TO BE IN LOVE WITH THE

COCO(NUT)?Virgin Coconut Oil and Health

Emily Walker

Objective ◦Explain coconut oil’s role in health and explore

research behind coconut oil’s recent glorification as a “superfood” Describe the biochemical makeup of coconut oil ◦ Describe coconut oil’s antimicrobial properties◦ Summarize recent meta analyses findings regarding the

connection between saturated fat and cardiovascular disease◦ Describe the role medium-chain triglycerides play in and weight

loss◦ Summarize the effect of coconut oil on lipid panels◦ Determine if coconut oil deserves its recent claim of a

“superfood” ◦ Name how to appropriately include coconut oil in a healthy diet

What is Coconut Oil? ◦Derived from mature coconuts ◦ Standard Vs. Virgin Coconut Oil◦ Standard: produced by first drying the kernel

and then refining, bleaching and deodorizing the extracted oil.

◦ Virgin: Made by a wet process- either extracted from coconut milk or from a fresh kernel which is not subject to drying or chemical refining

◦ Virgin coconut oil has been found to contain up to 7 times higher concentrations of polyphenols than standard- 80 mg gallic acid equivalents/100 g of oil ◦ Focus on “Virgin Coconut oil” (VCO) as this is

the compound that is associated with health benefits, NOT its processed counterpart.

Biochemical Makeup of Coconut Oil

◦99.9% fatty acids◦91.9% SFA, 6.4% MUFA; 1.5 PUFA; 0

cholesterol1◦ Individual FA makeup:

1. Lauric2. Myristic3. Palmitic Fas

◦1 tbsp◦117 kcal◦14 g fat ◦12 g SFA ◦ .8 g MUFA◦ .2 g PUFA

Coconut Oil: A “Health” Food?◦May seem contradictory that coconut oil is proclaimed a “health” food when it is higher in saturated fat than most oils/fats◦Historically regarded as potent agent for elevating serum cholesterol ◦Butter 52g/100g sat fat; coconut oil

92g/100g

Coconut Oil: A “Health” Food?◦The plasma lipid raising potential of SFAs has been established in literature for decades (Keys et al, 1965) ( Castelli et al 1992) ( Hu et al. 2001) ◦BUT are SFA as detrimental to health as we once thought? ◦Recent meta analyses have found no

association between saturated fat consumption and heart disease (Siri Tarino et al. 2010; De Souza et al. 2015; Chowdhury et al. 2014)

VCO and Health ◦Powerful antimicrobial ◦Improving dementia◦Weight Loss ◦Increased thermogenesis

◦Cardiovascular system◦Effects on lipid panels

A Powerful AntimicrobialAntimicrobial properties of coconut oil come from lauric acid and monolaurin. ◦ Almost 50% of the fatty acids in coconut oil

is the 12-carbon Lauric Acid.◦ When coconut oil is enzymatically digested,

it also forms a monoglyceride called monolaurin◦ Lauric acid and monolaurin can kill

harmful pathogens like bacteria, viruses and fungi.

Coconut oil and oral health ◦ “Oil Pulling” ◦ Study showed significant decreases in

plaque and oral gingitis after 30 days (Peedikayil et. Al, 2015)

Coconut Oil & Dementia◦ Phenolic compounds and hormones

(cytokinins) found in coconut may assist in preventing the aggregation of amyloid-β peptide, potentially inhibiting a key step in the pathogenesis of AD (Fernando, 2015).

◦ Ketones “calming” brain◦MCFA are unique in that they are easily

absorbed and metabolized by the liver, and can be converted to ketones.

◦ Ketone bodies are an important alternative energy source in the brain, and may be beneficial to people developing or already with memory impairment, as in Alzheimer's disease. (Fernando, 2015).

Coconut Oil & Dementia ◦ Study 40 ml/day of extra virgin coconut oil/day

Alzheimer's Statistically significant improvement in cognitive status improving especially women's, those without diabetes mellitus type II, and severe patients(Hu Yang et al, 2015.)

