Have you ever wondered if there’s a natural way to lower your high blood pressure, guard against Alzheimer's, lose weight, and feel better? Well as it turns out there is. Michael Greger, M.D. FACLM, founder of NutritionFacts.org, and author of the instant New York Times bestseller “How Not to Die” celebrates evidence-based nutrition to add years to our life and life to our years.

What’s the Deal with Coconuts?

On today’s show, we take a close look at coconut oil, the fat in coconut milk. Should we eat it or avoid it? Let’s see what the science says.

This episode features audio from Coconut Oil & the Boost in HDL “Good” CholesterolWhat About Coconuts, Coconut Milk, & Coconut Oil MCTs?, and Does Coconut Oil Cure Alzheimer’s?

Discuss

Hello and welcome to Nutrition Facts. I’m your host, Dr. Michael Greger. Today, we’re going to explore smart nutrition choices based, naturally, on facts. Whenever there’s a new drug or surgical procedure, you can be assured that you and your doctor will probably hear about it because there’s a corporate budget driving its promotion; but, what about advances in the field of nutrition? That’s what this podcast is all about. 

On today’s show we take a close look at coconut oil, the fat in coconut milk. Should we eat it?  Should we avoid it? What does the science say?

Our first study compares the effects of coconut oil to butter and tallow, or beef fat. Even if virgin coconut oil and other products high in saturated fats raise LDL “bad” cholesterol, isn’t that countered by the increase in HDL “good” cholesterol?  Let’s find out:

We’ve known for nearly a half century, according to “200 of the country’s leading experts in cardiovascular diseases,” in a report representing 29 “national medical organizations,” including the American Heart Association and the American College of Cardiology, that “coconut oil is one of the most potent agents” for elevating the level of cholesterol in the blood. Studies showing coconut oil elevates cholesterol date back to 1955, when it was first shown experimentally that switching someone from coconut oil to something like soybean oil could drop cholesterol from like 200 down to 150.

Coconut oil can significantly raise cholesterol levels within hours of consumption: a significantly increased blood cholesterol within hours of eating a slice of cake made from coconut oil—or from cod liver oil for that matter—mmm!—but not from the same cake made from flax seed oil.

Coconut oil may even be worse than tallow, or beef fat, but not as bad as butter. The latest interventional trial was published in March of 2017, a month-long randomized, controlled, crossover study looking at “the impact of [two tablespoons a day of] virgin coconut oil,” and it elevated cholesterol about 14% over control—consistent with the other seven interventional trials published to date in this 2016 review.

But wait; saturated fats can make so-called good cholesterol—HDL—go up. So, what’s the problem? The problem is that doesn’t seem to help. Having a high blood HDL level “is…no longer regarded as protective.” What? But, wait a second. Higher HDL is clearly associated with lower risk of heart disease. In fact, “HDL…levels are among the most consistent and robust predictors of [cardiovascular disease] risk.” Ah, but see, there are two types of risk factors: causal and non-causal. Association does not mean causation—meaning that just because two things are tightly linked, doesn’t mean one causes the other.

Let me give you an example. I bet that the number of ashtrays someone owns is an excellent predictor of lung cancer risk. I bet study after study would show that link, but that doesn’t mean that if you intervene and lower the number of ashtrays, their lung cancer risk would drop, because it’s not the ashtrays that were causing the cancer, it was the smoking. The ashtrays were just a marker of smoking, an indicator of smoking, as opposed to playing a causal role in the disease. So, just like having a high number of running shoes and gym shorts might predict a lower risk of heart attack, having a high HDL predicts a lower risk of heart attack. But, raising HDL, just like raising the number of gym shorts, wouldn’t necessarily affect disease risk.

How do you differentiate between causal and non-causal risk factors? You put it to the test. The reason we know LDL cholesterol really is bad is because people who were just born with genetically low LDL end up having a low risk of heart disease. And if you intervene and actively lower people’s LDL through diet or drugs, their heart disease risk drops. Not so with HDL.

People who live their whole lives with high HDL levels don’t appear to have a lower risk of heart attack, and if you give people a drug that increases their HDL, it doesn’t work. That’s why we used to give people high-dose niacin—to raise their HDL. But, it’s time to face the facts. “The lack of benefit of raising…HDL…seriously undermine[s] the [concept of] HDL [being] a causal risk factor.” In simple terms:  “High HDL may not protect the heart.” We should “[c]oncentrate on lowering LDL.”

