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Coconut Products - Are They Safe?

Over the past few years, there has been a resurgence of coconut oil, coconut milk and coconut water. Is there research to support the addition of coconut to our diets?

Coconut Oil

We know that coconut oil is high in saturated fat at 92%. Coconut oil is primarily made up of lauric acid (12:0), myristic acid (14:0) and palmitic acid (16:0). But another important description is the length of the fatty acid chain. Coconut oil is considered a medium chain triglyceride (MCT). MCTs are fatty acids that contain 6 to 12 carbon fatty acids. They are rapidly absorbed in the intestine and transported to the liver and rapidly used for energy.1 Because of the rapid absorption, fats from MCT show improved insulin metabolism, decreased adiposity, and decrease in insulin resistance. This is compared to long chain fatty acids (LCFAs), which are commonly used in the American diet. LCFAs are metabolized slower and contribute to glucose disturbances and promote insulin resistance.2 This may be the information that some people have focused on to claim that coconut oil is good for us. 

However, Eyres et al. identified 8 clinical trials and 13 observational studies through 2015 that primarily looked at the effect of coconut oil compared to another fat on serum lipids. Given the limitations of the research due to small sample sizes and insufficient dietary information, the studies primarily found that coconut oil raised cholesterol when compared to mono- or polyunsaturated plant oils. There were no studies showing cardiovascular disease outcomes.3 Additionally, the National Lipid Association (NLA) found research to show increase in total cholesterol, LDL-C and HDL-C. So because coconut oil is high in saturated fat and increases LDL-C, without further research showing its effects on cardiovascular outcomes, it is not recommended by guidelines.4 At this time, there is inconclusive evidence of harm or benefit from coconut oil and further studies are needed. The American Heart Association (AHA), the American College of Cardiology (ACC) and the NLA recommend limiting the intake of saturated fat to <7% of total daily calories.5

Coconut Milk

There have been numerous articles promoting coconut milk for its nutritional value and enhanced flavor in food preparation and drinks, but there are few scientific studies to show the effect of coconut milk on cardiovascular disease risk factors. We do know that coconut milk is high in saturated fat with 43 grams of saturated fat and 445 calories per cup.6 The AHA, ACC, NLA all recommend reducing saturated fat to less than 7% of total daily calories to reduce cardiovascular risk.

Coconut Water

What about coconut water? Coconut water is derived from young green coconuts.  The content of the coconut water includes sugars, vitamins, minerals, amino acids and phytohormones. It does not contain fat.7 There are no studies looking at the effect on cardiovascular disease risk, but as with all foods, the caloric content and purity of the product should be considered. Each cup (eight ounces) of coconut water contains 50 calories. There are many varieties; choose plain coconut water without added juice or sugar.8
So, the national recommendations remain the same: foods high in saturated fat should be avoided if possible and, if consumed, limited to <7% of the daily intake. Coconut water is different. It does not have saturated fat, but the sugar content and caloric content should be considered and limit the total consumption as you would any sugary drink.

References

  1. Bolick J P, Rasmussen H. Coconut Oil Supplementation and Lipids.  LipidSpin volume 14, issue 3, May 2016.
  2. Montgomery MK, Osborne B, Brown S H J, et al.  Contrasting metabolic effects of medium-versus long-chain fatty acids in skeletal muscle. Journ Lipid Research. 2013 Dec; 54(12):3322-3333.
  3. Eyres L, Eyres M F, Chisholm A, Brown R C.  Coconut oil consumption and cardiovascular risk factors in humans.  Nutrition Reviews 2016; vol. 74(4):267-280
  4. Jacobson T A, Maki K C, Orringer C E, et al.  National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2.  Journ of Clin Lipidology 2015 (9),S1-S122
  5. Freeman A M, Morris P B, Barnard N, et al. Trending Cardiovascular Nutrition Controversies.  JACC 2017. Vol. 69 no.9; 1172-1187.
  6. https://books.google.com/books?id=GcgLBwAAQBAJ&pg=PA118&lpg=PA118&dq=american+dietetic+association+nutritional+information+on+coconut+milk&source=bl&ots=aXN4QIakNT&sig=2Hpm_Uyosf3TSNHeW2zQLLvMmi4&hl=en&sa=X&ved=0ahUKEwiMqYuMienSAhXIxYMKHVeQC_84ChDoAQhqMAk#v=onepage&q=american%20dietetic%20association%20nutritional%20information%20on%20coconut%20milk&f=false (American Dietetic Association) – Accessed 3/23/17
  7. Yong J W H, Ge L, Ng Y F, Tan S N.  The Chemical Composition and Biological Properties of Coconut (Cocos nucifera L.) Water.  Molecules 2009, 14, 5144-5164.
  8. https://www.pritikin.com/your-health/healthy-living/eating-right/1795-is-coconut-water-good-for-you.html – Accessed 3/23/17