Coconut oil: As “Bad” as pure poison or as “Good” as next to mother’s milk

By Devesh Tewari*

Contribution participating in the INPST 2018 Science Communication Awards contest.

The recent talk of Prof. Karin Michels on coconut oil titled “Coconut oil and other nutritional errors” ignited a global concern and a significant hype in all major media newsrooms of the globe. The Harvard Professor of epidemiology declared coconut oil as a “pure poison” and “one of the worst foods you can eat.”. Her statement was based on the presence of saturated fats in coconut oil which are associated with cardiovascular diseases. However, there are reliable reports of epidemiologists which contradict these statements. A meta-analysis published in the Annals of Internal Medicine led by the University of Cambridge analyzed the intake of fatty acids and coronary risk, and their study did not support a restriction of the consumption of saturated fats to prevent heart diseases [1].

Mythology and historical attributes

In India, coconut (Cocos nucifera L.) oil is used since ancient times not only as a cooking oil but also under different forms and applications like for the instant relief of burns, as a lubricant, to promote hair growth, for body massage of infants and so on. The use of coconut is not limited to various internal and external applications, but it is also used widely in many rituals of Hindu mythology.

The coconut fruit is known as “Srifala” in Sanskrit, which means that it is a fruit of God; moreover, this fruit is widely used to symbolize God in various rituals and no Hindu ritual completes without the coconut fruit. Apart from that, the coconut fruit symbolizes the human brain as it is covered with fibers (similar to hair) and possesses a hardcover that resembles the skull. Inside, the water is comparable to the blood (although this is not scientific, if one wants to explain the basic anatomy of the head to a child, the structure of a coconut can be used). The fruit of coconut is broken before the initiation of a new project which is a mythological way to pay gratitude to God and showing that one is destroying his/her ego. Coconut is one of the plants identified as ‘Kalpavriksha’ that means a “wish-fulfilling divine tree.”

In Sanskrit, a synonym of coconut is Trayambak (त्रयम्बक (Trayambak)=त्रि (Tri) (three)+अम्बक (Ambak) (eyes)) which is also a name of Lord Shiva. This is due to the presence of three eye-like structure of the coconut fruit. Even Charles Darwin praised this tree, and when he reached Keeling or Cocos Island, he wrote that coconut was the main crop of the island and the whole prosperity of the region was dependent on coconut trees. He not only stopped here, but he also told that the coconut oil and nut was exported from the island to other neighboring countries where they were used in making curries and other purposes. Additionally, he mentioned, “the crab begins by tearing the husk, fiber by fiber, and always from that end under which the three eye-holes are situated” [2].

In Ayurveda (Ancient traditional Indian system of medicine), the coconut tree has its distinct reputation. It is stated in Ayurveda that the coconut fruit protects its sweet and nutritious water inside itself. This is highly useful for Human and therefore the tree’s benevolence must be praised. Coconut is also utilized in the preparation of a variety of traditional foods which are also mentioned in Ayurvedic dietetics [3].

Coconut oil: the scientific perspective

The relation of fat and cardiovascular diseases was always a matter of controversy. It is a general perception that high cholesterol levels are dangerous for the cardiovascular system. However, there is evidence that women over the age of 60 with the highest levels of cholesterol lived longest [4]. Moreover, the same study also revealed that the death rate was five times higher for women with very low levels of cholesterol. Coconut oil mostly consists of medium chain fatty acids, lauric acid, and capric acid. It is well known that lauric acid is converted to monolaurin inside the human body which is the fat of the mother’s milk with the highest quality [5,6].

Various scientific studies revealed the potential benefits of coconut oil in different disease conditions. Results showed the improvement of the quality of life in breast cancer patients after consumption of virgin coconut oil during chemotherapy [7]. A recent study showed that virgin coconut oil is excellent for skin health and its use in the dermal formulations should be promoted. The oil was found to possess anti-inflammatory and skin protective effect by suppression of inflammatory markers and augmenting skin barrier function [8].

