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The Impact of Virgin Coconut Oil and High-Oleic Safflower Oil on Body Composition, Lipids, and Inflammatory Markers in Postmenopausal Women

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This randomized crossover study compared the impact of virgin coconut oil (VCO) to safflower oil (SO) on body composition and cardiovascular risk factors. Twelve postmenopausal women (58.8 ± 3.7 year) consumed 30 mL VCO or SO for 28 days, with a 28-day washout. Anthropometrics included body weight and hip and waist circumference. Fat percent for total body, android and gynoid, fat mass, and lean mass were measured using dual-energy X-ray absorptiometry. Women maintained their typical diet recording 28 days of food records during the study. Results were analyzed with SPSS v24 with significance at P ≤ .05. Comparisons are reported as paired t-test since no intervention sequence effect was observed. VCO significantly raised total cholesterol, TC (+18.2 ± 22.8 mg/dL), low-density lipoprotein (+13.5 ± 16.0 mg/dL), and high-density lipoprotein, HDL (+6.6 ± 7.5 mg/dL). SO did not significantly change lipid values. TC and HDL were significantly different between test oils. The TC/HDL ratio change showed a neutral effect of both VCO and SO. One person had adverse reactions to VCO and increased inflammation. VCO decreased IL-1β for each person who had a detected sample. The impact of VCO and SO on other cytokines varied on an individual basis. This was the first study evaluating the impact of VCO on body composition in Caucasian postmenopausal women living in the United States. Results are suggestive that individuals wishing to use coconut oil in their diets can do so safely, but more studies need to be conducted with larger sample sizes, diverse populations, and more specific clinical markers such as particle size.
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The Impact of Virgin Coconut Oil and High-Oleic Safflower Oil
on Body Composition, Lipids, and Inflammatory
Markers in Postmenopausal Women
Margaret Harris, Andrea Hutchins, and Lisa Fryda
Department of Health Sciences, University of Colorado Colorado Springs, Colorado Springs, Colorado, USA.
ABSTRACT This randomized crossover study compared the impact of virgin coconut oil (VCO) to safflower oil (SO) on
body composition and cardiovascular risk factors. Twelve postmenopausal women (58.8 3.7 year) consumed 30 mL VCO or
SO for 28 days, with a 28-day washout. Anthropometrics included body weight and hip and waist circumference. Fat percent
for total body, android and gynoid, fat mass, and lean mass were measured using dual-energy X-ray absorptiometry. Women
maintained their typical diet recording 28 days of food records during the study. Results were analyzed with SPSS v24 with
significance at P£.05. Comparisons are reported as paired t-test since no intervention sequence effect was observed. VCO
significantly raised total cholesterol, TC (+18.2 22.8 mg/dL), low-density lipoprotein (+13.5 16.0 mg/dL), and high-density
lipoprotein, HDL (+6.6 7.5 mg/dL). SO did not significantly change lipid values. TC and HDL were significantly different
between test oils. The TC/HDL ratio change showed a neutral effect of both VCO and SO. One person had adverse reactions
to VCO and increased inflammation. VCO decreased IL-1bfor each person who had a detected sample. The impact of VCO
and SO on other cytokines varied on an individual basis. This was the first study evaluating the impact of VCO on body
composition in Caucasian postmenopausal women living in the United States. Results are suggestive that individuals wishing
to use coconut oil in their diets can do so safely, but more studies need to be conducted with larger sample sizes, diverse
populations, and more specific clinical markers such as particle size.
KEYWORDS: adiposity cholesterol cytokines fatty acid
INTRODUCTION
Consumption of coconut oil has increased over the
years. In 2015, between January and November, exports
from the Philippines increased by 61%.
1
Virgin coconut oil
(VCO) has garnered public and scientific attention as a potential
‘‘superfood’’ due to its high phytochemical content, particularly
of phenolic compounds.
2,3
Research supports the benefit of
VCO for a variety of conditions, including supporting weight
loss,
4,5
fighting infection,
6
improving the cardiovascular disease
risk profile (or maintaining its neutrality),
4,7–9
and even less-
ening the decline in neurodegenerative disorders.
10,11
Nevertheless, confusion about VCO continues because it is
a highly saturated fat (93%) food. While researchers have
suggested that saturated fat may not be detrimental for
health,
12,13
the most recent 2015 Dietary Guidelines for
Americans still suggest limiting saturated fats, including
tropical oils.
14
VCO is a unique saturated fat because it is rich
(65%) in short and medium chain fatty acids that metabolize
rapidly without depositing in arteries and fat cells.
8,15,16
The
most substantial medium-chain fatty acid, lauric acid, has
antimicrobial, antifungal, and antiviral properties giving a
unique benefit to VCO compared to other oils.
6,15
The ques-
tion remains what impact the resulting 35% long-chained fats
would have on health outcomes.
Although the evidence pointing to the benefits of VCO is
increasing, few human studies exist exploring VCO’s impact
on measurable health outcomes. The most recent review on
VCO and heart disease highlights the need for more studies.
17
Most studies that highlighted beneficial impacts of VCO were
in vitro animal studies that used medium-chain triglycerides
(MCTs) or were conducted in Pacific Islander/Asian popu-
lations. The human data in existence are not generalizable to
most Western societies due to different diets, lifestyles, and
genetic predispositions.
The purpose of this study was to compare the health im-
pacts of VCO to ‘‘heart healthy’’ safflower oil (SO) in post-
menopausal women living in the Rocky Mountain region of
the United States. To our knowledge, this is the first study to
examine VCO in an older U.S. population.
MATERIALS AND METHODS
Study design and participants
This study was approved by the Institutional Review
Board at the University of Colorado Colorado Springs.
Manuscript received 19 July 2016. Revision accepted 22 January 2017.
Address correspondence to: Margaret Harris, PhD, MS, HC, Department of Health
Sciences, University of Colorado Colorado Springs, 1420 Austin Bluffs Parkway, Col-
orado Springs, CO 80918, USA, E-mail: mharris5@uccs.edu
JOURNAL OF MEDICINAL FOOD
J Med Food 20 (4) 2017, 345–351
#Mary Ann Liebert, Inc., and Korean Society of Food Science and Nutrition
DOI: 10.1089/jmf.2016.0114
345
Fourteen women were recruited from the Colorado Springs
community through fliers, email blasts, and word of mouth.
