Key points
- Coconut and its oil have been used for millennia as a traditional food
- When substituted for other oils, coconut might aid fat-reduction
- Coconut oil is a good moisturiser that could help combat skin infections
- Coconut oil exhibits anti-candida actions
- Despite having less ketogenic MCTs, coconut oil could aid Alzheimer’s treatment
- In the context of a healthy diet, and unless consumed to excess, coconut oil is not detrimental for cardiovascular or overall health
Coconut oil has gone from being a traditional oil, mostly used in South Asia and the Pacific, into an incredibly popular oil used around the world. But it isn’t without some controversy. Some people claim it’s a boon to health while others suggest caution.
So, what does the evidence say about coconut oil and health?
What are Medium Chain Triglycerides?
Coconut oil contains several fatty acids. Much of the attention for health benefits falls on ‘MCTs’, which stands for medium-chain triglyceride. A ‘triglyceride’ is a fat, and so, a medium-chain triglyceride refers to a fat with three medium-length fatty acids (between 6 and 12 carbon atoms in length) attached to a glyceride, or glycerol backbone. Due to this shorter chain length, MCTs aren’t digested in the way most of the longer-chain fats (which make up most of our dietary fats) are and are absorbed more easily from the gut and transported directly to the liver where they can be converted into ketones which can then be used by the brain and body as fuel.
MCTs are also directly used by beneficial bacteria in the gut, and cells of the intestinal wall, thereby improving gut health.
Which MCTs are in coconut oil?
Around half of the fat in coconut oil comes from the longest of the medium-chain fatty acids, the twelve-carbon lauric acid (C12) with caprylic and capric acid (C8 and C10) making up around 15% of the oil, the rest of the fatty acid composition of coconut oil comes from longer chain fats (especially myristic, palmitic, and oleic acid).
What are the benefits of coconut oil?
Because it contains caprylic and capric acids, coconut oil can provide some of the benefits of supplemental MCT oils but because of the slightly longer chain-length of lauric acid, far less is transported directly to the liver when compared to the other MCTs1, 2 and so, it isn’t considered ‘ketogenic’ like the other medium-chain fats.3 Despite this lesser effect of coconut oil and lauric acid on ketosis, there are several other health benefits from taking coconut oil.
Weight management
At least one study has shown that coconut oil might help to reduce waist circumference. In a 12-week, randomised, double-blind clinical trial involving 40 women aged 20–40 years, participants were given a supplement of either 30 ml of coconut oil or soybean oil. Reductions in BMI were observed in both groups but only the group taking coconut oil reduced waist circumference.4 Waist circumference is a primary marker for insulin resistance and metabolic disorder and overall health.
Skin health
When used as a moisturizer, coconut oil is likely to reduce Staphylococcus aureus infection of the skin. Topical application of coconut oil has also been shown to increase the speed of skin wound healing in rats,5 and other animal studies also suggest pain-reducing and anti-inflammatory effects of coconut oil.6
Coconut oil has received attention as a topical treatment for preterm babies. In research on this application, coconut oil has been shown to improve the skin condition of preterm infants,7 decrease water loss and infection rates, and improve growth rates and brain development, without significant adverse effects.8, 9
Anti-candida actions
Coconut oil and its constituent fatty acids like lauric acid have demonstrable antifungal activity.10 In mice fed a coconut oil-rich diet, colonisation of the gastrointestinal tract by candida was lower than that for diets rich in either beef tallow or soybean oil. Interestingly, coconut oil reduced colonisation when the diet also contained beef tallow, and dietary coconut oil also altered the metabolic program of colonising candida cells. This finding suggests that coconut oil could be an intervention for humans with candida.11 In a 2007 paper, Ogbolu and colleagues suggested “Coconut oil should be used in the treatment of fungal infections in view of emerging drug-resistant Candida species”10
Oral health
Oil pulling with coconut oil has been a traditional Indian remedy to improve oral health. Research is showing that this practice might reduce oral plaques and gingivitis,12 and reduce tooth staining.13
Brain health
Ketones (and ketogenic diets) are known to have positive effects on neurodegenerative disorders like Alzheimer’s disease.14-25 Despite the lesser impact of coconut oil on ketones, in vitro research suggests another role of coconut oil in neurodegeneration; it might be able to reduce the formation of damaging beta-amyloid plaques found in Alzheimer’s disease.26
But isn’t coconut oil bad for the heart?
