How Coconut Oil Affects Heart Health

Coconut oil has grown in popularity in recent years, due in part to its many reported health benefits. In a 2016 New York Times survey, nearly three-quarters (72%) of Americans indicated that they viewed coconut oil as a healthy choice. Coconut oil is a saturated fat, however, and saturated fats have long been known to increase risk of cardiovascular disease (CVD). So, is all this talk of coconut oil’s heart healthy properties unfounded? Or is coconut oil somehow different from other saturated fats?

Coconut oil is composed of several types of fatty acids, about 90% of which are saturated. By contrast, butter and lard are composed of roughly 66% and 41% saturated fatty acids, respectively (Sankararaman and Sferra 2018). Lauric acid (12:0) makes up around half of coconut oil’s fatty acid content, with myristic (14:0) and palmitic acid (16:0) making up another 25% (Neelakantan et al. 2020). Many people have cited its medium-chain triglyceride (MCT) content as the reason for coconut oil’s superiority over other saturated fats because MCTs are generally absorbed differently than long-chain triglycerides (LCTs) in the body. However, lauric acid, the primary MCT in coconut oil, behaves more like an LCT than an MCT (Sankararaman and Sferra 2018).

One study comparing the effects of coconut oil, butter, and olive oil on blood lipids found that coconut oil significantly increased high-density lipoprotein (HDL) cholesterol levels when compared with both butter and olive oil. Butter increased low-density lipoprotein (LDL) cholesterol levels, compared with coconut oil and olive oil, but the researchers did not observe a difference in LDL levels between coconut oil and olive oil (Khaw et al. 2018). However, in 2020, a meta-analysis of 12 studies examining the effects of coconut oil on blood lipids determined that while coconut oil did increase HDL levels compared with both plant oils and animal fats, it also increased LDL levels when compared with plant oils (Teng et al. 2020). A 2018 systematic review similarly concluded that coconut oil significantly increases LDL cholesterol compared with mono- and polyunsaturated fats (Sankararaman and Sferra 2018).

Changing Views

What does this mean for heart health? HDL cholesterol, which coconut oil appears to increase, has long been thought to reduce risk of CVD. However, the studies previously linking HDL cholesterol levels to a reduced risk of CVD were primarily observational studies. More recent studies, including randomized controlled trials, have suggested that the association between HDL cholesterol and the potential to reduce CVD risk may be weaker than once thought (Sacks et al. 2017).  At the very least, these recent studies have demonstrated that the association between HDL cholesterol and CVD is not causal. LDL cholesterol, on the other hand, has been definitively linked to an increase in CVD risk, and intake of saturated fats, such as coconut oil, has been shown to increase LDL levels and CVD risk accordingly (Sacks et al. 2017).

In light of this evidence, the American Heart Association recommends choosing mono- or polyunsaturated fats, such as canola or olive oil, over coconut oil (Neelakantan et al. 2020, Sacks et al. 2017). Whether coconut oil is preferable to butter and other animal fats remains to be seen and presents an opportunity for future research. Further research is also needed to determine whether different types of coconut oil—for example, virgin coconut oil, filtered coconut oil, and refined coconut oil—have different effects on blood lipids. For now, the consensus among researchers seems to be that the possible benefits of consuming coconut oil cannot offset the risks. Like other saturated fats, therefore, coconut oil should be used sparingly.