Of these 14 women, 12 completed the study. One woman
dropped out during the first month due to loss of the oils
while travelling and the second dropped out due to enroll-
ment in another study before the beginning of the first
testing phase of this study.
Inclusion criteria included the following: (1) postmeno-
pausal women between the age of 45–65, (2) not taking any
hormone replacement therapy, (3) not taking medication or
supplements that could alter lipids, (4) normal fasting lipid
levels (total cholesterol [TC] <240 mg/dL at screening), and
(5) willing to ingest two tablespoons of VCO and SO each
day for two nonconsecutive 28-day periods.
This randomized, crossover clinical trial included two 28-
day dietary supplementation interventions consisting of daily
ingestion of either two tablespoons (30mL) of VCO or SO
distributed throughout the day. Testing was done in 1 day and
women were selected into alternating oil intervention groups
based on their arrival times. Participants were instructed to
add oils to already-prepared foods as a topping, into
smoothies, or to make dressings out of them. Participants
were instructed not to cook with the oils to avoid chemical
breakdown; however, upon evaluation of dietary records,
participants did lightly saute
´their food when using VCO.
Each subject received 28 plastic containers with premeasured
doses of the designated oil in each container. They were in-
structed to ingest one container per day throughout the sup-
plementation period and return all containers (used and
unused) at the next measurement period. Participants were
instructed to continue their normal diet and exercise routine
throughout both supplementation periods as well as the 30-
day washout period to replicate normal living conditions.
Origin and composition of oil supplements
The intervention oils were Organic VCO (Tropical Tra-
ditions, Gold Label, West Bend, WI) and Organic High Heat
SO (Spectrum; The Hain Celestial Group, Inc., Boulder,
CO). The VCO was made in the Philippines from USDA
certified organic coconuts using the traditional fermented
method. Shredded coconut meat is added to water from in-
side the coconut to make coconut milk. After sitting for
about 12 h, the oil naturally separates from the heavier wa-
ter. The oil is heated for a short time and filtered from the
curds. Each oil was measured by weight (1 oz/30 mL/2 Tbs)
using an electronic kitchen scale (Salter Model 3001) and
packaged in individual portions. Oil composition was tested
at the UCCS Department of Chemistry laboratory.
Anthropometric evaluation
Measurements were collected before and after each sup-
plementation period. Body mass was measured using a Tanita
BF679W scale to the nearest 10th of a ounce. Height was
measured using a stadiometer at commencement of the study.
Body mass index was calculated by dividing the body mass (kg)
by the square of the height (meters). Hip and waist circum-
ference were measured with a standard tape measure to the
nearest quarter of an inch and converted to centimeters. Waist
was measured at the smallest circumference and hip at the
widest circumference. Dual-energy X-ray absorptiometry
(DXA) scans were completed at the beginning and conclusion
of each testing period to determine percent body fat and dis-
tribution. Two participants declined to be measured by DXA.
Dietary evaluation
Upon commencement into the study, participants were
shown how to complete a detailed food journal. Participants
completed four food records during a 2-week wash-in period
before starting the first intervention. During each interven-
tion and the washout period, participants recorded all food
consumed for eight assigned days per month (about 2 days
each week) for a total of 28 food journals. Data were entered
and analyzed using Food Processor Software (ESHA Re-
search, Salem, OR).
Biochemical evaluation
Blood samples for the measurement of cytokines and
cholesterol concentrations were collected before and after
supplementation of VCO and SO. Blood was taken in the
morning following a 12-h overnight fast.
Blood samples were collected in 4 mL ESTA and 7.5 mL
serum separator tubes for cholesterol and cytokine evalua-
tion, respectively. Samples were immediately spun in a
centrifuge for 20 min, aliquoted, and frozen to -80C.
Cholesterol (high-density lipoprotein [HDL], low-density
lipoprotein [LDL], triglycerides, and TC) was measured
using a Beckman Coulter AU400 Chemistry analyzer. In-
flammatory markers (TNF-a, IL-1b, IL-10, and IL-6) were
measured using a high sensitivity multiplex kit by Randox.
All biochemical data were processed at the Colorado Clin-
ical and Translational Sciences Institute (CCTSI: Denver,
CO; CCTSI is supported, in part, by Colorado CTSA Grant
UL1 TR001082 from NIH/NCATS).
Statistical analysis
Data were analyzed using SPSS (Version 24; IBM, Ar-
monk, New York) to determine normal distributions of
continuous variables (visually and Shapiro–Wilk’s test),
descriptive statistics, and repeated-measures mixed model
ANOVA using sequence of oil intervention as a covariate.
The intervention sequence was not determined to be sig-
nificant. Therefore, paired t-tests were conducted to deter-
mine difference before and after oil supplementation on the
following: weight, waist circumference, hip circumference,
total fat%, android fat%, gynoid fat%, android-to-gynoid
ratio, fat mass, lean mass, and bloodwork. Differences from
premeasures and postmeasures were calculated and paired t-
tests were used to compare difference between oils. Sig-
nificance was set to P£.05.
Surveys
Before supplementation, all participants completed a medical
history survey and a demographic survey. Upon completing
346 HARRIS ET AL.
each supplementation period, a short survey was completed
regarding experiences with ingesting the oils.
RESULTS
Twelve women successfully completed the study. One
woman completed a total of about 2 weeks of the coconut
protocol after suspicion that she was having an intolerance
to the oil. Complaints included a scratchy throat and feelings
of being unhealthy. After stopping the oil, her symptoms
disappeared. She restarted the oils in the fourth week and
symptoms returned. Upon closer inspection, all her inflam-
matory markers were elevated after coconut oil consump-
tion markedly more than other subjects (Subject 1). One
subject completed the coconut oil protocol for 3 weeks, due
to a work-related trip. Other participants successfully used
all oils as instructed. Excluding these two women from
analyses did not change findings; however, they were ex-
cluded from group analyses to provide more reliable data.