The short answer is not really. Of course, any food can be detrimental in excess, and this is true of the saturated fats found in coconut oil. But the overall evidence suggests that in the context of a healthy diet containing saturated fats, they do not pose a significant or meaningful risk for either cardiovascular or all-cause mortality.27-30
Population evidence
In a comparison of Pacific peoples using differing amounts of coconut oil, researchers evaluated the diets of atoll dwellers in Pukapuka and Tokelau, in which coconut is the chief source of energy for both groups. Tokelauans consumed more saturated fat with ~63% of their energy derived from coconut, than Pukapukans (34% energy derived from coconut) and had higher cholesterol levels. But despite this, cardiovascular diseases were uncommon in both groups, and there was no evidence that the higher saturated fat intake from coconut oil was harmful.31
In the Southern Indian province of Kerala, coconut oil has been extensively used as a traditional food source. A study was performed in this province to explore the presumed link between coconut oil and heart disease risk. It was found that coconut oil was consumed in similar amounts between those with and without heart disease.32 The groups did not differ in fat, saturated fat or cholesterol consumption, which suggests that coconut oil plays no role in the development of heart disease in this population. It has been further noted (in this same population) that the lipid composition of arterial plaques is not altered by replacing coconut oil with sunflower oil.33 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 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 heart disease and diabetes.34
A community based longitudinal study in Cebu, Philippines found a positive, also found a small association between coconut oil and HDL cholesterol, with no worsening of HDL to cholesterol, or triglycerides (likely to be the strongest risk factor for heart disease).35
A report by 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 high coronary heart disease mortality or morbidity rate.”36
Intervention studies
In the previously mentioned comparison between coconut oil and soy oil, the coconut oil group also had lower levels of LDL (‘bad’) cholesterol while the soybean oil-treated group increased LDL.4
In a study of 96 men and women between 50 and 75 years of age, there was no difference between virgin coconut oil and olive oil for changes in LDL, but coconut oil significantly increased HDL compared to either butter or olive oil. There were no significant differences for changes in weight, blood glucose, body fat, or blood pressure between butter, coconut oil, and olive oil groups.37
In another recent study, 15 women randomised to receive either coconut oil or olive oil showed no difference in insulin homeostasis, LDL, HDL, uric acid, or triglycerides.38
In healthy men, coconut oil (compared to equivalent amounts of peanut oil) resulted in increased fat-free mass and plasma HDL-C levels while reducing inflammation and increasing insulin sensitivity.39 It might also improve vascular endothelial function (the health of the interior surface of blood vessels).40
A recent systematic review and meta-analysis found that in comparison to other oils, coconut oil increases HDL, and increases LDL compared to plant oils but lowers it compared to animal-based fats. It’s also likely to either have no effect or improve triglyceride levels (fats in the blood), which is the strongest marker for future heart health. Additionally, extra virgin coconut oil results in better lipid profiles than poorer quality coconut oil.41 Another review concluded, “Coconut oil consumption did not significantly affect markers of glycemia [blood sugar], inflammation, and adiposity [body fat levels] as compared with non-tropical vegetable oils.”42
Who should use Coconut oil, and how?
Coconut oil is a useful all-round oil. Because it is a heat-stable oil, it can be used in cooking and baking and makes a better option for this than more common seed oils which are easily damaged by heat. It can also be used in smoothies or as a spread, and it’s a great natural alternative to moisturisers that often carry undesirable chemicals.
The key consideration for the use of coconut or any other oil is that it fits within the context of your diet. In other words, don’t go adding oils in addition to your best-fit diet. Instead, substitute healthier or more functionally more beneficial oils (dependant on your goals) for other oils, especially highly refined see oils.
References
1. Mu H, Hoy CE. Effects of different medium-chain fatty acids on intestinal absorption of structured triacylglycerols. Lipids. 2000;35(1):83-9.
2. St-Pierre V, Vandenberghe C, Lowry C-M, Fortier M, Castellano C-A, Wagner R, et al. Plasma Ketone and Medium Chain Fatty Acid Response in Humans Consuming Different Medium Chain Triglycerides During a Metabolic Study Day. Frontiers in nutrition. 2019;6:46-.
3. Norgren J, Sindi S, Sandebring-Matton A, Kåreholt I, Daniilidou M, Akenine U, et al. Ketosis After Intake of Coconut Oil and Caprylic Acid—With and Without Glucose: A Cross-Over Study in Healthy Older Adults. Frontiers in Nutrition. 2020;7.
4. Assunção M, Ferreira H, dos Santos A, Cabral C, Jr., Florêncio TMT. Effects of Dietary Coconut Oil on the Biochemical and Anthropometric Profiles of Women Presenting Abdominal Obesity. Lipids. 2009;44(7):593-601.
