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Coconut Oil & MCTs: Unhealthy Or Boost Health?

Overcome Candida Overgrowth With This Functional Medicine Expert's Guide Dr. Will Cole 1

The world is all abuzz over a USA Today article (1) saying coconut oil is not healthy and never was. This article was referencing a statement (2) from the American Heart Association (AHA) saying saturated fats such as coconut oil increase heart attacks and strokes and should not be consumed.

There has never been a debate over the fact that coconut oil (3) contains high amounts of saturated fat and can increase total cholesterol levels. This isn’t new news.

The studies the AHA cite do not link eating more coconut oil to heart disease, they link it to increasing cholesterol numbers.

The reality is, total cholesterol is a poor predictor for assessing heart attack and stroke risk. Studies have found (4) that there might be no association (5) between high total cholesterol and heart attack and stroke risk.

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It is very interesting that the AHA is still suggesting for us to switch from using saturated fats like coconut oil to polyunsaturated fats like corn and vegetable oil. One of the references the AHA cites is the Minnesota Coronary Experiment from 40 years ago. A recent reevaluation (6) of the data, published in the British Medical Journal found that the study participants that swapped saturated fats for polyunsaturated corn oil had a 22% increase risk of death for every 30 points their cholesterol went down!

Better predictors for heart attack and stroke risks are high inflammation markers like CRP and homocysteine, low HDL (“good” cholesterol), high triglycerides, and high small dense LDL protein carriers.

The other LDL subtype are the large buoyant particles, the non-oxidized, non-inflamed LDL particles are protective just like HDL.

The truth is, only a small handful of studies in the AHA report deal with coconut oil specifically. The coconut oil studies that the AHA does cite show that it raises both HDL and LDL! Again I would reiterate, coconut oil tends to increase beneficial, large buoyant LDL not small dense LDL.

Researchers have found (7) high-fat diets containing coconut raised HDL, lowering triglycerides and small LDL cholesterol particles. Pacific Islanders who consumed (8) a majority of their calories from coconut fat raised their total cholesterol mainly from their “good” HDL rising. Another meta-analysis (9) published in the British Medical Journal found no association between increased saturated fat intake and heart attack, stroke, and death risk.

A randomized control trial (10) published in the American Journal of Clinical Nutrition found a diet rich in fats, including a high percentage of calories from saturated fats, actually lowered cardio-metabolic risk factors: HDL came up, triglycerides came down, insulin sensitivity improved and blood sugar was lowered.

The context and quality of a total cholesterol panel is so much more important than looking at a total cholesterol above 200 and deeming it “bad”. It may be or may not be. Coconut oil seems to, according to the research, improve the quality while yes, increasing the quantity as well.

In reality, there is a growing amount of studies showing similar results that lowering dietary saturated fat and cholesterol did not decrease heart attacks.

The problem with saturated fats like coconut oil occurs when people eat them with refined grains (which turn into sugar) such as breads and pasta or sugary foods. This “mixed meal” combination amplifies the inflammation of sugar.

So if you’re not going to eat vegetables and avoid carby junk foods, I suggest limiting your saturated fat intake.

Some of my favorite whole-food fats include olives, coconut, avocados, nuts, seeds, wild-caught fish, and grass-fed ghee. But my ultimate favorite fat-hack is MCT oil, which I use often in my functional medicine center.

What the heck is MCT oil?

Well, I am glad you asked! MCT stands for medium-chain triglycerides which are a super-special type of fats (or fatty acid) that are six to 12 carbons in length. (11)

There are four main types of MCTs that are categorized by length:

  • Capronic acid: 6 carbons (C6)
  • Caprylic acid: 8 carbons (C8)
  • Capric acid: 10 carbons (C10)
  • Lauric acid: 12 carbons (C12)

Technically, lauric acid from a biology perspective, should actually be considered a long-chain triglyceride (LCT) not an MCT. Lauric acid is processed by your liver unlike MCTs that skip the longer pathway through the liver and are quickly converted into an energy source by our body. Think of lauric acid more like the really close cousin of the MCT family – always over at the house but not directly related.