And so, specifically, as this relates to coconut oil:  “The increase in HDL…is of uncertain clinical [significance], but the increase in LDL [cholesterol you get from eating coconut oil] would be expected to have an adverse effect on [atherosclerotic cardiovascular disease] risk.”

But, what about the MCTs? Proponents of coconut oil, who lament that this whole “coconut oil causes heart disease” thing “has created this bad image” for their national exports, assert that the medium chain triglycerides, the shorter saturated fats found in coconut oil, aren’t as bad as the longer chain saturated fats in meat and dairy. And, what about that study that purported to show low rates of heart disease among Pacific Islanders who ate tons of coconuts? I’ll cover both these topics, next.

Here’s something to wrap your brain around.   Do the medium-chain triglycerides in coconut oil, and the fiber in flaked coconut; counteract the negative effects on cholesterol and artery function?  Let’s take a look.   

Studies of populations who eat a lot of coconuts are “frequently cited” by those who sell coconut oil “as evidence” that it does not have harmful effects. For example, there was an apparent absence of stroke and heart disease on the island of Kativa. What were they eating? Well, their diets centered around tubers, like sweet potatoes, with fruits, greens, nuts, corn, and beans. Yes, they ate fish a few times a week, but they were eating largely whole food plant-based diets. So, no wonder they may have had such low rates of artery disease, and one of those whole foods was coconut, not coconut oil.

Now, if you go to Pukapuka, they eat even more coconuts. And, there’s even an island where that’s most of what they eat—and they get high cholesterol. What’s a population eating 87% plant-based—red meat, chicken, and eggs only eaten seldomly, no dairy—doing with cholesterol levels over 200? Well, they’re eating all these coconuts every day. What are their disease rates like? We don’t know. There’s no clinical surveys, no epidemiological data, no autopsies. They did do some EKGs, which can sometimes pick up evidence of past heart attacks, and found few abnormalities, but the sample was too small to be a definitive study. And, even if they did have low disease rates, they weren’t eating coconut oil; they were eating coconuts. Coconut oil proponents pointing to these studies is like the high-fructose corn syrup lobby pointing to studies of healthy populations who eat corn on the cob or the sugar industry pointing to studies on fruit consumption, and saying see, eat all the refined sugar you want. But, fruit has fiber—and so do coconuts. Just like adding psyllium fiber—Metamucil—to coconut oil can help blunt the adverse effects on cholesterol, fiber derived from defatted coconut itself can reduce cholesterol levels as much as oat bran. And, the plant protein in coconut—also missing from the oil—may also help explain why whole coconut may not have the same effects on cholesterol.

Although coconut fat in the form of powdered coconut milk may not have the same effects on cholesterol as coconut oil, frequent consumption—defined as three or more times a week—has been associated with increased risk of vascular disease, stroke, and heart attack. And no wonder, as coconut milk may acutely impair artery function—as badly as a sausage-and-egg McMuffin. They tested three meals, three different meals: a Western high-fat meal, comprised of an egg McMuffin, a sausage McMuffin, and two hash browns, versus a local high-fat meal (this was done in Singapore; so, the more traditional high-fat meal was rice cooked with coconut milk, though there were also anchovies and an egg), vs. the same amount of calories in an unhealthy low-fat meal, comprised of Frosted Flakes, skim milk, and juice.

So, whether mostly meat-and-oil fat, or coconut milk fat, the arteries similarly clamped down, whereas that horrible sugary breakfast had no effect, no bad effect, on artery function, because, as terrible as it was, it had no saturated fat at all—though it also didn’t have any egg, which may have also helped.

Coconut oil proponents also try to argue that coconut oil has MCTs—medium chain triglycerides—shorter-chain saturated fats that aren’t as bad as the longer-chain saturated fats in meat and dairy. But you can’t apply the MCT research to coconut oil. Why? MCT oil is composed of MCTs, the medium-chain fats, caprylic and capric acid, about 50% of each, whereas those MCTs make up only like 10% of the coconut oil. Most of coconut oil is the cholesterol-raising longer-chain saturated fats, lauric and myristic. “It is therefore inaccurate to consider coconut oil to contain…predominantly [MCTs].” So, you can’t extrapolate from MCT studies to coconut oil.