5. Nevin KG, Rajamohan T. Effect of Topical Application of Virgin Coconut Oil on Skin Components and Antioxidant Status during Dermal Wound Healing in Young Rats. Skin Pharmacology and Physiology. 2010;23(6):290-7.
6. Intahphuak S, Khonsung P, Panthong A. Anti-inflammatory, analgesic, and antipyretic activities of virgin coconut oil. Pharmaceutical Biology. 2010;48(2):151-7.
7. Strunk T, Pupala S, Hibbert J, Doherty D, Patole S. Topical Coconut Oil in Very Preterm Infants: An Open-Label Randomised Controlled Trial. Neonatology. 2018;113(2):146-51.
8. Pupala SS, Rao S, Strunk T, Patole S. Topical application of coconut oil to the skin of preterm infants: a systematic review. European Journal of Pediatrics. 2019;178(9):1317-24.
9. Konar MC, Islam K, Roy A, Ghosh T. Effect of virgin coconut oil application on the skin of preterm newborns: A randomized controlled trial. Journal of Tropical Pediatrics. 2020;66(2):129-35.
10. Ogbolu DO, Oni AA, Daini OA, Oloko AP. In Vitro Antimicrobial Properties of Coconut Oil on Candida Species in Ibadan, Nigeria. Journal of medicinal food. 2007;10(2):384-7.
11. Gunsalus KTW, Tornberg-Belanger SN, Matthan NR, Lichtenstein AH, Kumamoto CA. Manipulation of Host Diet To Reduce Gastrointestinal Colonization by the Opportunistic Pathogen <span class="named-content genus-species" id="named-content-1">Candida albicans</span>. mSphere. 2016;1(1):e00020-15.
12. Peedikayil FC, Sreenivasan P, Narayanan A. Effect of coconut oil in plaque related gingivitis — A preliminary report. Nigerian Medical Journal : Journal of the Nigeria Medical Association. 2015;56(2):143-7.
13. Sezgin Y, Ozgul BM, Alptekin NO. Efficacy of oil pulling therapy with coconut oil on four-day supragingival plaque growth: A randomized crossover clinical trial. Complementary therapies in medicine. 2019;47:102193.
14. Craft S, Neth BJ, Mintz A, Sai K, Shively N, Dahl D, et al. KETOGENIC DIET EFFECTS ON BRAIN KETONE METABOLISM AND ALZHEIMER’S DISEASE CSF BIOMARKERS. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. 2016;12(7):P342-P3.
15. Vanitallie TB, Nonas C, Di Rocco A, Boyar K, Hyams K, Heymsfield SB. Treatment of Parkinson disease with diet-induced hyperketonemia: a feasibility study. Neurology. 2005;64:728-30.
16. Van der Auwera I, Wera S, Van Leuven F, Henderson ST. A ketogenic diet reduces amyloid beta 40 and 42 in a mouse model of Alzheimer’s disease. Nutrition & Metabolism. 2005;2(1):28.
17. Beckett TL, Studzinski CM, Keller JN, Paul Murphy M, Niedowicz DM. A ketogenic diet improves motor performance but does not affect β-amyloid levels in a mouse model of Alzheimer’s Disease. Brain Research. 2013;1505:61-7.
18. Corsi M, Di Raimo T, Pinto A, Di Lorenzo C, Fuso A. Ketogenic diet: a nutritional protocol for a non-pharmacological treatment of Alzheimer’s disease. Italian Journal of Anatomy and Embryology; Vol 121, No 1 (Supplement) 2016. 2017.
19. Krikorian R, Shidler MD, Dangelo K, Couch SC, Benoit SC, Clegg DJ. Dietary ketosis enhances memory in mild cognitive impairment. Neurobiology of Aging. 2012;33(2):425.e19-.e27.
20. Swerdlow RH. THE KU ALZHEIMER’S DISEASE KETOGENIC DIET FEASIBILITY AND RETENTION TRIAL: RESULTS FROM A PILOT STUDY. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. 2017;13(7):P883.
21. Shaafi S, Mahmoudi J, Najmi S, Sadigh-Eteghad S, Farhoudi M, Aliasgharpour H. Modulatory role of ketogenic diet on neuroinflammation; a possible drug naïve strategy to treatment of Parkinson’s disease. Advances in Biosciences & Clinical Medicine. 2015;3(4):43.
22. Cheng B, Yang X, An L, Gao B, Liu X, Liu S. Ketogenic diet protects dopaminergic neurons against 6-OHDA neurotoxicity via up-regulating glutathione in a rat model of Parkinson’s disease. Brain Research. 2009;1286:25-31.