The composition of the oils is presented in Table 1. As
expected, VCO was rich in short- and medium-chain fatty
acids, together comprising about 70% of the oil. SO nor-
mally has the highest linoleic acid content of any vegetable
oil in the market. However, due to recent changes in the
market, this type of oil is difficult to find. We used an oil that
is typical of what is found on store shelves: high-oleic SO,
which is hybridized to withstand high-heat cooking. This oil
contained 80% oleic acid.
The energy and macronutrient contents of the diet are
presented in Table 2. Since one of the purposes of the study
was to test the feasibility of consuming 30 mL of oil, diet
was not altered. An objective was to observe the impact of
the oils in a way that people would normally consume the
oils, within their own regular diets, and whether the oils
impacted their dietary intake. Variations in consumption
were due to illness and vacation. Results showed that wo-
men ingesting coconut oil ate 318 kcal more per day
(P=.05) and had significantly more protein consumption.
Descriptive characteristics at baseline are presented in
Table 3. Data not shown in the table include age and general
lifestyle characteristics. Women on average were 57.8 3.7
years old. There was a wide variation in exercise habits and
intensity with women reporting about 229.1 224.2 min per
week of exercise (33% light activity, 42% moderate activity,
and 25% intense activity). Women tended to be light drinkers
consuming predominantly wine on an occasional to weekly
basis (66%). Only one woman reported heavy drinking. Four
women took daily medications (blood pressure and SSRI
antidepressants). All women consumed dietary supplements.
These consisted of vitamin/mineral supplements or bone
support supplements such as glucosamine, chondroitin, or
calcium.
Neither oil affected anthropometry significantly (Table 4).
Although not statistically significant, the small increase in
lean mass after VCO consumption and decrease after SO may
be potentially clinically meaningful.
Table 5 shows results of lipid changes after oil inter-
ventions. Results show that VCO significantly raised TC,
LDL, and HDL (P<.05), while decreased TG (P=NS).
Conversely, SO decreased TC, LDL, and HDL and in-
creased TG, but changes were not significant. The ratio of
TC to HDL showed no changes to risk profile with either oil,
while the TG/HDL showed a small improvement after VCO
and small worsening after SO.
Figure 1 presents results of inflammatory markers IL-1b,
TNF-a, and IL-6 as well as the anti-inflammatory marker IL-
10. These markers were not detected in some samples. Due to
the small numbers available, results are presented individually
by subject number and only those results where we had
markers detected are shown. Subject 1 (intolerant reaction to
Table 1. Fatty Acid Composition of Virgin Coconut
and High-Oleic Safflower Oils
Fatty acid
Virgin coconut
oil (%)
High oleic
safflower oil (%)
Caproic acid C6:0 0.676
Caprylic acid C8:0 9.037
Capric acid C10:0 5.961
Lauric acid C12:0 54.293
Myristic acid C14:0 19.016
Palmitic acid C16:0 6.461 4.559
Stearic acid C18:0 1.263 1.896
Oleic acid C18:1 3.023 80.210
Linoleic acid C18:2 0.270 13.335
Samples were analyzed by GC/MS using a Hewlett Packard 6890 Series II
Gas Chromatograph with 5973 Mass Selective Detector.
Table 2. Dietary Data at Baseline and Pre and Post Virgin Coconut Oil and Safflower Oil
Baseline
Virgin coconut oil Safflower oil
Pre Post DPre Post D
Calories, kcal 1648 625 1603 639 1966 553 318
a
1769 550 1784 336 40
Protein, g 83 61 83 62 96 62 12
a,b
69 15 68 18 -1
Carbohydrate, g 193 107 194 104 214 82 13 204 76 192 35 -7
Fat, g 72 32 77 30 96 26 16 68 21 78 21 10
DChange calculated as postintervention minus preintervention.
a
Statistically significant (P£.05) between pre and post oil, paired t-test.
b
Statistically significant (P£.05) between the change of VCO compared to SO, paired sample t-test.
COCONUT OIL AND CARDIOVASCULAR RISK FACTORS 347
VCO) showed dramatically increased inflammation after co-
conut oil. IL-1b, aside from Subject 1, showed varying levels
of decreased inflammation after coconut oil consumption in
every subject. TNF-alpha and IL-6 showed variability of in-
flammation with some women showing decreased inflamma-
tion, while others showed increased inflammation on each oil.
IL-10, an anti-inflammatory cytokine, revealed small, but
mostly inconsequential, variability.
DISCUSSION
The results of this study show that VCO contributes
negligible changes to body composition and the cardiovas-
cular risk profile in Caucasian postmenopausal women liv-
ing in the United States. Previous studies reported that VCO
decreased waist circumference in both men and women.
Many of these studies used MCT oil making the comparison
irrelevant.
18,19
Of the studies using VCO as an intervention,
VCO contributed to smaller waist circumferences and
weight loss in three studies.
4,5,20
In this study, participants
consumed an extra 318 kcal on average when consuming the
VCO, offsetting any weight loss that may have occurred had
caloric intake stayed the same in both oils. Despite reporting
they felt ‘‘fuller’’ quicker with VCO, participants reported
adding VCO to more smoothies with whey protein (re-
placement of breakfast drinks) and to meat-based dishes
(predominantly eggs at breakfast and meat at dinner). When
consuming SO, women tended to add the oil to salad
dressings (at dinner) and oatmeal (at breakfast) due to ease
of working with the flavor and textures of the oils. Although
small and not statistically significant, VCO also slightly
increased lean mass by +0.4%, while SO decreased lean
mass by -0.3%. This may be clinically meaningful in the
postmenopausal years, particularly if the addition of weight
training regimen is added. In light of the excess calories
consumed with no changes in body composition, combined
with the well-known impact of VCO on faster energy ex-
penditure, using VCO can potentially contribute to weight
maintenance/loss efforts.
Animal models have suggested that using coconut oil as a
fat source in the diet may increase lipolysis and decrease
lipogenesis in the liver as well as other tissues.
21–23
Mice fed
coconut oil plus conjugated linoleic acid (CLA) experienced
a more rapid onset of lipolysis and decreased lipogenesis
compared to mice fed a soy oil/CLA combination.