That’s actually quite a common misconception, that the saturated fat in coconut oil is mainly MCTs. Actually, coconut oil is mainly lauric and myristic, which have potent LDL (bad cholesterol)-raising effects. “Coconut oil should therefore not be advised for people who should or want to reduce their risk of” the #1 killer of U.S. men and women—heart disease.

It’s like how the beef industry loves to argue that beef fat contains stearic acid, a type of saturated fat that doesn’t raise cholesterol. Yeah, but it also has palmitic and myristic that, like lauric, does raise cholesterol. If you compare the effects of different saturated fats, yes, stearic has a neutral effect on LDL, but palmitic, myristic, and lauric shoot it up. And, frankly, so may MCT oil itself, bumping up LDL like 15% compared to control. So, this “[p]opular belief,” spread by the coconut oil industry, that “coconut oil is healthy” is “not supported by [science].”

So, basically “coconut oil should be [treated no] differently than [animal] sources of dietary saturated fat.” The latest review, published in March 2017 in the Journal of the American College of Cardiology, put it even more simply in their recommendations for patients: “Avoid.”

Though there have been more than a thousand papers published on coconut oil in medical journals, there is little evidence it helps with Alzheimer’s disease.  Here’s why.

Those that tend to profit from coconut oil claim it has miraculous powers—curing everything from cancer to jock itch. Perhaps the boldest claim may be as a potential cure for Alzheimer’s, based on a series of anecdotes, and one study. “Study of the ketogenic agent AC-1202.” You can certainly make money selling 20-pound buckets of coconut oil, but even more, selling some kind of patented supplement, which is what this is—a concentrated form of the medium-chain fatty acids in coconut oil, purported to be the active ingredient.

At first, it looked like it was working. But, by the end of the study, any effect it had had disappeared—though there was one genetic subgroup where it appeared to be working better. But, when that group was properly randomized, even that effect disappeared. So, the only such study ever done on concentrated coconut oil components found little effect.

And, no studies have ever been done whatsoever on Alzheimer’s and coconut oil itself. As the Alzheimer’s Association put it, “there is no scientific evidence that coconut oil helps with Alzheimer’s.” And hey, you know, “The coconut oil promise has been around for more than three years. If the administration of coconut oil was, indeed, beneficial, it would presumably be shouted from every mountaintop.” And, not just the mountains that sell coconut oil.

And that’s all we know so far. Why don’t we know more? There have been over a thousand articles published on coconut oil in the medical literature. The problem is, they’re studies like this. Did you know “Coconut Oil Enhances Tomato Carotenoid Tissue Accumulation Compared to Safflower Oil in the Mongolian Gerbil?” It includes nuggets like this: “The testes of the coconut oil-fed animals…weighed significantly less than those of the safflower oil-fed animals.” Who says coconut oil isn’t effective? How else are you going to shrink the testicles of Mongolian gerbils?

To see any graphs, charts, graphics, images, or studies mentioned here, please go to the Nutrition Facts podcast landing page.  There, you’ll find all the detailed information you need plus links to all the sources we cite for each of these topics.

NutritionFacts.org is a nonprofit, science-based public service, where you can sign up for free daily updates on the latest in nutrition research via bite-sized videos and articles.

Everything on the website is free.  There’s no ads, no corporate sponsorship.  It’s strictly non-commercial.  I’m not selling anything.  I just put it up as a public service, as a labor of love, as a tribute to my grandmother, whose own life was saved with evidence-based nutrition.

Thanks for listening to Nutrition Facts. I’m Dr. Michael Greger.

This is just an approximation of the audio content, contributed by Allyson Burnett.

 

45 responses to “What’s the Deal with Coconuts?

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  1. Thank you Dr. Greger for this article!
    I do have a question though: what about gettin my saturated fat requirement on a vegan diet? Please correct me if I’m wrong, but we do need a certain amount of saturated fat right, and on a vegan diet that might be kind of tricky to find. That’s why in my opinion the coconut oil might help a vegan in obtaining that amount of saturated fatty acid.