◦ Conclusion: Although this seems like a promising therapy it is a relatively new area of research. More research is needed before claims can be made about coconut oil and dementia prevention/treatment.

Coconut Oil Increased Thermogenesis?

• MCT & Increased thermogenesis: The medium-chain triglycerides (MCTs) in coconut oil can increase energy expenditure compared to the same amount of calories from longer chain fats• Mean postprandial oxygen consumption was 12%

higher than basal after the MCT meal but was only 4% higher post LCT meal (De Jong, 1985).

• Studies show that post prandial thermogenesis is enhanced in both lean and obese subjects when LCTs in a mixed meal are replaced with MCTs (Scalifi, 1991).

Conclusion: The MCT oil in coconut oil may increase the thermic effect of food but this increase is likely too small to make a substantial difference in weight loss.

Research Supporting Beneficial Effects of VCO

◦May raise HDL, promote reduction in abdominal obesity ◦ Beneficial effect of virgin coconut oil in lowering lipid levels in serum

and tissues and LDL oxidation by physiological oxidants. This property of VCO may be attributed to the biologically active polyphenol components present in the oil (Nevin, 2004).

◦ It was observed that the nutritional treatment associated with extra virgin coconut oil consumption reduced the waist circumference and increased HDLC levels in patients with CAD (Cardoso, 2015).

◦Dietetic supplementation with coconut oil does not cause dyslipidemia and seems to promote a reduction in abdominal obesity (Assuncao, 2009).

◦ Coconut oil even though rich in saturated fatty acids in comparison to sunflower oil when used as cooking oil media over a period of 2 years did not change the lipid-related cardiovascular risk factors and events in those receiving standard medical care (Vijayakumar, 2016)

Meta Analysis: Effects VCO on Lipid Panels◦Meta Analysis Report Coconut Oil + Lipid Profiles (Eyres et al,

2016). ◦ Coconut oil generally raised total and low-density

lipoprotein cholesterol to a greater extent than cis unsaturated plant oils, but to a lesser extent than butter.

◦ The effect of coconut consumption on the ratio of total cholesterol to high-density lipoprotein cholesterol was often not examined.

◦Observational evidence suggests that consumption of coconut flesh or squeezed coconut in the context of traditional dietary patterns does not lead to adverse cardiovascular outcomes. However, due to large differences in dietary and lifestyle patterns, these findings cannot be applied to a typical Western diet.

Special Populations◦ Pukapukans and Tokelauans

◦ Diet rich in saturated fat- predominant source coconuts. Diets low in cholesterol and sucrose.

◦ Tokelauans 63% energy from coconut: Pukapukans 34% ◦ The serum cholesterol levels are 35 to 40 mg higher in

Tokelauans than in Pukapukans.◦ Vascular disease is uncommon in both populations and there

is no evidence of the high saturated fat intake having a harmful effect in these populations (Prior, 1981).

◦ Kitava, Papua New Guinea◦ Tubers, fruit, fish and coconut are dietary staples. ◦ No case corresponding to stroke, sudden death or angina pectoris was

described by the interviewed subjects. Stroke and ischaemic heart disease appear to be absent in this population (Lindeberg, 1993).

◦ Important to keep in mind how the western diet differs from this!

Recommendations • Bottom line: Research shows virgin coconut oil may

provide some health benefits however it is not a “superfood” food by any means! • Acceptable to include VCO in the diet among other

healthy oils• Discourage excessive use (eating spoonfuls, adding to

coffee/smoothies etc.)• It is essentially a pure fat void of micronutrients• It is calorically dense• Excessive consumption likely raises HDL and LDL

• More research is needed before we can can eliminate saturated fat as a nutrient of concern. <10% of calories.

• Cooking- heat stable • Ensure it is Virgin Coconut Oil!

References ◦ Lockyer S, Stanner S. Coconut oil - a nutty idea? Nutrition Bulletin. 2016;41(1):42–54.◦ Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fat, carbohydrate, and cardiovascular disease. American Journal of Clinical Nutrition.

