Ask the Doctors

Dear Doctor: I'm 75, healthy, and want to stay that way -- despite a bad family history regarding hearts and arteries. I have taken 10 milligrams of Lipitor daily for several years, but am wondering if I should try coconut oil to lower my cholesterol?

Dear Reader: Coconut oil is very high in saturated fat, with 12 grams per tablespoon. Compare that to olive oil, which has 1.9 grams of saturated fat per tablespoon. Both have 14 grams of total fat, but almost all of olive oil's is monounsaturated, widely considered to be better for the heart and cardiovascular system. Saturated fats in meats and dairy products, on the other hand, have been shown to increase LDL cholesterol, the so-called "bad" cholesterol linked to coronary artery disease.

For someone with a family history of vascular disease, we really have no good data on coconut oil's ability to reduce the risk of heart disease and strokes. We do have observational data from societies that have lower heart disease rates and include coconuts as a significant percentage of their diet. But they're consuming the coconut, not just the oil of the coconut.

One factor to consider: The meat of the coconut has a considerable amount of fiber. This fiber is not found in the oil, and it may be the fiber that confers the greatest benefit from coconut consumption. Also, the diet and lifestyle of societies that consume large amounts of coconut cannot be translated well to our Western diets and lifestyle, meaning they probably are healthier in many respects.

One aspect of coconut oil that we can assess is how it might affect cholesterol levels. As I noted earlier, coconut oil is high in saturated fat. But the majority of the saturated fat is in the form of lauric acid; the majority of the saturated fat in animal fat is palmitic acid. Lauric acid is absorbed differently than palmitic acid, which could suggest that coconut oil doesn't cause the same degree of LDL elevation as animal fat.

But that would appear to be wishful thinking.

A study published in the journal Nutrition Reviews in 2016 analyzed multiple studies and found no difference in the LDL cholesterol level between people who used coconut oil and people who used butter. It does appear, however, that consumption of coconut oil was linked to lower triglyceride levels as compared to beef fat. That said, the cholesterol profiles found among consumers of coconut oil are much worse than those found among people who consume olive oil, canola oil, or even corn, safflower and palm oil.

I believe that you should look at coconut oil as a saturated fat. The current recommendation is that these fats should make up only 10 percent of your diet. You could use coconut oil as a replacement to the fat from meat or dairy.

However, if you have a family history of heart disease, I would use olive and canola oils in recipes and when cooking; these oils have shown beneficial effects in regards to cholesterol.

In addition, if you have risk factors for heart disease, there is a significant benefit in staying on the statin you are taking. I would not stop that in lieu of adding coconut oil to your diet.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

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