    Cheers!




    5
    1. Thanks for your great question. We do not have a saturated fat requirement. The only fat sources Dr. Greger recommends are whole food plant sources such as nuts and avocados. Here are a few videos you might find interesting:
      https://nutritionfacts.org/video/lipotoxicity-how-saturated-fat-raises-blood-sugar/
      https://nutritionfacts.org/video/lipotoxicity-how-saturated-fat-raises-blood-sugar/
      https://nutritionfacts.org/video/fatty-meals-may-impair-artery-function/

      This video lays out what Dr. Greger recommends we all eat in a day:
      https://nutritionfacts.org/video/dr-gregers-daily-dozen-checklist/

      Kelly
      NF moderator




      1
  2. I am in shock. Until today I was lead to believe that coconut milk was good for my health. Everyday I make a blended drink with lots of seeds greens protein power and coconut milk for breakfast. what do you suggest as a replacement for coconut milk. What do you think of flaxseed milk?By the way thank you so much for what you are doing.




    4
    1. I feel your shock. I had the same revelation some time back. I would go with any milk substitute that is unsweetened and has no oil. I would avoid flaxseed milk because most of it has flax seed oil and Dr. Greger recommends avoiding any oils. Try unsweetened soy milk or almond milk. Soy milk doesn’t have as much benefit as whole soy beans, but Dr. Greger does recommend soy in general for health.
      https://nutritionfacts.org/video/who-shouldnt-eat-soy/

      Kelly
      NF moderator.




      2
      1. Thanks for getting back to me about milk. I have read about how saturated the soy industry has become with GMO are you sure that it is safe to use soy?




        1
      2. So let me try to understand oils with your help. I should not use any oils even oils like Safflower seed oil? I do lots of cooking with olive oil and put it on my daily salads is there any good replacement oil to save my cooking? thanks Carl




        0
        1. It’s hard to wrap your head around when oils have been promoted as a health food. Oils are a highly processed food. Think of them as the fruit juice of the oil world. They’ve been promoted as healthy but it’s essentially just the fat and oil sucked out of olives, coconuts, corn, peanuts etc. It’s nothing but fat. No fiber. No vitamins. We recommend whole food plant sources. Eat the avocados not avocado oil. Eat peanuts. Don’t cook with peanut oil. Oils have negative effects on your health. Here are a few videos that explain a little more.
          https://nutritionfacts.org/video/olive-oil-and-artery-function/
          https://nutritionfacts.org/video/mediterranean-diet-and-atherosclerosis/
          https://nutritionfacts.org/video/which-parts-of-the-mediterranean-diet-extended-life/

          Kelly
          Moderator




          0
  3. walnuts and avocados provide plenty of saturated fats combined with SCFA’s and phyto nutrients and trace minerals so while they have some SF’s they both assist in nitric oxide production without the contraction on vessels upon intake and as major bonus is they both assist in the higher uptake of some vitamin groups …..this would have the follow-on affect of staving off long-term age-related diseases……




    3
    1. Dr. Greger mentioned in other video that coconut water is similar to Our cellular plasma So if u are dehydrated on the desert u can even inject it in your veins :p




      2
    2. It does not have any of the fat or oil, so there is no issue there. It does have some sugar so I would keep your intake of it moderate.

      Kelly
      NF moderator.




      2
  4. Is Dr. Greger familiar with the research of Dr. Dale Bredesen on preventing and even reversing Alzheimer’s, which has led to his “Bredesen Protocol?” Much of what Dr. Bredesen calls for has to do with getting our bodies to a state of mild ketosis, enough consumption of “heathy” fats being one of the ways to accomplish this. His book, _The End of Alzheimer’s_ was just published this year. I would really appreciate hearing a thorough critique from Dr. Greger on this subject.




    2
  5. Thank you for your interesting question. As you will have seen from Dr Greger’s post and videos, there is not such thing as a ‘healthy fat’ unless it is part of the whole plant food like avocado, nuts and seeds. Refined, processed fats including coconut oil and olive oil are harmful to our blood vessels and promote diseases like heart disease and Alzheimers disease. The underlying process of Alzheimer’s disease is the same that causes heart disease – artherosclerosis. So for prevent of Alzheimers disease we should use the same diet that has been shown over and over again to prevent and reserve heart disease – a whole food plant based diet. The populations with the lowest incidence of Alzheimer’s are those eating a predominantly plant based diet.

