On the 15th of June the American Heart Association (AHA) released a study that was apparently designed to address confusion around the relationship between dietary saturated fat and risk of cardiovascular disease. The review is free and pretty easy to read, so you should check it out. But the conclusions that have been made from it are not as easily digestible.
The media frenzy around this and the assumptions made from the study would almost be laughable were it not such an important topic. So I’d like to suggest we all take a deep breath before I take you through some important points to consider in the whole debate.
1. Coconut oil was not actually in the study
The publication is a meta-analysis of four different studies. The authors gathered the data of the studies and then analysed them together. So while the study looked at saturated fat, it had nothing to do with the main component of coconut oil: which is the incredibly high levels of the immune boosting lauric acid that it contains in abundance. It must also be noted the chosen 4 studies were cherry picked from numerous other studies that are arguably more stringent and thorough.
The studies in the new AHA publication had all the patients replace animal fats in their diet with polyunsaturated fats, mainly from soybean oil. They recorded a drop in coronary heart disease in the groups that made the switch compared to the control groups. One could pick apart their statistical analysis or their research methods (some of the studies were far from double-blind) but as far as coconut oil goes, that is not even necessary. Plainly put, coconut oil was not a part of the study at all.
2. Fat is not just fat and not all saturated fats are made equal
Even dividing fat into saturated and unsaturated fat is not enough to truly understand it. So, let’s break it down. There are essentially three types of fat: saturated, unsaturated, and trans fats. All fats are made of fatty acids (which are carbon-hydrogen chains), which are then further categorised by how long they are (based on the number of carbons) and whether or not these chains contain double bonds. Whether a fatty acid chain has more or less than 12 carbons is really important, because the body finds it easier to absorb short- and medium-chain fatty acids. Their smaller chain lengths allow them to bypass the fat storage pathway and, as a result, they are sent directly to the liver to rapidly become energy for the brain and muscles.
The types of fatty acids that one finds in saturated fats are stearic acid, lauric acid, myristic acid and palmitic acid. Coconut oil is rich in lauric acid, a medium-chain saturated fatty acid with 12 carbons. Stearic acid and lauric acid have been shown to be beneficial to the body, whereas myristic acid and palmitic acid (found in meat, dairy and processed foods) are potentially harmful contributing to inflammation and elevated lipid level.
MCFA’s, like the lauric acid, are a fantastic source of sustained energy that the body will prefer to use and so wont convert them into body fat. The advantage of this is that there is no energy slump from the consumption of coconut oil, as they do not trigger an insulin response (unlike carbohydrates) as well as that it can potentially aid with weight loss by stimulating thermogenic activity similar to that of green tea. The particular irony here is that these MCFA’s are well known for their benefit to the cardiovascular system, and are able to prevent atherosclerosis (hardening and narrowing of the artery wall) and reduce platelet aggregation (which can cause heart attacks and blood clots). MCFA’s have also been shown to lower bad cholesterol but we will get onto that later.
So while coconut oil was not part of the study at all, neither was the fatty acid makeup of saturated fats considered in the study – and as you can see this is an incredible oversight in the bigger picture of heart health.
The bottom line is that there is benefit to eating the right kind of saturated fat, as saturated fats are needed by the body for the health of every cell membrane.
(Incidentally it is also the unique abundance of lauric acid that has made coconut oil stand out. Lauric acid has proven immune boosting qualities and the only other place it can be found in such abundance is mother’s breastmilk.)
3. Cholesterol is sorely misunderstood
The studies don’t link eating more saturated fat to heart disease — they link it to changing cholesterol metric. A very complicated metric indeed because one piece of the hype that has not been addressed is the vital role that cholesterol plays in cellular structure. It is an essential building block of the lipid bilayer of the cell membrane. In fact, so essential that if our bodies are not getting adequate amounts from our diets, it will actually make cholesterol from carbon, hydrogen and oxygen. cholesterol and heart attack or stroke risk.