22
Deol
et al. reported that mice fed coconut oil instead of a soy/
coconut oil combination had less adiposity, including less
fat accumulation in the liver.
23
The increased oxidation of
fatty acids and decreased lipogenesis may be mediated, in
part, by coconut oil influencing the PPARa-dependent
pathways.
21
However, to date, these findings have not been
explored in humans.
VCO significantly raised TC, LDL, and HDL, while
safflower decreased all lipids, but not significantly. The
total/HDL and TG/HDL ratios have been suggested to be
good predictors of cardiovascular risk in addition to
Table 3. Baseline Characteristics of Nonsmoking
Postmenopausal Women
Characteristic at baseline Mean SD
Anthropometrics
Height (m) 1.6 0.1
Weight (kg) 68.3 10.9
BMI (kg/m
2
) 26.4 4.4
Waist circumference (cm) 85.6 13.2
Hip circumference (cm) 103.4 7.4
Total fat% (DXA) 37.2 5.8
Android fat% (DXA) 39.5 8.7
Gynoid fat% (DXA) 41.3 4.4
Fat mass (kg) 25.4 8.3
Lean mass (kg) 41.4 4.6
Cytokines
TNF-a(pg/mL) 1.80 0.57
IL-1b(pg/mL) 1.24 0.52
IL-6 (pg/mL) 0.810.68
IL-10 (pg/mL) 0.36 0.08
Lipids
Total cholesterol (mg/dL) 223.10 35.10
LDL (mg/dL) 128.70 26.13
HDL (mg/dL) 64.10 17.36
Triglycerides (mg/dL) 105.20 66.15
BMI, body mass index; DXA, dual-energy X-ray absorptiometry; HDL,
high-density lipoprotein; LDL, low-density lipoprotein.
Table 4. Effect of Virgin Coconut Oil and Safflower Oil on Anthropometrics
Virgin coconut oil
D
Safflower oil
DPre (mean SD) Post (mean SD) Pre (mean SD) Post (mean SD)
Anthropometrics
Weight (kg) 68.4 11.0 68.9 11.4 0.5 68.9 11.4 68.9 11.7 0.0
Waist (cm) 85.1 12.7 85.5 11.0 -0.4 86.2 13.6 87.1 11.9 0.9
Hip (cm) 103.6 7.5 103.1 7.8 -0.5 102.5 7.9 102.1 7.6 -0.4
Total fat (%) 37.2 5.8 37.5 5.4 0.3 37.3 5.4 37.6 6.0 0.3
Android fat (%) 36.8 8.9 37.8 8.5 1.0 36.7 8.9 37.6 9.5 0.9
Gynoid fat (%) 41.4 4.3 41.6 4.4 0.2 41.8 4.3 41.9 4.8 0.1
Android/gynoid 0.93 0.25 0.95 0.25 0.02 0.92 0.25 0.94 0.25 0.02
Fat mass (kg) 25.3 8.3 25.7 8.0 0.3 25.6 8.3 25.9 8.9 0.3
Lean mass (kg) 41.4 4.4 41.5 4.7 0.4 41.6 5.1 41.3 4.5 -0.3
DChange calculated as postintervention minus preintervention, rounded to nearest 10th decimal. No statistical significance (P£.05).
348 HARRIS ET AL.
individual lipid values.
24–26
In this study, women had a
relatively low risk of cardiovascular disease based on the
Total/HDL ratio, which also remained unchanged in both oil
interventions. More notably, TG’s and TG/HDL ratio im-
proved with VCO (bringing it down to optimal levels of 2.0
or less), but worsened with SO. Although LDL increased
with VCO and decreased with SO, this value was offset by
the increases and decreases in HDL with VCO and SO,
respectively. Results on lipids have been mixed in other
studies. While all human studies examined show significant
increases in HDL (including in coronary artery disease pa-
tients),
4,5,7,20,27
only one study showed a neutral impact on
LDL
5
and others showed an elevation.
4,7,20,27
While an el-
evated LDL may be concerning, numerous animal studies
show that VCO lowers oxidation and inflammation, ex-
plained by the increases in antioxidant status.
28–34
Several
studies show that fat increases LDL particle size from small
oxidizable phenotype B to a less atherogenic large pheno-
type A, although these diets were also lower in carbohy-
drates.
35–37
The effect of diet on LDL alone is insufficient
evidence for an increased cardiovascular risk.
38
There are no
human studies conducted examining oxidation or particle
size after VCO consumption. However, Voon et al. com-
pared olive, palm, and VCO and found no differences in
thrombogenicity and cell adhesion between the oils.
9
Other
studies found lowered Lp(a) after VCO intervention.
27,39
Palazhy et al. found no difference in plaque concentrations
between sunflower oil and VCO.
16
These findings suggest
that labeling VCO as atherogenic may be premature.
This was the first study to examine inflammatory markers
in a U.S. population on VCO. Of note, Subject #1, who
displayed sensitivity to VCO, also had every cytokine in-
crease, indicating inflammation. Of the VCO results, all
participants showed a lowering, to various degrees, of IL-
1b, a marker associated with neurodegenerative disease. To
our knowledge, this is the first human American study to
Table 5. Effect of Virgin Coconut Oil and Safflower Oil on Lipids
Virgin coconut oil Safflower oil
Pre Post DPre Post D
Total cholesterol (mg/dL) 219.6 32.6 237.8 24.1 18.20
a,b
222.8 26.7 219.3 22.8 -3.50
LDL (mg/dL) 124.0 24.7 137.50 27.2 13.50
a,b
130.7 25.6 126.8 25.7 -3.90
HDL (mg/dL) 63.9 16.2 70.5 18.8 6.60
a,b
63.2 14.7 62.9 14.5 -0.30
Total cholesterol/HDL 3.7 1.1 3.7 1.3 -0.01 3.8 1.4 3.8 1.2 -0.06
Triglycerides (mg/dL) 117.2 97.7 107.5 80.6 -9.70 110.3 64.4 118.3 112.7 8.00
TRG/HDL 2.5 3.7 2.1 3.9 -0.43 2.2 2.5 2.5 3.9 0.33
DChange calculated as postintervention minus preintervention.
a
Statistically significant (P£.05) between pre and post oil, paired t-test.
b
Statistically significant (P£.05) between the change of VCO compared to SO, paired sample t-test.
