It’s not every day the American Heart Association (AHA) is challenged, especially when it comes to the basics of a heart-healthy diet. Yet, when then AHA reported last June that coconut oil is not a health food after all and can, in fact, raise your risk of cardiovascular disease, it created quite a stir, and a lot of conflicting and sometimes misleading headlines.
Now that a few months have passed since the great coconut oil debate of 2017 (or as some mused, “CoconutGate”), we think it’s important to reaffirm our position that, for most people, coconut oil is a welcome addition to a healthy diet. It also tastes and smells great, and has rightfully earned its reputation as a good source of saturated fat.
The fervor began this past June when an AHA science advisory board recommended replacing saturated fats with polyunsaturated fats, after analyzing more than 100 studies over the past 60 years. The report was not designed to attack coconut oil but to address the role of a healthy diet in helping to manage cholesterol levels, and even reduce the use of cholesterol-lowering statin drugs.
The report recommended replacing coconut oil, butter and other saturated fats—known to raise LDL, or “bad,” cholesterol—with healthier, polyunsaturated fats. Its authors suggested that cutting out saturated fats could help to lower cardiovascular disease risk as much as statins do.
This was not breaking news. Keeping an eye on the fats you eat is an integral component of a healthy lifestyle. However, this was not the whole story. In the report, the AHA described an association between eating more saturated fats (such as coconut oil) and increasing cholesterol. It did not go on to cite a single study that concluded that coconut oil causes heart disease. Let’s dig a little deeper.
The AHA report addresses the role of fats in raising or lowering cholesterol, but what does that mean? A basic lipid panel measures total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. While this is vital health information, it is not always the best predictor of heart disease. This is why, as functional medicine practitioners, we often recommend that our patients have more advanced lipid testing.
We understand that total cholesterol is not the end-all predictor of cardiovascular risk. You may have a high total number, for example, because you also have high HDL, or “good,” cholesterol. Exercise, for example, can increase your HDL. Being in top physical shape is certainly not a risk factor for heart disease.
LDL can increase plaque in your arteries, while HDL can help to remove LDL. While it’s helpful to think of LDL as “bad” and HDL as “good,” these broad, oversimplified terms offer only a snapshot of a more complex issue.
LDL (low-density lipoprotein) is called “bad” cholesterol because it is believed to cause plaque to build up in the arteries (thus reducing the flow of blood to the heart), yet this is only part of the story. LDL comes in various shapes and sizes. It is the small, dense particles that are more likely to cause inflammation and disease.
HDL (high-density lipoprotein) cholesterol is called “good” cholesterol because it helps to take cholesterol out of the blood, not giving it a chance to build up and block coronary arteries.
Triglycerides. Your body converts calories it doesn’t need into a kind of fat or lipid called triglycerides. Excess calories, alcohol and sugar are converted into triglycerides and stored in fat cells throughout your body. Triglycerides provide your body with energy. However, high triglycerides (hypertriglyceridemia) can be a risk factor of many diseases and dysfunctions, including heart disease, stroke and type 2 diabetes.
Total Cholesterol measures both good and bad cholesterol.
Total Cholesterol to HDL Ratio is considered a better measure of your risk of heart disease and stroke because it takes into account the effect a high HDL level has on total cholesterol.
Not all saturated fats are created equal. They are classified based on the length of a carbon atom found within them as either short-chain fatty acids (SCFA), medium-chain fatty acids (MCFA) or long-chain fatty acids (LCFA). How does this chemistry lesson translate into your daily diet?
Medium-chain triglycerides (MCTs), which are derived from coconut oil, palm oil and dairy fat, get absorbed right from your gut to your liver, so they are not stored as fat. Their unique chemical structure means that they increase energy and metabolism, decrease appetite and reduce inflammation. It also makes them easier to digest than many other foods.
There are many studies that show little to no difference in cardiovascular risk in people who eat diets high in saturated fats versus low in saturated fats. Many leading scientists and physicians affirm that cholesterol is not nearly the indicator of heart disease risk as previously reported. There are many other contributing factors that need to be considered, such as an inflammatory diet, exposure to toxins and daily stress. Functional medicine practitioners seek to find the underlying causes of disease and dysfunction, and they are not quick to make recommendations without first looking at the whole person.
Individuals with high cholesterol should confer with their healthcare practitioner to determine their own best food choices, including how much, if any, coconut oil is best for them. There is no one-size-fits-all approach to healthcare.
It is always wise to consult with your healthcare professional about what is best for you.
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