In India, the state of Kerala is one of the major producer and consumer of coconut oil and other coconut products. It was postulated during the late 1990s that an increased cardiovascular risk in Kerala was associated with the consumption of coconut oil, but studies confirmed that there was no specific relationship between the consumption of coconut oil and coronary heart diseases [9]. Nevertheless, it is another fact that the life expectancy in Kerala is highest among other states of India, although various other factors are also associated with higher life expectancy.

An interesting study that was also contrary to the expectations of the authors showed that polyunsaturated fatty acid (PUFA)-rich soybean oil was more diabetogenic and obesogenic than coconut oil [10]. Moreover, scientists advocating in favor of coconut oil like Dr. Conrado S. Dayrit stated that “no evidence has ever been presented to prove that coconut oil causes coronary heart disease in humans” [11]. Not many clinical studies are reported about this topic, but a recent clinical study published in British Medical Journal revealed that there was a significant increase in low density lipoprotein (LDL)-C concentrations after butter consumption compared to coconut oil and olive oil. It is also notable that coconut oil significantly increased HDL-C levels compared with butter or olive oil [12]. Though the authors did not recommend changing the dietary requirements for saturated fats, they still highlighted the importance for more comprehensive studies to thoroughly understand the correlation between the dietary fat and health.

Is coconut oil next to mother’s milk?

It is exciting to note that the monolaurins in mother’s milk that are critical for the development of the immune system of the infant are also naturally present in coconut oil. The renowned cardiologist and eminent scientist Prof. B. M. Hegde compared coconut oil (in baby food) as the best alternative to the mother’s milk when mother’s milk is not available, and he also stated that other fats might be dangerous [6]. Although I was unable to find out a clinical study on consumption of coconut oil by infants, it was interesting to see that topical application of coconut oil can improve the skin condition of preterm infants without adverse effects [13]. Moreover, a letter-to-the-editor entitled “Infant feeding formulas using coconut oil and the medium chain triglycerides” advocated that saturated fats are not so-called “bad fats” [14] and it is rather favorable to the use of coconut in infants (though proper scientific studies are required for such purposes). Other studies about coconut oil massage in neonates demonstrated significantly superior weight gain velocity when compared to mineral oil and placebo. A more important length gain velocity compared to placebo was also recorded in preterm infants receiving coconut oil massage [15]. Another clinical study showed that in mild to moderate xerosis, coconut oil was as effective and safe as mineral oil when applied as a therapeutic moisturizer [16]. In a recent study, the virgin coconut oil was studied to observe its acute effects on cardiometabolic risk markers and energy metabolism in women with excessive body fat. The results of the study showed that a reasonable amount of coconut oil did not affect fat oxidation rates, cardiometabolic risk markers and energy metabolism. The authors also recommended caution while prescription of coconut oil as an adjuvant in weight loss programs [17]. Another open-label randomized control crossover clinical trial done on 35 healthy people from Thailand showed that 30 ml of virgin coconut oil significantly increased the level of HDL without major safety issues after 8 weeks [18].

Altogether, additional scientific and clinical studies are required to accurately establish the correlation between fats and cardiovascular diseases in general and for coconut oil in particular. Still, the scientific evidence, traditional uses, and consumption of coconut oil since ancient times maybe not enough to say claim that coconut oil is as beneficial as mother’s milk, but it seems there is sufficient evidence to refute that coconut oil is as bad as a “poison.”

