is coconut oil healthy?

Is coconut oil healthy? Should I put coconut oil in my coffee? What's the deal with coconut oil anyways???

I've been fielding questions about coconut oil for a long time. And rightly so, it's confusing! Coconut oil was totally fat-shamed in the 90's for being super high in saturated fat - about 82% of the fat in coconut oil is saturated. Over the last several years, however, coconut oil broke free from the nutritional naughty corner and catapulted to celebrity super-food status with people baking with it, making "healthy" treats with it, straight up eating spoonfuls of the stuff, and even stirring it into coffee.

But, when things seem too good to be true they usually are. Last month, the American Heart Association released an advisory on dietary fats and cardiovascular disease, which, among other things, called out coconut oil as being unhealthy and specifically advised against its use.

In the weeks since this review paper was published the internet has been in an uproar, mostly in the natural health community. I wanted to better understand what all of the hubbub was about before I weighed in, so I downloaded the full review and spent some time sifting through the document. Here is the statement that's causing all the fuss:

 Because coconut oil increases LDL cholesterol, a cause of CVD, and has no known offsetting favorable effects, we advise against the use of coconut oil.

Let's back up a bit.

Like I said, coconut oil was considered unhealthy due to its saturated fat content. Saturated fat - a fat in which all of the carbons in its chain have a hydrogen atom attached (therefore being saturated with hydrogen) have long been associated with poor cardiovascular health. A very, very simplified explanation goes something along these lines: there are two main types of blood cholesterol; low density lipoprotein (LDL), which is the "bad" cholesterol, and high density lipoprotein (HDL) which is the "good" cholesterol. A diet high in saturated fat from red meat, butter, lard, palm oil, and coconut oil is known to raise LDL cholesterol levels, which in turn causes fatty buildup in the arteries (atherosclerosis) that can lead to heart attack, angina, and stroke.

HDL cholesterol has been referred to "good" cholesterol because it acts as a sort of scavenger, carrying LDL cholesterol away from the arteries and towards the liver where it is broken down. But recent research is suggesting that changes in HDL cholesterol, either by diet or drug treatment, can no longer be directly linked to changes in cardiovascular disease. So when determining whether or not a food is heart healthy, what we really need to consider is whether or not it raises LDL cholesterol.

A review paper such as this one is created to summarize current knowledge on a topic. The researchers collect recent research papers and discuss the findings presented in order to better understand the subject. In the review by the American Heart Association, seven controlled clinical trials were referenced that compared coconut oil with monounsaturated (such as olive and avocado oils) and polyunsaturated (such as safflower and sunflower) oils. In all seven of these trials, coconut oil raised LDL cholesterol, significantly in 6 of them. And these aren't rinkey dink studies; they're citing research programs such as the Framingham Heart Study, which follows thousands of people over many decades.

From this work, we now know that coconut oil raises both HDL and LDL cholesterol, and that we can no longer rely on the benefit of HDL cholesterol to balance things out. Thus, coconut oil raises LDL cholesterol and the recommendation is to avoid it.

So why are people freaking out? I think this sums it up nicely:

 A recent survey reported that 72% of the American public rated coconut oil as a “healthy food” compared with 37% of nutritionists.  This disconnect between lay and expert opinion can be attributed to the marketing of coconut oil in the popular press.

Is that not completely bonkers?!

Bonkers, yes, but not at all surprising. And it completely mirrors my experience both online (in my private Facebook feed) and in real life. We live in an age of internet nutritionism where everyone is an expert and the actual experts are regarded with a side-eyed distrust. As I've said before, the nutrition pendulum has a tendency to swing. Nutrition research is incredibly complex, always changing. It's also at times unreliable due to research funding, conflicts of interest, the fact that people lie on nutrition surveys. And a lot of nutrition research is conducted on animals like mice, but mice are not people. So nutrition is complicated, even for the experts, and ever changing, which is I think where this distrust tends to come from.

In the 10 years I spent working on two nutrition degrees, the single most important thing I learned was critical thinking.  So when I look at this "new" information on coconut oil, my opinion is this: In the end this review doesn't really change much in terms of nutrition advice. It's not like the American Heart Association was telling folks to eat gobs of coconut oil and they're suddenly back pedalling.

Is coconut oil going to kill you? I think not. But nor do I think you should be eating great scoops of the stuff. If you like the taste of coconut oil, great. Consider it a treat and consume it in moderation.

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