In the modern Western diet, MCT fats are largely excluded. They are a type of saturated fat that are very easy for your body to break down for fuel unlike LCT (long-chain triglyceride) fats. In fact, from the very beginning we all relied on fat in the form of breast milk for energy and brain development. Even if you weren’t breastfed, MCT oil derived from palm and coconut oil is added to formulas to mimic breast milk.

MCT oils can be found in two forms: natural and synthetic. Natural MCTs are found in coconut oil, dairy fats, and palm kernel oil as well as certain foods. Two of my favorite sources are coconut oil and grass-fed ghee.

These foods include the percentages of MCTs found in the total amount of fats in each food:

  • Coconut oil: 15 percent
  • Palm kernel oil: 7.9 percent
  • Cheese: 7.3 percent
  • Milk: 6.9 percent
  • Butter: 6.8 percent
  • Yogurt: 6.6 percent

MCT oil is the pure source of these bioavailable fats.

What are the health benefits of MCT oil?

MCT oil and your brain

Research has shown that MCT oil can improve (12) memory and overall brain health of people with brain problems like brain fog. It can even help people with mild to moderate Alzheimer’s disease, (13) including those with the APOE4 gene which is linked to an increased risk factor for this condition.

MCT oil and ketosis

Including MCT oil in your diet is one way to help become (14) a metabolic fat burner, or more commonly known as being in a state of ketosis. The secret to a healthy ketogenic diet is to cut carbs and increase the intake of healthy fats like MCT.

Since MCT oil is easily absorbed, (15) it quickly boosts energy (16) and increases ketones. (17) MCTs are so powerful they can help maintain and increase ketosis even when carb intake is higher. (18)

Coconut oil has also been shown to help sustain ketosis since it contains a specific MCT called lauric acid. (19)

MCT oil and your immune system

Even though metabolically lauric acid is more similar to a long-chain fat and isn’t broken down as easily for energy, it has powerful antibacterial, antiviral, and antifungal (20) abilities. MCT can also work as a powerful antimicrobial by helping kill off pathogenic bacterial infections to promote a healthy microbiome balance. (21)

MCT oil and your weight

In connection with their ability to improve ketosis, MCTs are superstars when it comes to weight loss. Let me count the ways MCT oils help reduce weight:

After just a few weeks of using MCT oil, studies showed (25) that people lost more weight around their waist and hips as well as more fat around their organs (visceral), when compared to people who consumed other types of healthy fats.

MCT oil and your kidneys

For patients with kidney issues, I often have them focus on oils and foods that are rich in MCTs. Medical literature has shown (26) that MCTs found in coconut oil are ideal for people dealing with acute kidney failure.

MCT oil and exercise

If you want to take your workout to the next level, look no further than MCT oil. Supplementing with a blend of amino acids rich in leucine, vitamin D, and MCT oil can increase (27) muscle strength. Additionally, research has shown (28) that eating MCT-rich foods like coconut can increase a person’s ability to work out longer during high-intensity exercise.

MCT oil and omega absorption

It’s well known that omega fats from sources like wild-caught fish are super important for our brain, cardiovascular, hormone, brain, immune, and skin health. Studies have shown (29) that the effects of DHA and EPA omega fats were enhanced when they were combined with MCT oils. Take advantage of that fat synergy!

MCT oil and blood sugar

Diabetes has grown to epidemic proportions. There are many tools I use to help patients with blood sugar issues, but MCTs are definitely one of my favorites! MCTs have the ability to increase insulin (30) sensitivity and in turn, reverse insulin resistance and improve overall diabetes risk factors.

MCT and your liver

MCT fats in coconut can protect (31) the liver and gastrointestinal system as well as reduce fatty liver disease by reducing toxin buildup (32) in the liver.