FIG. 1. Differences in inflammatory markers after VCO and SO by subject. VCO, virgin coconut oil; SO, safflower oil.
COCONUT OIL AND CARDIOVASCULAR RISK FACTORS 349
show IL-1bresults after VCO ingestion. A study in healthy
Malaysians indicated that VCO’s impact on IL-1bwas also
lowered after VCO, in addition to other cytokines.
27
TNF-a
and IL-6 are both master regulating cytokines for inflam-
mation. Both were fairly well detectable by testing proce-
dures, unlike IL10 (the anti-inflammatory cytokine). While
some participants showed a decreased inflammation with
VCO, others showed a small increase. In addition, the op-
posite effect was seen in each individual when consuming
SO (if VCO lowered these cytokines, SO increased them
and vice versa). Some possible explanations may include
epigenetic and dietary factors. More research needs to be
done to explore how diet quality in conjunction with VCO
use may impact inflammation (since inflammation is an
underlying cause of heart disease). Additive effects of other
lifestyle choices such as sleep and exercise should also be
explored against the use of VCO.
There were strengths and limitations of this study. One
limitation was the small sample size; however, the sample
was very homogenous, limited to postmenopausal Cauca-
sian women. A highly motivated population, a high rate of
compliance, randomization of the oils, and a crossover de-
sign were also strengths of the study. The fermented nature
of VCO used contains the highest amounts of antioxidants
compared to other methods of extraction.
3,40,41
Nonblinding,
however, was a limitation. The texture and strong scent of
VCO may have impacted how the oils were ingested, even
though women were asked not to alter diets. Previous human
studies using VCO also were unblinded and incorporated the
oils into subjects’ regular diets. A blinded trial using VCO is
difficult to conduct. To ingest 1 oz. of oil per day in sup-
plement form, a total of about 47 capsules would be required
per day, which is unfeasible for most people, especially for
an extended amount of time (personal communication with
Capsugel Company). It is possible to mask the oils in a
beverage or food with the use of thickeners and coconut oil
extract, but the feasibility would be very costly.
In summary, this study showed VCO had mostly neutral
effects on cardiovascular disease and body composition,
although more studies need to be performed, determining its
effects on oxidation and particle size in relation to dietary
factors. This was the first study done in a Caucasian U.S.
population examining inflammatory markers. VCO may be
anti-inflammatory for some people, but more research
should be done exploring epigenetic, dietary, and lifestyle
factors. We conclude that VCO is neutral and possibly
beneficial for some people, when incorporated into everyday
use. However, intolerance to VCO is possible and should be
monitored individually.
ACKNOWLEDGMENTS
This research was supported by The University of Color-
ado, Colorado Springs’ Committee on Creative and Research
Works Seed Grant Program. We would like to thank Tropical
Traditions for voluntarily donating the oils upon our inquiry
for pricing before the study. We kindly thank CCSTI for the
processing of our bloodwork (CCSTI is supported, in part, by
Colorado CTSA Grant UL1 TR001082 from NIH/NCATS)
and Dr. Janel Owens and Luis Lowe of the UCCS Chemistry
Department for oil chemistry testing. We would also like to
thank the graduate and undergraduate health promotion and
nutrition students for their volunteer contributions in help-
ing with the coordination and data entry activities throughout
this study.
AUTHOR DISCLOSURE STATEMENT
No competing financial interests exist.
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COCONUT OIL AND CARDIOVASCULAR RISK FACTORS 351
... In 50 contrast, no change in BMI, WHR, or FM % was found in a randomised single-blind controlled experiment in individuals with coronary artery disease randomly allocated to either coconut oil or sunflower oil (Vijayakumar et al., 2020;Swarnamali et al., 2021). As a result of the ongoing debate regarding the potential beneficial effects of coconut oil in weight management, with both beneficial (Dulloo et al., 1996;Liau et al., 2011;Vijayakumar, Vasudevan and Sundaram, 2016;Oliveira-de-Lira et al., 2018;Korrapati et al., 2019) and neutral effects (Frantz and Carey, 1961;Vijayakumar et al., 2016;Harris et al., 2017;Khaw et al., 2018;Vogel et al., 2020;Nikooei et al., 2021) on BW reduction from individual clinical trials, we carried out another systematic review and meta-analysis to identify the impact of coconut oil on anthropometric parameters compared to other oils and fats, with a feeding length more than one month. p=0.29 respectively) (Swarnamali et al., 2021). ...
... According to literature (Reiser et al., 1985), a duration of 3 weeks is sufficient to determine the impact of any diet containing test fat on lipid and lipoprotein levels in the blood. Considering previous studies regarding the impact of dietary fat/oil on blood lipid parameters, the following randomized clinical trials; (Khaw et al., 2018), (Cox et al., 1995), (Voon et al., 2011), and (Harris et al., 2017) had 4, 6, 5 and 4 weeks of feeding periods respectively while the following sequential feeding trials; , and (Cox et al., 1998) had 8, 5 and 6 weeks of feeding periods respectively. Therefore 8 weeks was considered as a sufficient intervention period to ensure the changes in lipid profile in our study with the different oils. ...
... This is similar to findings from 3 previous clinical trials by , 1992 and Heber et al. (Heber et al., 1992), although not in keeping with findings from the study by Voon et al. which showed no significant difference between the two oils in relation to TC (Voon et al., 2011). It is also noteworthy that the observed significant increase in TC after the coconut oil feeding period in the current study is consistent with the findings from numerous previous individual studies in which TC has been increased at the end of coconut oil treatment (Mendis et al., 2001b;Balick and Lee, 2005;Laurene et al., 2016;Harris et al., 2017;Maki et al., 2018). ...