23. Shaafi S, Najmi S, Aliasgharpour H, Mahmoudi J, Sadigh-Etemad S, Farhoudi M, et al. The efficacy of the ketogenic diet on motor functions in Parkinson’s disease: A rat model. Iranian Journal of Neurology. 2016;15(2):63-9.
24. Zhao Z, Lange DJ, Voustianiouk A, MacGrogan D, Ho L, Suh J, et al. A ketogenic diet as a potential novel therapeutic intervention in amyotrophic lateral sclerosis. BMC neuroscience. 2006;7(1):29.
25. Ruskin DN, Ross JL, Kawamura M, Ruiz TL, Geiger JD, Masino SA. A ketogenic diet delays weight loss and does not impair working memory or motor function in the R6/2 1J mouse model of Huntington’s disease. Physiology & Behavior. 2011;103(5):501-7.
26. Bansal A, Kirschner M, Zu L, Cai D, Zhang L. Coconut oil decreases expression of amyloid precursor protein (APP) and secretion of amyloid peptides through inhibition of ADP-ribosylation factor 1 (ARF1). Brain research. 2019;1704:78-84.
27. Hooper L, Martin N, Abdelhamid A, Davey Smith G. Reduction in saturated fat intake for cardiovascular disease. The Cochrane database of systematic reviews. 2015(6):Cd011737.
28. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. The American journal of clinical nutrition. 2010;91(3):535-46.
29. Mente A, de Koning L, Shannon HS, Anand SS. A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Intern Med. 2009;169(7):659-69.
30. Astrup A, Bertram HCS, Bonjour J-P, de Groot LCP, de Oliveira Otto MC, Feeney EL, et al. WHO draft guidelines on dietary saturated and trans fatty acids: time for a new approach? BMJ. 2019;366:l4137.
31. Prior IA, Davidson F, Salmond CE, Czochanska Z. Cholesterol, coconuts, and diet on Polynesian atolls: a natural experiment: the Pukapuka and Tokelau island studies. The American Journal of Clinical Nutrition. 1981;34(8):1552-61.
32. Kumar PD. The Role of Coconut and Coconut Oil in Coronary Heart Disease in Kerala, South India. Tropical Doctor. 1997;27(4):215-7.
33. Palazhy S, Kamath P, Rajesh PC, Vaidyanathan K, Nair SK, Vasudevan DM. 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. 2012;31(6):392-6.
34. Sircar S, Kansra U. Choice of cooking oils–myths and realities. J Indian Med Assoc. 1998;96(10):304-7.
35. Feranil AB, Duazo PL, Kuzawa CW, Adair LS. Coconut oil is associated with a beneficial lipid profile in pre-menopausal women in the Philippines. Asia Pacific journal of clinical nutrition. 2011;20(2):190-5.
36. Kaunitz H, Dayrit, C.S. . Coconut Oil Consumption and Coronary Heart Disease: Food and Agriculture Organisation of the United Nations; N.D [
37. Khaw K-T, Sharp SJ, Finikarides L, Afzal I, Lentjes M, Luben R, et al. Randomised trial of coconut oil, olive oil or butter on blood lipids and other cardiovascular risk factors in healthy men and women. BMJ open. 2018;8(3).
38. Valente FX, Cândido FG, Lopes LL, Dias DM, Carvalho SDL, Pereira PF, et al. Effects of coconut oil consumption on energy metabolism, cardiometabolic risk markers, and appetitive responses in women with excess body fat. Eur J Nutr. 2018;57(4):1627-37.
39. Korrapati D, Jeyakumar SM, Putcha UK, Mendu VR, Ponday LR, Acharya V, et al. Coconut oil consumption improves fat-free mass, plasma HDL-cholesterol and insulin sensitivity in healthy men with normal BMI compared to peanut oil. Clinical Nutrition. 2019;38(6):2889-99.
40. Robinson SA, O’Brien MW, Grandy SA, Heinze-Milne S, Kimmerly DS. Short-term supplement of virgin coconut oil improves endothelial-dependent dilation but not exercise-mediated hyperemia in young adults. Nutrition research. 2019;67:17-26.
41. Teng M, Zhao YJ, Khoo AL, Yeo TC, Yong QW, Lim BP. Impact of coconut oil consumption on cardiovascular health: a systematic review and meta-analysis. Nutrition reviews. 2020;78(3):249-59.
42. Neelakantan N, Seah JYH, van Dam RM. The Effect of Coconut Oil Consumption on Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis of Clinical Trials. Circulation. 2020;141(10):803-14.