    I have briefly just reviewed Bredesen’s data. The original paper treated 10 patients (found here https://www.ncbi.nlm.nih.gov/pubmed/25324467). There was no control group. The diet that is being used appears to be mainly plant based with very little meat or fish. It emphasises fruits and vegetables. However, it is low on grains, a food that has over and over been shown to be beneficial to health. Intermittent fasting was also being used as a way to produce ketosis. There was the use of coconut oil and a whole heap of supplements. Without a control group it is impossible to know which aspects of this lifestyle approach is having a benefit, if at all.

    Our goal has to be to prevent the rising incidence of Alzheimers, and all the data so far points to a diet rich in whole plant foods, low in added oils and emphasising whole grains and legumes. In addition, physical activity, emotional resilience and social connection are very important in preventing this disease




    2
    1. Boy I am having all my so called healthy foods put into unhealthy fats. I thought that by having a salad everyday with olive oil instead of cream dressing I was doing the right thing.? Could I start using avocado oil in place of olive oil. and do you have other recamindation for dressing foe me . thanks Carl.




      1
      1. do you make you’re own dressing? try some herbs blended with a cucumber and a bit of vinegar or lemon. thicken up with some nutritional yeast or nut butter. i make pesto using the cucumber in place of oil.




        0
          1. I thought it was disgusting in the first place. Greasy greens, ugh. I only did it because I thought cold pressed virgin olive oil was supposed to be good for you, and that vegans didn’t get enough monounsaturateds. I am very grateful for Dr. Greger and this website. So many other vegan, excuse me, whole plant foods diet websites seem to have agendas that I’m not always on board with. He seems mostly intent on actually helping people stay/get healthy. I even gave his name to my doctor today (who is a fat lacto-ovo vegetarian), and texted my best friend (he has COPD), and insisted he watch some videos, at least the ones on rice.




            0
            1. You asked about mashed avacodo and it is indeed a whole food okay for a whole food plant-based diet. That said, recognize avacodo does have considerable fat and if you are trying to lose weight lots of avacodo (as opposed to other plant foods) might be counter productive. Also if you have coronary artery disease at least one respected wfpb doctor discourages avocados for those with coronary artery disease. Otherwise enjoy!




              0
              1. Thank you for your reply. Can you please elaborate on how avocados could be be harmful for those with CAD? Both of my parents had CAD, so I am at risk for it; however, I don’t have it at this point, and I have greatly reduced my risk factors this past year by losing weight (now at a normal weight), and eating mostly (about 80-90%) wfpb.




                0
                1. Let me reassure you, Karen, that the precaution I mentioned about avocados that Dr. Caldwell Esselstyn mentions is for those who have diagnosed coronary artery disease, not just risk factors. This has to do with damaged inner lining of the blood vessels of CAD patients (endothelium) . You can read more research at Dr Esselystyn’s website or go to this link: https://www.health.harvard.edu/heart-health/halt-heart-disease-with-a-plant-based-oil-free-diet- although this article also explains that in general avocados are considered a healthy food. Bottom line, enjoy your avocados just be aware that excessive intake is a precaution for those with diagnosed CAD.




                  0
  6. (Forgive me if I missed this while I scanned the transcript)
    I heard somewhere years ago that the saturated fat in coconut does not affect the body (arteries) in the same way as saturated fat from an animal source UNLESS it is part of a diet that includes animal products.
    Anybody heard of that?




    1
    1. I hear it too, from the people selling the product and from people that do not present any compelling unbiased peer-reviewed published evidence. Unfortunately all evidence points to the contrary. If you believe it, eat it, and the real peer-reviewed published evidence turns out to be correct (as it likely is since it’s the only evidence) then you could be dead. It doesn’t seem worth the risk to me.

      Dr. Ben




      1
  7. Thank you for this informative video and all the work that you do to share evidence based nutrition. There is a lot of conflicting information out there about coconut oil. I wanted to know what is the mechanism by which coconut oil raises cholesterol? Is coconut oil converted to cholesterol or is it that certain saturated fats (no matter the source) are converted to LDL cholesterol? Are there any studies comparing two groups both on a whole food plant based diet comparing coconut oil consumption vs no coconut oil consumption? Please reference the article. Thank you.