... The studies were performed in Europe (n = 2), Asia (n = 3), New Zealand (n = 1), the United States of America (n = 7), and Brazil (n = 4). In four studies, coconut oil was compared predominantly to MUFAs (olive and canola) [39][40][41][42], in 11 studies predominantly to PUFAs (soybean, chia, safflower, sunflower, and corn) [16,17,26,[42][43][44][45][46][47][48][49], and in six studies predominantly to SFAs (lard, butter, and palm oil) [39,40,44,50,51], followed by comparisons with soybean oil + psyllium, transgenic soybean, hydrogenated soybean, and a placebo in one study each [18,26,45,50]. The amount of coconut oil consumed varied and is expressed differently among studies (Table 1): 12 to 30 ml of coconut oil/day (n = 5), as part of the amount of SFAs or total daily consumed fat (n = 1), a variation of 6 to 54.4 g/day (n = 5), or as part of the total caloric energy intake (15 to 21%) (n = 6). ...
... The amount of coconut oil consumed varied and is expressed differently among studies (Table 1): 12 to 30 ml of coconut oil/day (n = 5), as part of the amount of SFAs or total daily consumed fat (n = 1), a variation of 6 to 54.4 g/day (n = 5), or as part of the total caloric energy intake (15 to 21%) (n = 6). Seven studies included healthy individuals [18,26,39,45,48,50,51]; two included subjects with hypercholesterolemia [41,44]; four, with abdominal obesity, overweight, or obesity [16,42,43,49]; one, in postmenopausal women [46]; and one, individuals with CVD [17]. The key characteristics of all included studies are in Supplementary Tables S2, S3, S4, S5, S6 and summarized in Table 1. ...
... Additionally, two crossover studies found no differences between the consumption of coconut oil and other oils and fats on body weight [26,46]. ...
Article
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Background Despite having a 92% concentration of saturated fatty acid composition, leading to an apparently unfavorable lipid profile, body weight and glycemic effect, coconut oil is consumed worldwide. Thus, we conducted an updated systematic review and meta-analysis of randomized clinical trials (RCTs) to analyze the effect of coconut oil intake on different cardiometabolic outcomes. Methods We searched Medline, Embase, and LILACS for RCTs conducted prior to April 2022. We included RCTs that compared effects of coconut oil intake with other substances on anthropometric and metabolic profiles in adults published in all languages, and excluded non-randomized trials and short follow-up studies. Risk of bias was assessed with the RoB 2 tool and certainty of evidence with GRADE. Where possible, we performed meta-analyses using a random-effects model. Results We included seven studies in the meta-analysis ( n = 515; 50% females, follow up from 4 weeks to 2 years). The amount of coconut oil consumed varied and is expressed differently among studies: 12 to 30 ml of coconut oil/day ( n = 5), as part of the amount of SFAs or total daily consumed fat ( n = 1), a variation of 6 to 54.4 g/day ( n = 5), or as part of the total caloric energy intake (15 to 21%) ( n = 6). Coconut oil intake did not significantly decrease body weight (MD -0.24 kg, 95% CI -0.83 kg to 0.34 kg), waist circumference (MD -0.64 cm, 95% CI -1.69 cm to 0.41 cm), and % body fat (-0.10%, 95% CI -0.56% to 0.36%), low-density lipoprotein cholesterol (LDL-C) (MD -1.67 mg/dL, 95% CI -6.93 to 3.59 mg/dL), and triglyceride (TG) levels (MD -0.24 mg/dL, 95% CI -5.52 to 5.04 mg/dL). However, coconut oil intake was associated with a small increase in high-density lipoprotein cholesterol (HDL-C) (MD 3.28 mg/dL, 95% CI 0.66 to 5.90 mg/dL). Overall risk of bias was high, and certainty of evidence was very-low. Study limitations include the heterogeneity of intervention methods, in addition to small samples and short follow-ups, which undermine the effects of dietary intervention in metabolic parameters. Conclusions Coconut oil intake revealed no clinically relevant improvement in lipid profile and body composition compared to other oils/fats. Strategies to advise the public on the consumption of other oils, not coconut oil, due to proven cardiometabolic benefits should be implemented. Registration PROSPERO CRD42018081461.
... 54% masy [9]) przyczyniła się do wzrostu popularności tego oleju na całym świecie -szacuje się, że spożycie oleju kokosowego w Unii Europejskiej wynosi 1,3 kg na osobę rocznie [13]. Badania prowadzone wśród mieszkańców obszaru występowania palmy kokosowej [14][15][16] są cytowane jako potwierdzenie założeń o pozytywnym wpływie oleju kokosowego na niektóre parametry metaboliczne i stanowią punkt wyjścia do kolejnych badań [17][18][19][20][21]. Należy podkreślić, że spożycie oleju kokosowego jest jednym z wielu czynników mogących wpływać na ryzyko wystąpienia chorób sercowo-naczyniowych -istotny jest również ogólny schemat żywieniowy pacjentów. ...
... Niestety w badaniu zabrakło dokładnej informacji o sposobie żywienia pacjentów zarówno w trakcie pierwszego, jak i drugiego etapu badania -pacjenci stosowali własne diety z uwzględnieniem wskazówek otrzymanych przed rozpoczęciem projektu. Interesująca jest również charakterystyka deklarowanych jadłospisów -obie grupy spożywały średnio 1500-1600 kcal, co w przybliżeniu stanowiło 24% energii pochodzącej z białka, 55,5% z węglowodanów oraz 20,1% Porównanie działania oleju kokosowego z olejem szafranowym stanowiło również przedmiot badań, którymi objęto kobiety w okresie postmenopauzalnym [18]. Celem projektu było sprawdzenie różnic pomiędzy składem ciała, profilem lipidowym oraz markerami stanu zapalnego u pacjentek suplementujących jeden z dwóch wymienionych olejów roślinnych. ...
... Różnice w wyglądzie (stan skupienia oraz barwa) badanych olejów mogły wskazywać, na jakim etapie badania znajdują się pacjentki. Warto jednak podkreślić, że jest to jedno z nielicznych badań przeprowadzonych na kobietach rasy kaukaskiej [18]. ...
... Researchers have confirmed that there are significant benefits experienced by the intervention group (subjects who consume VCO as an intervention). Several studies on animals claimed that VCO has a valuable benefit on health such as lowering lipid and glucose levels, serving as anti-inflammation and analgesic agent, and increasing the effectiveness of hepatoprotective activity [5,8,10,11,12,13,14). ...