Dr Lori Shemeck from the Huffington Post puts this into a great metaphor, “Cholesterol is not the cause of heart disease, it is the band-aid that tries to repair the arteries when damage occurs from a diet high in sugar, white flour products and most packaged, fast processed foods. You can look at cholesterol as an association much the same way you would look at a firefighter at the scene of a fire – there to do its job of putting out the fire and saving our lives. The same is true for cholesterol.”
The point is that you don’t want to limit the cholesterol quantity in your body, due to its vital function, instead you want to ensure that you have good quality cholesterol circulating in your blood… And this is the thing. There are two main types of cholesterol – LDL (“lousy”) cholesterol, and HDL (“healthy”) cholesterol and quality varies within these two types.
While, saturated fat in the diet has been shown to increase your LDL numbers, it also increases the quality of your LDL molecules. On the other hand refined carbohydrates have been shown to decrease the quality of LDL molecules, turning them into “free radical” molecules that can damage the body.
The bottom line is that quantity is not an indication for heart disease, rather LDL quality is an indication for heart disease, which is why many doctors (and for instance the USDA) recommend a diet that is low in refined carbohydrates and added sugars, and higher in fat, including saturated fat.
Clearly this issue is a lot more complex than one blanket statement announcing that “high cholesterol = heart disease.”
4. Be weary of the alternatives being recommended and why they are
Firstly, remember that the American Heart Association are the group that recommended margarine as the healthy choice over butter for decades. (Their tails are now firmly behind their legs on this one, with even the FDA moving to ban the use of partially hydrogenated oils in 2018) Secondly, the scientific research that they do is funded by companies and organisations who have financial interests in the outcome of the study. There simply is not enough money coming from organizations that do not have a vested interest in the outcome. Vani Hari (the Food Babe) has also done some investigating (a really great article to ready by the way) on the authors of the recent AHA study on coconut oil. She found that several of them are sponsored by nonprofit organisations that have financial interests in the sales of certain vegetable oils and fats. (In fact I would also highly recommend that you read this great article from Get Better Wellness on the poor dietary advice that we have historically received from the AHA)
As for the actual recommendation from this study, that one should choose polyunsaturated vegetable oils (like soy, canola and corn) over saturated fats, please exercise some caution.
While olive oil (a monounsaturated fat) is well researched and is known for its powerful protective effects on the cardiovascular system many other vegetable oils are generally highly processed and are often inflammatory and therefore should be consumed very minimally. They should not be used for cooking at high temperatures as they are less stable than say coconut oil and Ghee and are easily oxidised.
In fact canola and soy oils can be the byproduct of extensive factory processing techniques and as a result contain fewer nutrients due to this chemical processing.
5. Health should always be thought of in the broader context
The overall effect of any one food type on our health is dependent on the diet and lifestyle practices of an individual. So it is best not to view a single food or macronutrient independently of the overall diet within which it is being consumed.
A massive piece of this study that is ignored, is that there is no real evidence that shows that saturated fat increases the likelihood of heart disease. But we do know for instance that inflammation is a possible culprit for heart disease and there are a variety of factors in our diet that could lead to this. Bad cholesterol as described above, is also a possible culprit and so the list goes on.
There are countless populations of people in the pacific who have been eating coconut oil as a significant part of their diet for thousands of years with little incidence of heart disease or diabetes. What needs to be taken into consideration is their whole diet and lifestyle however – the same with those groups of people used in this study.
So remember to always think of health in a more holistic sense. Focusing only on one piece of the nutritive puzzle can be harmful since we lose sight of the bigger picture. It is more worthwhile to pay attention to your overall lifestyle and dietary patterns than to focus on whether one food or one nutrient is better for you than another. The golden rule of nutrition is to eat a whole foods diet that is full and balanced with a variety of minerals, vitamins and fats and to keep it all in moderation. Eating coconut oil in the context of a diet rich in whole foods will have a different overall effect than eating coconut oil in the context of the Standard American Diet (SAD) which is rich in processed sugar and flours.
And don’t forgot that the benefits of coconut oil can used in a variety of ways. It’s antibacterial, antioxidant, hydrating and anti-inflammatory properties can be found in coconut based soaps and lotions too.