De Silva, P. G. S. M. (2013). Impact of a Traditional Dietary Supplement with Coconut Milk and Soya Milk on the Lipid Profile in Normal Free Living Subjects. Journal of Nutrition and Metabolism, 2013, 11. doi: 10.1155/2013/481068
Feranil, A. B., Duazo, P. L., Kuzawa, C. W., & Adair, L. S. (2011). Coconut oil is associated with a beneficial lipid profile in pre-menopausal women in the Philippines. Asia Pac J Clin Nutr, 20(2), 190-195.
Gupta, R., Vairale, M. G., Deshmukh, R. R., Chaudhary, P. R., & Wate, S. R. (2010). Ethnomedicinal uses of some plants used by Gond tribe of Bhandara district, Maharashtra. Indian Journal of Traditional Knowledge, 9(4), 713-717.
Jeeva, G. M., Jeeva, S., & Kingston, C. (2007). Traditional treatment of skin diseases in South Travancore, southern peninsular India. Indian J Traditional Knowledge, 6(3), 498-501.
Kaunitz, H., Dayrit, C.S. . (N.D). Coconut Oil Consumption and Coronary Heart Disease.
Kumar, P. D. (1997). The Role of Coconut and Coconut Oil in Coronary Heart Disease in Kerala, South India. Tropical Doctor, 27(4), 215-217. doi: 10.1177/004947559702700409
Kumar, P. P., Ayyanar, M., & Ignacimuthu, S. (2007). Medicinal plants used by Malasar tribes of Coimbatore district, Tamilnadu. Indian journal of traditional Knowledge, 6(4), 579-582.
Lemieux, H., Bulteau, A. L., Friguet, B., Tardif, J.-C., & Blier, P. U. (2011). Dietary fatty acids and oxidative stress in the heart mitochondria. Mitochondrion, 11(1), 97-103. doi: http://dx.doi.org/10.1016/j.mito.2010.07.014
Mensink, R. P., Zock, P. L., Kester, A. D., & Katan, M. B. (2003). Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr, 77(5), 1146-1155.
Müller, H., Lindman, A. S., Blomfeldt, A., Seljeflot, I., & Pedersen, J. I. (2003). A Diet Rich in Coconut Oil Reduces Diurnal Postprandial Variations in Circulating Tissue Plasminogen Activator Antigen and Fasting Lipoprotein (a) Compared with a Diet Rich in Unsaturated Fat in Women. The Journal of Nutrition, 133(11), 3422-3427.
Muthu, C., Ayyanar, M., Raja, N., & Ignacimuthu, S. (2006). Journal of Ethnobiology and Ethnomedicine. Journal of Ethnobiology and Ethnomedicine,2, 43.
Nevin, K. G., & Rajamohan, T. (2004). Beneficial effects of virgin coconut oil on lipid parameters and in vitro LDL oxidation. Clinical Biochemistry, 37(9), 830-835. doi: http://dx.doi.org/10.1016/j.clinbiochem.2004.04.010
Nevin, K. G., & Rajamohan, T. (2006). Virgin coconut oil supplemented diet increases the antioxidant status in rats. Food Chemistry, 99(2), 260-266. doi: http://dx.doi.org/10.1016/j.foodchem.2005.06.056
Nevin, K. G., & Rajamohan, T. (2008). Influence of virgin coconut oil on blood coagulation factors, lipid levels and LDL oxidation in cholesterol fed Sprague–Dawley rats. e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism, 3(1), e1-e8. doi: http://dx.doi.org/10.1016/j.eclnm.2007.09.003
Palazhy, S., Kamath, P., Rajesh, P. C., Vaidyanathan, K., Nair, S. K., & Vasudevan, D. M. (2012). Composition of Plasma and Atheromatous Plaque among Coronary Artery Disease Subjects Consuming Coconut Oil or Sunflower Oil as the Cooking Medium. Journal of the American College of Nutrition, 31(6), 392-396. doi: 10.1080/07315724.2012.10720464
Prior, I. A., Davidson, F., Salmond, C. E., & Czochanska, Z. (1981). Cholesterol, coconuts, and diet on Polynesian atolls: a natural experiment: the Pukapuka and Tokelau island studies. The American journal of clinical nutrition, 34(8), 1552-1561.
Rajakumar, N., & Shivanna, M. B. (2010). Traditional herbal medicinal knowledge in Sagar taluk of Shimoga district, Karnataka, India. Indian Journal of Natural Products and Resources, 1(1), 102-108.
Sircar, S., & Kansra, U. (1998). Choice of cooking oils--myths and realities. Journal of the Indian Medical Association, 96(10), 304-307.
Revathi, P., & Parimelazhagan, T. (2010). Traditional knowledge on medicinal plants used by the Irula tribe of Hasanur hills, Erode District, Tamil Nadu, India.Ethnobotanical Leaflets, 2010(2), 4.