References

1. Chowdhury, R., Warnakula, S., Kunutsor, S., Crowe, F., Ward, H.A., Johnson, L., Franco, O.H., Butterworth, A.S., Forouhi, N.G., Thompson, S.G., et al.. Association of dietary, circulating, and supplement fatty acids with coronary risk: A systematic review and meta-analysis. Ann. Intern. Med. 2014 Mar; 18; 160(6): 398-406. 
2. Harries, H.C. The Coconut Palm, the Robber Crab, and Charles Darwin: April fool or a curious case of instinct. Principes. 1983; 27(3): 131–137.
3. Sarkar, P., Lohith, K.D.H., Dhumal, C., Panigrahi, S.S., and Choudhary, R. Traditional and ayurvedic foods of Indian origin. J. Ethn. Foods. 2015 Sep; 2(3): 97-109.
4. Forette, B., Tortrat, D., and Wolmark, Y. Cholesterol as risk factor for mortality in elderly women. Lancet. 1989 Apr; 22; 1(8643): 868-70.
5. Halden, W., and Lieb, H. The influence of biologically improved coconut oil products on the blood cholesterol values of human volunteers. Nutr. Dieta. 1961; 3:75-88.
6. Hegde, B.M. Coconut oil–ideal fat next only to mother’s milk (scanning coconut’s horoscope). Journal, Indian Acad. Clin. Med. 2006, 7 (1): 16-19.
7. Law, K.S., Azman, N., Omar, E.A., Musa, M.Y., Yusoff, N.M., Sulaiman, S.A., and Hussain, N.H.N. The effects of virgin coconut oil (VCO) as supplementation on quality of life (QOL) among breast cancer patients. Lipids Health Dis. 2014 Aug; 27;13:139. 
8. Varma, S.R., Sivaprakasam, T.O., Arumugam, I., Dilip, N., Raghuraman, M., Pavan, K.B., Rafiq, M., and Paramesh, R. In vitro anti-inflammatory and skin protective properties of Virgin coconut oil. J. Tradit. Complement. Med. 2018 Jan; In press doi.org/10.1016/j.jtcme.2017.06.012 .
9. Kumar, P.D. The Role of Coconut and Coconut Oil in Coronary Heart Disease in Kerala, South India. Trop. Doct. 1997 Oct; 27(4): 215-7.
10. Deol, P., Evans, J.R., Dhahbi, J., Chellappa, K., Han, D.S., Spindler, S., and Sladek, F.M. Soybean oil is more obesogenic and diabetogenic than coconut oil and fructose in mouse: Potential role for the liver. PLoS One. 2015 Jul; 22; 10(7): e0132672.
11. Dayrit, C.S. Coconut oil in health and disease: its and monolaurin’s potential as cure for HIV/AIDS. Indian Coconut Journal-Cochin. 2000; 31: 19–24.
12. Khaw, K.-T., Sharp, S.J., Finikarides, L., Afzal, I., Lentjes, M., Luben, R., and Forouhi, N.G. 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: e020167.
13. Strunk, T., Pupala, S., Hibbert, J., Doherty, D., and Patole, S. Topical Coconut Oil in Very Preterm Infants: An Open-Label Randomised Controlled Trial. Neonatology. 2018; 113(2):146-151.
14. Blackburn, G.L., and Babayan, V.K. Infant feeding formulas using coconut oil and the medium chain triglycerides. J. Am. Coll. Nutr. 1989 Jun; 8(3): 253-4.
15. Sankaranarayanan, K., Mondkar, J., Chauhan, M., Mascarenhas, B., Mainkar, A., and Salvi, R. Oil massage in neonates: An open randomized controlled study of coconut versus mineral oil. Indian Pediatr. 2005 Sep; 42(9): 877-84.
16. Agero, A.L.C., and Verallo-Rowell, V.M. A randomized double-blind controlled trial comparing extra virgin coconut oil with mineral oil as a moisturizer for mild to moderate xerosis. Dermatitis. 2004 Sep;15(3):109-16.
17. Valente, F.X., Cândido, F.G., Lopes. L.L., Dias, D.M., Carvalho, S.D., Pereira, P.F., Bressan, J. Effects of coconut oil consumption on energy metabolism, cardiometabolic risk markers, and appetitive responses in women with excess body fat. European J Nutr. 2018 Jun 1; 57(4):1627-37.
18. Chinwong, S., Chinwong, D., Mangklabruks, A. Daily consumption of virgin coconut oil increases high-density lipoprotein cholesterol levels in healthy volunteers: a randomized crossover trial.  Evid. Based Complement Alternat. Med. 2017; 7251562.

*Dr. Devesh Tewari is affiliated with the Department of Pharmaceutical Sciences, Faculty of Technology, Kumaun University Nainital, Uttarakhand, India

Image:  Coconut and coconut oil (photo by Himanshu Joshi)

Keywords: cardiometabolic risk, monolaurin, lauric acid, Coconut oil As “Bad” as pure poison or as “Good” as next to mother’s milk, virgin coconut oil, coconut oil consumption, Ayurveda, heart diseases, saturated fats, cardiovascular diseases.

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