Article
Introduction: Acute coronary syndrome (ACS) is a leading cause of death in Malaysia and worldwide. Besides, teh current treatment which involves teh prescription of statins is found to TEMPhas several side TEMPeffects on ACS patients. Those side TEMPeffects TEMPhas guided teh author to introduce virgin coconut oil (VCO) as supplemental management of ACS. However, its benefits TEMPhas not been widely tested on humans. Methodology: dis study examines teh use of VCO among ACS patients via a crossover trial. It seeks to ascertain teh TEMPeffect of VCO on serum lipid profile and hs-CRP level among ACS patients. Result: VCO was found to be statistically significant in reducing serum lipid level and hs-CRP level (p<0.001). These findings measured from small to moderate Cohen’s d TEMPeffect size, thus proving teh results from dis study as statistically and clinically significant. Conclusion: These findings suggest dat dietary intake wif saturated fatty acid (C6 to C12) can improve health condition. Keywords: virgin coconut oil, acute coronary syndrome, saturated fatty acid, medium-chain triglycerides
... A randomized crossover study was carried out on 12 menopausal women who received 30ml of VCO or safflower oil (SO) for 28 days showed a significant rise TC and HDL levels in VCO receiving group as compared to SO without any adverse side effects (Harris M, 2017). ...
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Nowadays, we are bombarded on every step with numerous superfoods by salespeople, the media, magazines and social media, which attach them almost magical-like qualities for the human health. In Slovenia, one of such foods is currently also coconut oil, which is regarded by many as a superfood, while its regular consumption is associated with the prevention against numerous modern chronic diseases. Coconut oil is also associated with weight loss and an antimicrobial, anti-inflammatory and antiviral effect. The market offers various food preparations from coconut as a natural plant food, such as coconut flour, beverages, but�ter and virgin or refined oil. Numerous athletes, recreationists and enthusiasts of a healthy and active lifestyle use coconut oil as a part of a healthy diet. Due to non-transparent contradictory information on whether coconut oil is a healthy, “magical” or unhealthy food, the authors will present a relative scientific overview on studies of the influence of consuming coconut oil on the human health, especially in relation to cardiovascular health and the loss of excess weight. By doing so, we wish to increase the readers’ ability to make an informed choice about their eating behavior.
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Anaerobic digestion is one of the most sensitive wastewater treatment processes where a major component of organic matter such as carbohydrates, proteins, and lipids are degraded by the syntrophic correlation between anaerobic microorganisms. The anaerobic reactors in desiccated coconut processing plants are frequently subjected to lipid inhibition due to the presence of oily compounds consisting of high concentrations of medium-chain and long-chain fatty acids. Improper treatment leads to severe issues such as biomass washout, inefficient treatment, and reactor failures during anaerobic digestion. This review critically analyzes lipid inhibition mechanisms and controlling factors to overcome the inhibition during anaerobic digestion. The existing strategies provide positive outcomes to overcome lipid inhibition. However, the effectiveness of these strategies may change due to different process variations and environmental conditions. Therefore, more research should be further conducted to optimize these strategies to improve process stability, treatment efficiency, and economic viability of desiccated coconut wastewater treatment.
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Objective: This review was conducted with the objective to review most commonly used edible oils and fats in India, determine their effect on lipid profile and anthropometric parameters and study their association with the development of NCDs such as cardiovascular diseases and diabetes. Methods: A comprehensive literature search was conducted using a combination of search terms by two independent researchers using PubMed from 2010 to January 2019. Studies including adult population evaluating the effect of different vegetable oils and fats via both observational and experimental designs were included. Reviews of studies in similar area were also included. The searches were managed in Mendeley, and duplicate entries were removed. Titles and abstracts of retrieved articles were screened by two reviewers. A tailored data abstraction tool was used to record characteristics of included studies, such as location, outcomes assessed, findings and demographics, by the study authors. For quantitative studies, we recorded further data on the parameters compared and outcomes measured. Results: A total of 34 articles were reviewed. Vanaspati and ghee were the most commonly used fats/oils in the northern states of India whereas, a preference for groundnut oil has been noted in southern and western states. Coconut oil in all its forms including virgin and extra virgin was found to have an overall beneficial effect on anthropometric parameters with decrease in BMI, waist circumference, neck circumference and an increase in lean muscle mass. Coconut oil has been linked improved lipid profile. Similar effects have also been seen with the usage of sunflower oil ghee. Intake of >1.25 kg/month ghee along with <0.5 L/month mustard oil has been reported to cause decrease in total cholesterol. Coconut oil has also been shown to have a protective effect on cardiovascular health as reported by 15 studies. Consumption of olive oil credited to its anti-inflammatory effects has been associated with decreased risk for diabetes. Conclusions: With the emerging middle class and shifting demand towards packaged-food options, it is important that the impact of edible oils on health are understood well. Edible oils are only one important part of our diet. As public health nutrition professionals, it is also important to emphasise on choosing overall healthier diets.
Chapter
High-oleic (HO) oils are defined as edible oils that contain at least 70% oleic acid per serving. Oils that meet this definition include both trait-enhanced (i.e., high-oleic sunflower or soybean) and naturally occurring high-oleic acid variants (i.e., olive oil). This chapter reviews the health aspects of HO oils with an emphasis on cardiovascular risk factors because this has been the predominant focus of clinical research. Evidence from clinical trials shows that replacing saturated fat with HO oils lowers total cholesterol and low-density lipoprotein cholesterol in a dose-dependent manner. On the basis of the cholesterol-lowering effect, the US Food and Drug Administration approved a qualified health claim for HO oils related to coronary heart disease risk. Current research is examining oleic acid metabolites and their association with energy expenditure and fat metabolism. Overall, the evidence supports incorporating HO oils, as a replacement for saturated fat, into healthy dietary patterns for general health and cardiovascular disease risk reduction.