Sviridov, D., Mukhamedova, N., Remaley, A. T., Chin-Dusting, J., & Nestel, P. (2008). Antiatherogenic functionality of high density lipoprotein: how much versus how good. J Atheroscler Thromb, 15(2), 52-62.
U.S. Department of Agriculture, Agricultural Research Service. 2014. USDA National Nutrient Database for Standard Reference, Release 27. Nutrient Data Laboratory Home Page, http://www.ars.usda.gov/ba/bhnrc/ndl
Post by Cliff Harvey ND
Peter Rana – founder of BodyTech Gyms (and apparent expert on all things health, fitness and nutrition) has recently come out guns blazing against the Paleo diet in this article: [HERE]
Rana’s lack of understanding of both Paleo as a dietary concept and fundamental tenets of nutrition is baffling.
He suggests: “Sorry Paleo dieters” “The Paleo diet is seriously flawed” and claims that the very foundation upon which it is based is unsound. I fail to see how a diet that promotes the eating of liberal amounts of real food can cause such an outcry….
BUT he goes on to say that “Statements such as "fat, not carbohydrate, is the preferred fuel for human metabolism and has been for all human evolution" are unfounded and contradict human biochemistry.”
When in fact any good nutritional scientist will tell you that fat IS the primary source of fuel for the human animal.
Tell me – are you sitting down right now? If the answer is ‘Yes’ then what the heck are you mainly burning?
If you answered fat – go to the head of the class and get a gold sticker.
If you are burning mainly carbohydrate for fuel (sugar) I suggest you get along to your health practitioner because you have pre-diabetes and should get on a better nutrition plan stat!
Rana goes on to say: “For example, the carbohydrate glucose (blood sugar) is virtually the sole fuel for the human brain.”And: “Starve yourself of complex carbohydrate and see what happens to your concentration and energy.”
Notwithstanding that Paleo is a real-food (whole, natural, unprocessed) dietary paradigm, and not necessarily restrictive of carbohydrates, Rana makes the common mistaken assumption (based probably on an incomplete undergraduate level understanding of human metabolism) that neurons rely on carbohydrate for fuel, when it is widely known that they can subsist VERY happily on ketone bodies and short-chain and medium-chain fatty acids. In fact ketone bodies such as beta-hydroxy butyrate (BOHB) provide more fuel (adenosine triphosphate (ATP) – our cellular fuel) for neurons, than glucose (Manninen, 2004). It has also been demonstrated that insulin induced hypoglycaemic coma can be reversed by intravenous administration of BOHB (Thurston, Hauhart, & Schiro, 1986) and that BOHB preserves synaptic function even in the presence of glucose deprivation and reduction of glycolysis (Izumi, Ishii, Katsuki, Benz, & Zorumski, 1998).
In short – the brain doesn’t need you to be guzzling down carbs as a) it does quite well without them thank you very much and b) endogenous requirement is more than facilitated by endogenous production.
So why would there in Rana’s words be “a lot of hallucinogenic Neanderthals roaming the earth.” [in the presence of low carb intake].
Well…there wouldn’t be…because ketosis is a state of human metabolism that is both safe and appropriate physiologically and evolutionarily. Lest we forget that there is no essential requirement for carbohydrate to be ingested by the human animal (Westman, 2002)…
But of course we don’t actually need to go there and give Pete a lesson in biochemistry because as previously mentioned Paleo is not necessarily carb-restrictive!
Rana lists several points in respect to Paleo:
• Nutritional completeness is the key factor. Any diet that short changes fruit, vegetables or wholegrains is suspect. The U.S. News & World Report's experts said the Paleo diet was too restrictive for most people to follow long term and that it limited some essential nutrients. That's because the regime excludes dairy, grains and legumes. "It's one of the few diets that experts considered somewhat unsafe" the report says.
This again shows Rana’s misunderstanding of Paleo. Paleo focuses on natural, whole and unprocessed foods and so incorporates fruits, berries, tubers and LOTS of vegetables. Sure – it limits or excludes (depending on one’s interpretation of Paleo) grains (big deal) and legumes. But for any ‘expert’ to say that a diet that encourages one to eat large amounts of vegetables, berries, nuts, seeds, free-range meats and undenatured oils is ‘unsafe’ is simply ridiculous. And the suggestion that it’s lacking in nutrients is also unfounded and lacking scientific credibility.
• Giving credit where credit's due, the Paleo diet on the surface sounds like a good idea by consuming very lean, pure meats and lots of wild plants. However encompassing such a regime in modern times would take a lot of discipline, as well as take the enjoyment out of eating.
It has been demonstrated that contrary to popular belief lower-carbohydrate and ‘Paleo’ style diets have higher compliance rates than typical low-fat, high-carbohydrate, calorie restrictive nutrition plans, with similar or greater results for fat loss (Bueno, de Melo, de Oliveira, & da Rocha Ataide, 2013; Sondike, Copperman, & Jacobson, 2003; Volek, Quann, & Forsythe, 2010; Yancy, Olsen, Guyton, Bakst, & Westman, 2004).