2010;91(3):502–509.◦ de Souza RJ, Mente A, Maroleanu A, Cozma AI, Ha V, Kishibe T, Uleryk E, Budylowski P, Schünemann H, Beyene J, Anand SS. Intake of

saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: Systematic review and meta-analysis of observational studies. BMJ. 2015:h3978.

◦ Chowdhury R, Warnakula S, Kunutsor S, Crowe F, Ward HA, Johnson L, Franco OH, Butterworth AS, Forouhi NG, Thompson SG, Khaw K-T, Mozaffarian D, Danesh J, Di Angelantonio E. Association of dietary, circulating, and supplement fatty acids with coronary risk.Annals of Internal Medicine. 2014;160(6):398–406.

◦ Kabara JJ, Swieczkowski DM, Conley AJ, Truant JP. Fatty acids and derivatives as Antimicrobial agents. Antimicrobial Agents and Chemotherapy. 1972;2(1):23–28.

◦ 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):384–387.

◦ Peedikayil F, Sreenivasan P, Narayanan A. Effect of coconut oil in plaque related gingivitis - A preliminary report. Nigerian Medical Journal. 2015;56(2):141.

◦ Fernando WMADB, Martins IJ, Goozee KG, Brennan CS, Jayasena V, Martins RN. The role of dietary coconut for the prevention and treatment of Alzheimer’s disease: Potential mechanisms of action.British Journal of Nutrition. 2015;114(01):1–14.

◦ Fernando WMADB, Martins IJ, Goozee KG, Brennan CS, Jayasena V, Martins RN. The role of dietary coconut for the prevention and treatment of Alzheimer’s disease: Potential mechanisms of action.British Journal of Nutrition. 2015;114(01):1–14.

References ◦ Hu Yang I, De La Rubia Orti J. Coconut Oil: Non-Alternative Drug Treatment Against Alzheimer’s Disease. Nutricion Hospitalaria. 2015;32(6):2822–2827.◦ de Jong AJL, Hopman WPM, Jansen JBMJ, Lamers CBHW. Effect of medium-chain triglycerides and long-chain triglycerides on plasma pancreatic polypeptide

secretion in man. Regulatory Peptides. 1985;11(1):77–81.◦ Scalifi L, Coltorti A. Postprandial thermogenesis in lean and obese subjects after meals supplemented with medium-chain and long-chain

triglycerides. American Journal of Clinical Nutrition. 1991;53(5):1130–1133.◦ Assunção ML, Ferreira HS, dos Santos AF, Cabral CR, Florêncio TMMT. Effects of dietary coconut oil on the biochemical and Anthropometric profiles of

women presenting abdominal obesity. Lipids. 2009;44(7):593–601.◦ Nevin KG, Rajamohan T. Beneficial effects of virgin coconut oil on lipid parameters and in vitro LDL oxidation. Clinical Biochemistry. 2004;37(9):830–835.◦ Vijayakumar M, Vasudevan DM, Sundaram KR, Krishnan S, Vaidyanathan K, Nandakumar S, Chandrasekhar R, Mathew N. A randomized study of coconut oil

versus sunflower oil on cardiovascular risk factors in patients with stable coronary heart disease.  Indian Heart Journal. 2016.◦ Eyres L, Eyres MF, Chisholm A, Brown RC. Coconut oil consumption and cardiovascular risk factors in humans. Nutrition Reviews. 2016;74(4):267–280.◦ Prior A, Davidson F, Salmound C, Czochanska Z. Cholesterol, coconuts, and diet on Polynesian atolls: a natural experiment: the Pukapuka and Tokelau

island studies. American Journal of Clinical Nutrition. 1981;34(8):1552–1561.◦ Lindeberg S, Lundh B. Apparent absence of stroke and ischaemic heart disease in a traditional Melanesian island: A clinical study in Kitava.  Journal of

Internal Medicine. 1993;233(3):269–275.◦ Images:◦ Freedigitalphotos.net ◦ http://www.tokelau.com/◦ http://coconutoil.com/coconut-oil-offers-hope-for-antibiotic-resistant-germs/: Imagw◦ http://www.healthlifesecret.com/node?page=1