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Background and Aims The often-purported claim that coconut fat is beneficial for cardiovascular health was disputed in several recent meta-analyses. However, evidence on the effects of coconut fat intake on glycemic control remains equivocal. We conducted a systematic review and meta-analysis per the PRISMA guidelines to determine the effects of dietary coconut fats on markers of acute and long-term glycemic control. Methods and Results PubMed, Scopus, ProQuest, and Web-of-Science databases were searched and the records were screened by three independent reviewers to identify interventional studies examining acute and long-term (i.e., >10 days) effects of coconut fat on glycemic control. DerSimonian-Liard random-effects meta-analyses were performed using the meta package in R (4.0.2). Seven interventional studies on acute effects and 11 interventional studies on long-term effects of coconut fat were included. Meals with coconut fat acutely increased the incremental area under the curve (AUC) of glucose (p = 0.046) and decreased the incremental AUC of insulin (p = 0.037) vs. control meals. Long-term coconut fat intake increased HOMA-IR (p = 0.049), but did not significantly affect fasting glucose, insulin, or HOMA-β vs. control meals. Conclusions Coconut fat in meals seems to be associated with a diminished postprandial insulin response, resulting in a subtle increase in the postprandial glycemic response. Long-term intake of coconut fat seems to increase insulin resistance, yet does not seem to be beneficial for long-term glycemic control. Thus, our results disprove the popular claim that coconut fat improves glycemic control. Registration PROSPERO registry (CRD42020183450)
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Coconut oil is being heavily promoted as a healthy oil, with benefits that include support of heart health. To assess the merits of this claim, the literature on the effect of coconut consumption on cardiovascular risk factors and outcomes in humans was reviewed. Twenty-one research papers were identified for inclusion in the review: 8 clinical trials and 13 observational studies. The majority examined the effect of coconut oil or coconut products on serum lipid profiles. Coconut oil generally raised total and low-density lipoprotein cholesterol to a greater extent than cis unsaturated plant oils, but to a lesser extent than butter. The effect of coconut consumption on the ratio of total cholesterol to high-density lipoprotein cholesterol was often not examined. Observational evidence suggests that consumption of coconut flesh or squeezed coconut in the context of traditional dietary patterns does not lead to adverse cardiovascular outcomes. However, due to large differences in dietary and lifestyle patterns, these findings cannot be applied to a typical Western diet. Overall, the weight of the evidence from intervention studies to date suggests that replacing coconut oil with cis unsaturated fats would alter blood lipid profiles in a manner consistent with a reduction in risk factors for cardiovascular disease.
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Introduction: saturated fat restriction has been recommended for coronary arterial disease, but the role of coconut oil (Cocos nucifera L.) extra virgin, lauric acid source in the management of lipid profile remains unclear. Objective: to evaluate the effect of nutritional treatment associated with the consumption of extra virgin coconut oil in anthropometric parameters and lipid profile. Methods: we conducted a longitudinal study of 116 adults of both sexes presenting CAD. Patients were followed in two stages: the first stage (basal-3 months), intensive nutritional treatment. In the second stage (3-6 months), the subjects were divided into two groups: diet group associated with extra virgin coconut oil consumption (GDOC) and diet group (DG). Held monthly anthropometric measurements: body mass, waist circumference (WC), neck circumference (PP), body mass index (BMI). Gauged to collected blood pressure and blood samples were fasted for 12 hours, for total cholesterol analysis and fractions apoproteins (Apo A-1 and B), glucose, glycated hemoglobin (HbA1C), insulin (I). Comparing the averages at the beginning and end of the study employing the paired Student t-independent. And set the diastolic blood pressure by BMI using ANOVA. Analyses were performed using the SPSS statistical package, being significant p < 0.05. Results: the mean age of the population was 62.4 ± 7.7 years, 63.2% male, 70% elderly, 77.6% infarcted, 52.6% with angina, hypertension and dyslipidemia 100%. In the first stage the nutritional treatment reduced body weight, WC, BMI and PP and insulin concentrations, HbA1C, HOMA-IR and QUICK, without changing the other parameters. In the second stage of the study, it was observed that the GDOC maintained the reduction of body mass, BMI, WC, with a significant difference between groups for DC (-2.1 ± 2,7 cm; p < 0.01). In addition, there was an increase in HDL-C concentrations, Apo A, with significant difference in GD, only for HDL-C (3.1 ± 7.4 mg/dL; p = 0.02). Conclusion: it was observed that the nutritional treatment associated with extra virgin coconut oil consumption reduced the CC and increased HDL-C levels in patients with CAD.
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The obesity epidemic in the U.S. has led to extensive research into potential contributing dietary factors, especially fat and fructose. Recently, increased consumption of soybean oil, which is rich in polyunsaturated fatty acids (PUFAs), has been proposed to play a causal role in the epidemic. Here, we designed a series of four isocaloric diets (HFD, SO-HFD, F-HFD, F-SO-HFD) to investigate the effects of saturated versus unsaturated fat, as well as fructose, on obesity and diabetes. C57/BL6 male mice fed a diet moderately high in fat from coconut oil and soybean oil (SO-HFD, 40% kcal total fat) showed statistically significant increases in weight gain, adiposity, diabetes, glucose intolerance and insulin resistance compared to mice on a diet consisting primarily of coconut oil (HFD). They also had fatty livers with hepatocyte ballooning and very large lipid droplets as well as shorter colonic crypt length. While the high fructose diet (F-HFD) did not cause as much obesity or diabetes as SO-HFD, it did cause rectal prolapse and a very fatty liver, but no balloon injury. The coconut oil diet (with or without fructose) increased spleen weight while fructose in the presence of soybean oil increased kidney weight. Metabolomics analysis of the liver showed an increased accumulation of PUFAs and their metabolites as well as γ-tocopherol, but a decrease in cholesterol in SO-HFD. Liver transcriptomics analysis revealed a global dysregulation of cytochrome P450 (Cyp) genes in SO-HFD versus HFD livers, most notably in the Cyp3a and Cyp2c families. Other genes involved in obesity (e.g., Cidec, Cd36), diabetes (Igfbp1), inflammation (Cd63), mitochondrial function (Pdk4) and cancer (H19) were also upregulated by the soybean oil diet. Taken together, our results indicate that in mice a diet high in soybean oil is more detrimental to metabolic health than a diet high in fructose or coconut oil.
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