• The Paleo diet glycemic index argument is misleading when talking about bread and link to grains. Remember, the type of bread you eat and level of refinement of the ingredients has an impact on the GI of the bread. The fact is, wholegrains rather than processed grains can prevent big rises and drops in glucose and insulin. So there is no reason to throw the baby out with the bath water and eliminate grains altogether.
This is also a technical falsehood. The insulin response of a food is not necessarily proportionate to its glycaemic response, as first demonstrated by Holt and colleagues back in the 90’s (Holt, Miller, & Petocz, 1997). More importantly the glycaemic load provided by foods (of which grains are a primary culprit) is more of a consideration in these modern days of rampant metabolic disorder.
Rana finishes by proclaiming his love of the Mediterranean Diet: “My favourite, the Mediterranean diet is more or less how I eat. The report says it "may include weight loss, heart and brain health, cancer prevention, and diabetes prevention and control".
While gushing over the Mediterranean Diet the authors of the report and Rana may be interested to know that the ‘dangerous’ diet they are lambasting has been demonstrated to reduce blood pressure, average insulin, average glucose, total cholesterol, LDL cholesterol and triglycerides, whilst improving HDL cholesterol and anthropometric markers of diabetes and obesity (Frassetto, Schloetter, Mietus-Synder, Morris, & Sebastian, 2009; Jonsson et al., 2009)…oh and it’s probably more satiating than a Mediterranean Diet too (Jonsson, Granfeldt, Erlanson-Albertsson, Ahren, & Lindeberg, 2010)…
Now I’m not here to be a defender of Paleo diets. When people ask if I’m ‘Paleo’ I say: “Hell no – I’m not caveman…I’m a spaceman!” But I do think it’s disingenuous to lambast something that on the whole is a positive and health promoting diet without even a minimal understanding of what it is, nor the science underpinning it.
Bueno, N. B., de Melo, I. S. V., de Oliveira, S. L., & da Rocha Ataide, T. (2013). Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. British Journal of Nutrition, 110(07), 1178-1187. doi: doi:10.1017/S0007114513000548
Frassetto, L. A., Schloetter, M., Mietus-Synder, M., Morris, R. C., Jr., & Sebastian, A. (2009). Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. Eur J Clin Nutr, 63(8), 947-955.
Holt, S., Miller, J., & Petocz, P. (1997). An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods. The American journal of clinical nutrition, 66(5), 1264-1276.
Izumi, Y., Ishii, K., Katsuki, H., Benz, A. M., & Zorumski, C. F. (1998). beta-Hydroxybutyrate fuels synaptic function during development. Histological and physiological evidence in rat hippocampal slices. J Clin Invest, 101(5), 1121-1132. doi: 10.1172/jci1009
Jonsson, T., Granfeldt, Y., Ahren, B., Branell, U. C., Palsson, G., Hansson, A., . . . Lindeberg, S. (2009). Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol, 8, 35. doi: 10.1186/1475-2840-8-35
Jonsson, T., Granfeldt, Y., Erlanson-Albertsson, C., Ahren, B., & Lindeberg, S. (2010). A paleolithic diet is more satiating per calorie than a mediterranean-like diet in individuals with ischemic heart disease. Nutr Metab (Lond), 7, 85. doi: 10.1186/1743-7075-7-85
Manninen, A. (2004). Metabolic Effects of the Very-Low-Carbohydrate Diets: Misunderstood "Villains" of Human Metabolism. Journal of the International Society of Sports Nutrition, 1(2), 1-5. doi: 10.1186/1550-2783-1-2-7
Sondike, S. B., Copperman, N., & Jacobson, M. S. (2003). Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents. The Journal of pediatrics, 142(3), 253-258.
Thurston, J. H., Hauhart, R. E., & Schiro, J. A. (1986). Beta-hydroxybutyrate reverses insulin-induced hypoglycemic coma in suckling-weanling mice despite low blood and brain glucose levels. Metab Brain Dis, 1(1), 63-82.
Volek, J. S., Quann, E. E., & Forsythe, C. E. (2010). Low-Carbohydrate Diets Promote a More Favorable Body Composition Than Low-Fat Diets. Strength and Conditioning Journal, 32(1), 42-47.
Westman, E. C. (2002). Is dietary carbohydrate essential for human nutrition? The American journal of clinical nutrition, 75(5), 951-953.
Yancy, W. S., Jr., Olsen, M. K., Guyton, J. R., Bakst, R. P., & Westman, E. C. (2004). A Low-Carbohydrate, Ketogenic Diet versus a Low-Fat Diet To Treat Obesity and Hyperlipidemia: A Randomized, Controlled Trial. Annals of Internal Medicine, 140(10), 769-777.