    2
  8. Wow, I am glad listened to this podcast. I’ve had a Functional Medicine Doctor tell me we need these “healthy fats”..coconut milk, butter, olive oil..etc..And to make sure I was getting this with each and every meal…which was sometimes 4 to 5 times a day. He has me eating coconut milk in smoothies daily and sometimes twice a day and like half a can. Also, butter with every meal, saying we need these fats for our brain health and for thryroid health. There is so much conflicting information out there from so many different doctors, even saying eggs are so healthy for us. I have been incorporating a WFPB diet and friends are in shock that I’m not eating “protein” eggs, chicken, fish etc. I look forward to listening to many more of his podcasts and currently reading his How not to Die book. Thank you!




    0
    1. Your point is valid. We are overloaded with information. Unfortunately much of it is totally unsubstantiated and based on “what sounds right” which is often just “medical superstition” as Dr. G. says. This is nothing but a half-educated, often wrong, guess in the absence of objective information.
      Dr. G now shows the objective information as you’ve seen. There is a very simple solution to all this. If your MD makes a recommendation that conflicts with what you’ve seen here, you can say: “all the peer-reviewed clinical studies in humans and animals clearly points to the fact that animal products and isolated fats increase morbidity and mortality. Do you have an citations for peer-reviewed clinical studies that support the need to eat eggs/butter/cocount etc for optimal health?”

      The silence will be deafening since there is no compelling evidence.

      Dr. Ben

      Virus-free.
      http://www.avg.com




      0
  9. Ok. So I am confused to the bone. I am also following Nora Gedgaudas for some time. Her analysis of the same topic concludes the opposite as dr G. (see http://www.primalbody-primalmind.com/saturated-fat-health-food-health-hindrance/ . In the article isn’t the”be-all and end-all” of dietary fats. However for cooking it is superbly stable.

    My question is would I use it for cooking in which you use a limited amount or avoid it altogether. Question is what to use for cooking as butter and ghee are animal based. Also olive oil is unstable and according to dr G not to be used.




    0
    1. It’s not necessary to use oil to cook. Baking, steaming, and using a pressure cooker, slow cooker, or Instant Pot are great ways of cooking that don’t require oil. When you get accustomed to eating food that has not been oiled, tasting food that has been cooked in oil is actually quite disgusting. You’ll wonder why people do it in the first place.

      Dr. Jamie Koonce




      0
  10. Thanks, Dr. Greger, for proving me right. I have ALWAYS thought there was something fishy about that claim “that they’re MCT’s, they’re good for you” crap. I don’t trust any studies put out by anyone with a link to the manufacturing corporation.




    0
  11. Hi Doctor Greger,
    I love your work but I Am confused about coconut oil.
    I started talking it after reading the book by Dr. Mary Newport.
    She regularly described how eating several spoonfuls of coconut oil every day had created a miraculous turnaround for her Alzheimer’s.




    0
  12. It can be very tempting to listen to a single “anecdotal” report like this and believe that this represents “evidence”. Unfortunately, it’s not. One person feeling better after doing something does not mean that “doing that something” actually is the answer. There are other factors such as the placebo effect to consider. All available peer-reviewed, published research evidence suggests that eating coconut oil will increase your serum cholesterol which could cause cardiovascular disease.

    Dr. Ben




    0
  13. Hi! Regarding coconut milk being unhealthy due to oil, is the coconut oil added into the milk or are you referring to the fat that occurs naturally in coconuts? Is shredded coconut bad then too? Or eating the flesh of a young coconut? If the oil is added I understand that it’s bad, but if it’s due to the fat that occurs naturally in the coconut, shouldn’t coconut meat be considered a whole food and the fat not be dangerous because it’s a package deal? Trying to wrap my head around this.




    0
    1. Hi, Sanna! You may find this video helpful. The studies referenced found that like coconut oil, coconut milk did have an adverse effect on arterial function, while shredded coconut did not. The inclusion of small amounts of coconut flesh in the diet (the whole food, fresh or dried) should be perfectly fine.




      0

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