MCT oil and cholesterol

Healthy cholesterol levels are essential for optimal health. When looking at these though, we need to take into consideration context and quality of lipid levels. MCTs can lower (33) cardiometabolic risk factors and LDL/HDL ratios.

How much MCT oil should I take?

One word of advice: Start off slowly. Too much can cause your stomach to cramp and lead to diarrhea. 1 teaspoon a day is a good starting point and you can work your way up to 2 to 3 tablespoons a day. MCT oil with more caprioic acid, C6, can cause more digestive problems for people who tend to have gastrointestinal issues. However, this short MCT is the best when it comes to energy bioavailability.

The short C8 carbon is more easily broken down which makes it ideal for brain fuel for those looking to optimize brain health. You can find MCT oil that is higher in caprylic acid, C8, or even exclusively caprylic acid. It also helps to fight off infections so it’s a win-win!

I always emphasize the importance of getting your nutrients in through food as much as possible, so make sure to include more coconuts and other MCT containing foods into your diet. Depending on the quality of coconut oil that you are purchasing it roughly consists of:

  • Caprylic acid (C8): 6 percent of coconut oil
  • Capric acid (C10): 9 percent of coconut oil
  • Lauric acid (C12): 50-plus percent of coconut oil

Easily incorporate MCT oil into your diet by mixing it into:

  • Salad dressings
  • Smoothies
  • Mayonnaise
  • Bone broth
  • Soups
  • Tea
  • Coffee
  • Water
  • Baked goods (if they are cooked under 300 degrees F)

I suggest only using coconut oil in its whole-food form to fry food with and not MCT oil.

If you want to learn more about your own health case please check out our consultation process. We offer webcam as well as in-person consultations for people across the country and around the world.

Photo: Stocksy

References:

