Cholesterol and Coconut Oil

High cholesterol, high blood pressure and cardiovascular disease run in my family.  Both my mother and father have had coronary artery bypass operations as did my paternal grandfather.  Being interested in health and knowing my predisposition, I have followed my cardiovascular risk markers with interest.  I believe that improper diet and inadequate exercise play a significant part in the development of heart disease as well as in cancer, type 2 diabetes and many other diseases.

This year, my fiftieth year on the planet, I checked in with blood pressure 110/70, an unremarkable echocardiogram, and total cholesterol at 201 (just a point above the desirable range).  However, a closer look at the cholesterol readings showed that my HDL, the cholesterol that has the beneficial role of acting like a scavenger in the body, was off the chart at 75.  The standard range for HDL is 40 to 59 mg/dl. It was my elevated HDL level that actually put my total cholesterol slightly over range.

My first question was – what does it mean to have HDL way above normal?  Naturally, I did a Google search.  What I found was when HDL is higher than normal it is actually considered protective.  My risk for cardiovascular disease was actually lowered!  (Trumpets sound here!)  All the energy I devote to living a simple, healthy lifestyle paying off.

I then began to wonder – what caused my increase in HDL?  When searching on that question I bumped right into the answer:  Coconut Oil.  Researchers have found that coconut oil consumption is associated with higher levels of total cholesterol and HDL.  (2011)

Every morning for breakfast I have a cup of germinated brown rice with some type of legume dish, typically chili or lentil soup. For years, I adorned the rice with Spike (a salt seasoning blend) and about 1 to 2 teaspoons of flaxseed, hempseed, or other oil high in essential fatty acids.  Then I discovered coconut oil.  It has such a lovely flavor that I started using it on my rice.

Now one of the things about me, the thing that makes my experiment with right diet for a healthy heart so daring, is that I don’t buy into the mainstream ideas.  For instance, when they said eggs were bad for my heart, since they were high in cholesterol, I defied the mainstream ideas and had two or three a day.  When people were switching over to margarine, I was still eating salted butter (I like it plain…).  They think salt raises blood pressure?  Great, I eat as much of it as I can.

Now “they” were saying coconut oil was good for my heart because it increased HDL.  My reaction?  I immediately cut back and started eating more flaxseed oil again.

Yes, I understand that HDL is associated with lower cardiovascular risk, but that is HDL that is naturally high.  My HDL was being artificially elevated by increased intake of coconut oil.  This doesn’t mean that it is beneficial.  It also doesn’t mean it is not beneficial.

This is the mistake people made with eggs.  They thought “eggs have cholesterol,”  then, “Cholesterol is bad” and finally decided “eggs are bad”.  I knew coconut oil raised HDL and I suspected that it has a place in my healthy diet, but I wanted to see some direct evidence about whether it was really beneficial.

To achieve my objective I had to move away from the mainstream news and information websites and into PubMed for primary literature.  I wanted to read, first hand, what scientists had found.

The first thing I discovered was that a 2009 research study reporting on the effects of dietary coconut oil consumption in women with belly fat was being misrepresented by some major health information websites.  The study showed after 12 weeks women that added coconut oil (vs soybean oil) to their diet had a significant reduction in waist circumference.

The first misquote I found said the reduction was after only one week. However, the biggest issue I have was that the reduction was not “real world” significant.  The women using soybean oil (2 Tablespoons (30ml) a day) had a drop of 0.6 centimeter (about a quarter inch) while the women using coconut oil dropped 1.4 cm (just over half an inch).  We are talking about a 1/4 inch difference (technically it would be 5/16ths of an inch) between the two groups. Anybody out their measure their waist lately?  I would say the error in measurements would be greater than a quarter inch!

Next study I looked at was from 2012.  Nice research that investigated what happens to atherosclerotic plaques when people living in Kerala, India switch from the coconut oil they’ve used all their lives to sunflower oil because they have cardiovascular disease.  Well designed study –  but the fact they found 71 people that had used coconut oil all their lives and were undergoing coronary artery bypasses suggests that coconut oil is not a miracle cure nor a miracle prevention for heart disease.

Their results?  The switch to sunflower oil for at least a year didn’t change the composition of the plaques at all.  Here we have a situation where the details of the study are more interesting than the results.  It is interesting to me that the researcher found a population of long term coconut oil users with heart disease. In addition, many of the participants had diabetes and hypertension as well as coronary artery disease.

The last study I looked at was perhaps the most negative regarding coconut oils benefits.  Completed in 2006, it revealed that six hours after a meal (carrot cake and a milkshake made with about two ounces of oil) HDL from people ingesting coconut oil made the cells that line blood vessels more inflammatory than the HDL from safflower eating people.

There were some limitations to the study design and other researcher have published comments suggesting that the differences observed were due to safflower oil having a greater concentration of Vitamin E rather than the fact it is a polyunsaturated oil.  Christopher Masterjohn says,

Compared to coconut oil.. safflower oil contains 77 times the alpha-tocopherol, more than 100 times the gammatocopherol, and 73 times the total tocopherol.

This suggests if you normalize for vitamin E there may have been no difference between coconut oil and safflower oil.  In other words:  their results are inconclusive.

All this said, I’m still looking for evidence regarding the benefits of coconut oil in cardiovascular disease.  In the meantime, it is remains a tasty addition to my morning rice on occasion.

Asia Pac J Clin Nutr. 2011;20(2):190-5.
Lipids (2009) 44-593-601
J Am Coll Nutr. 2012 Dec;31(6):392-6.
J Am Coll Cardiol. 2006 Aug 15;48(4):715-20. Epub 2006 Jul 24.
J Am Coll Cardiol. 2007 May 1;49(17):1825-6. Epub 2007 Apr 16.


Cholesterol is a lipid molecule with the following structure: structure of cholesterol

Steroid hormones (estrogen, progesterone, aldosterone, testosterone, etc) are made of cholesterol.  It is a component of every cell wall in the body.  As such it is essential for normal body functioning.

HDL (high density lipoprotein) and LDL (low density lipoprotein) cholesterol are not actually cholesterol.  There is only one type of cholesterol (structure above), but the way cholesterol travels in the blood varies.  Cholesterol cannot easily float around in the blood since fat does not mix readily with water.  In order to move around the blood, fats come together as droplets and associate with proteins.  This is the general structure:

HDLThe protein is called a lipoprotein because it is a protein associated with lipids (lipo).  Lipoproteins in the “fat droplet” can have different structures.  The different structures are genetically determined and certain structures are associated with cardiovascular disease.

What is the difference between HDL and LDL?  The fat composition of the “fat droplet” varies.  This figure gives a summary:

Cholesterol table comparisonChylomicrons are the form that fats take when traveling from the intestines to the liver.  They move via the lymph initially.  VLDL is the fat droplet that the liver creates to send fats to the tissues – in particular to the adipose (fat cells) for storage.  If you eat extra sugar your liver turns that into fatty acids and uses VLDL to transport them out into the body.  HDL is a form that is sent out to pick up fat from the tissues.  High levels of HDL are considered beneficial since these droplets are scavengers of cholesterol and fat in the body.  LDL transports extra lipids to the body tissues as well.

From the above descriptions it would follow that HDL would become LDL once it has picked up extra cholesterol and fatty acids.  Higher HDL levels in the blood indicates less extra cholesterol and fatty acids.