  1. Ashley May, Coconut oil isn't healthy. It's never been healthy. USA Today June 16 2017. https://www.usatoday.com/story/news/nation-now/2017/06/16/coconut-oil-isnt-healthy-its-never-been-healthy/402719001/
  2. Frank M. Sacks, Alice H. Lichtenstein, Jason H.Y. Wu et al., Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association Circulation. 2017;136:e1–e23 https://doi.org/10.1161/CIR.0000000000000510
  3. Dildy T. Evidence for and against dietary recommendations to prevent cardiovascular disease. Tex Heart Inst J. 2015;42(3):234‐236. Published 2015 Jun 1. doi:10.14503/THIJ-15-5072
  4. Schilling S, Tzourio C, Dufouil C, et al. Plasma lipids and cerebral small vessel disease. Neurology. 2014;83(20):1844‐1852. doi:10.1212/WNL.0000000000000980
  5. Prof Dr. Irwin J Schatz, MD, Prof Kamal Masaki, MD et al., Cholesterol and all-cause mortality in elderly people from the Honolulu Heart Program: a cohort study The Lancet Volume 358, Issue 9279, P351-355, August 04, 2001. Doi: https://doi.org/10.1016/S0140-6736(01)05553-2
  6. Christopher E Ramsden, Daisy Zamora, et al., Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73) BMJ 2016;353:i1246 doi: https://doi.org/10.1136/bmj.i1246
  7. Feranil AB, Duazo PL, Kuzawa CW, Adair LS. Coconut oil is associated with a beneficial lipid profile in pre-menopausal women in the Philippines. Asia Pac J Clin Nutr. 2011;20(2):190‐195.
  8. Cox C, Sutherland W, Mann J, de Jong S, Chisholm A, Skeaff M. Effects of dietary coconut oil, butter and safflower oil on plasma lipids, lipoproteins and lathosterol levels. Eur J Clin Nutr. 1998;52(9):650‐654. doi:10.1038/sj.ejcn.1600621
  9. Russell J de Souza, Andrew Mente, et al., Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies BMJ 2015;351:h3978 doi: https://doi.org/10.1136/bmj.h3978
  10. Vivian L Veum, Johnny Laupsa-Borge, Øyvin Eng, Espen Rostrup, Terje H Larsen, Jan Erik Nordrehaug, Ottar K Nygård, Jørn V Sagen, Oddrun A Gudbrandsen, Simon N Dankel, Gunnar Mellgren, Visceral adiposity and metabolic syndrome after very high–fat and low-fat isocaloric diets: a randomized controlled trial, The American Journal of Clinical Nutrition, Volume 105, Issue 1, January 2017, Pages 85–99, https://doi.org/10.3945/ajcn.115.123463
  11. Berit Marten, Maria Pfeuffer, Jurgen Schrezenmeir, Medium-chain triglycerides International Dairy Journal Volume 16, Issue 11, November 2006, Pages 1374-1382 https://doi.org/10.1016/j.idairyj.2006.06.015
  12. Rebello CJ, Keller JN, Liu AG, Johnson WD, Greenway FL. Pilot feasibility and safety study examining the effect of medium chain triglyceride supplementation in subjects with mild cognitive impairment: A randomized controlled trial. BBA Clin. 2015;3:123‐125. Published 2015 Jan 16. doi:10.1016/j.bbacli.2015.01.001
  13. Sharma A, Bemis M, Desilets AR. Role of Medium Chain Triglycerides (Axona®) in the Treatment of Mild to Moderate Alzheimer's Disease. Am J Alzheimers Dis Other Demen. 2014;29(5):409‐414. doi:10.1177/1533317513518650
  14. Rebello CJ, Keller JN, Liu AG, Johnson WD, Greenway FL. Pilot feasibility and safety study examining the effect of medium chain triglyceride supplementation in subjects with mild cognitive impairment: A randomized controlled trial. BBA Clin. 2015;3:123‐125. Published 2015 Jan 16. doi:10.1016/j.bbacli.2015.01.001
  15. Fernando WM, Martins IJ, Goozee KG, Brennan CS, Jayasena V, Martins RN. The role of dietary coconut for the prevention and treatment of Alzheimer's disease: potential mechanisms of action. Br J Nutr. 2015;114(1):1‐14. doi:10.1017/S0007114515001452
  16. Fernando WM, Martins IJ, Goozee KG, Brennan CS, Jayasena V, Martins RN. The role of dietary coconut for the prevention and treatment of Alzheimer's disease: potential mechanisms of action. Br J Nutr. 2015;114(1):1‐14. doi:10.1017/S0007114515001452
  17. Fernando WM, Martins IJ, Goozee KG, Brennan CS, Jayasena V, Martins RN. The role of dietary coconut for the prevention and treatment of Alzheimer's disease: potential mechanisms of action. Br J Nutr. 2015;114(1):1‐14. doi:10.1017/S0007114515001452
  18. Liu YM, Wang HS. Medium-chain triglyceride ketogenic diet, an effective treatment for drug-resistant epilepsy and a comparison with other ketogenic diets. Biomed J. 2013;36(1):9‐15. doi:10.4103/2319-4170.107154
  19. McCarty MF, DiNicolantonio JJ. Lauric acid-rich medium-chain triglycerides can substitute for other oils in cooking applications and may have limited pathogenicity. Open Heart. 2016;3(2):e000467. Published 2016 Jul 27. doi:10.1136/openhrt-2016-000467
  20. Shilling M, Matt L, Rubin E, et al. Antimicrobial effects of virgin coconut oil and its medium-chain fatty acids on Clostridium difficile. J Med Food. 2013;16(12):1079‐1085. doi:10.1089/jmf.2012.0303
  21. Kabara JJ, Swieczkowski DM, Conley AJ, Truant JP. Fatty acids and derivatives as antimicrobial agents. Antimicrob Agents Chemother. 1972;2(1):23‐28. doi:10.1128/aac.2.1.23
  22. St-Onge MP, Mayrsohn B, O'Keeffe M, Kissileff HR, Choudhury AR, Laferrère B. Impact of medium and long chain triglycerides consumption on appetite and food intake in overweight men. Eur J Clin Nutr. 2014;68(10):1134‐1140. doi:10.1038/ejcn.2014.145
  23. Rial SA, Karelis AD, Bergeron KF, Mounier C. Gut Microbiota and Metabolic Health: The Potential Beneficial Effects of a Medium Chain Triglyceride Diet in Obese Individuals. Nutrients. 2016;8(5):281. Published 2016 May 12. doi:10.3390/nu8050281
  24. Rial SA, Karelis AD, Bergeron KF, Mounier C. Gut Microbiota and Metabolic Health: The Potential Beneficial Effects of a Medium Chain Triglyceride Diet in Obese Individuals. Nutrients. 2016;8(5):281. Published 2016 May 12. doi:10.3390/nu8050281
  25. Rial SA, Karelis AD, Bergeron KF, Mounier C. Gut Microbiota and Metabolic Health: The Potential Beneficial Effects of a Medium Chain Triglyceride Diet in Obese Individuals. Nutrients. 2016;8(5):281. Published 2016 May 12. doi:10.3390/nu8050281
  26. Ge Y, Xu Y, Liao L. Comparison of the fat elimination between long-chain triglycerides and medium-chain triglycerides in rats with ischemic acute renal failure. Ren Fail. 2002;24(1):1‐9. doi:10.1081/jdi-120002655
  27. Abe S, Ezaki O, Suzuki M. Medium-Chain Triglycerides in Combination with Leucine and Vitamin D Increase Muscle Strength and Function in Frail Elderly Adults in a Randomized Controlled Trial. J Nutr. 2016;146(5):1017‐1026. doi:10.3945/jn.115.228965
  28. Nosaka N, Suzuki Y, Nagatoishi A, Kasai M, Wu J, Taguchi M. Effect of ingestion of medium-chain triacylglycerols on moderate- and high-intensity exercise in recreational athletes. J Nutr Sci Vitaminol (Tokyo). 2009;55(2):120‐125. doi:10.3177/jnsv.55.120
  29. Kondreddy VK, Anikisetty M, Naidu KA. Medium-chain triglycerides and monounsaturated fatty acids potentiate the beneficial effects of fish oil on selected cardiovascular risk factors in rats. J Nutr Biochem. 2016;28:91‐102. doi:10.1016/j.jnutbio.2015.10.005
  30. Eckel RH, Hanson AS, Chen AY, Berman JN, Yost TJ, Brass EP. Dietary substitution of medium-chain triglycerides improves insulin-mediated glucose metabolism in NIDDM subjects. Diabetes. 1992;41(5):641‐647.
  31. Ronis MJ, Korourian S, Zipperman M, Hakkak R, Badger TM. Dietary saturated fat reduces alcoholic hepatotoxicity in rats by altering fatty acid metabolism and membrane composition. J Nutr. 2004;134(4):904‐912. doi:10.1093/jn/134.4.904
  32. Nanji AA, Zakim D, Rahemtulla A, et al. Dietary saturated fatty acids down-regulate cyclooxygenase-2 and tumor necrosis factor alfa and reverse fibrosis in alcohol-induced liver disease in the rat. Hepatology. 1997;26(6):1538‐1545. doi:10.1002/hep.510260622
  33. Rial SA, Karelis AD, Bergeron KF, Mounier C. Gut Microbiota and Metabolic Health: The Potential Beneficial Effects of a Medium Chain Triglyceride Diet in Obese Individuals. Nutrients. 2016;8(5):281. Published 2016 May 12. doi:10.3390/nu8050281

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BY DR. WILL COLE

Evidence-based reviewed article

Dr. Will Cole, IFMCP, DNM, DC, leading functional medicine expert, consults people around the world via webcam and locally in Pittsburgh. He received his doctorate from Southern California University of Health Sciences and post doctorate education and training in functional medicine and clinical nutrition. He specializes in clinically researching underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. Dr. Cole was named one of the top 50 functional medicine and integrative doctors in the nation and is the best selling author of Ketotarian and The Inflammation Spectrum.

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