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.)

Dear Doctor: Our dad insists that he doesn't want any heroic or extraordinary measures taken if he gets really sick, and he wants one of us children to relay this message to his medical team. Should he have a living will?

Dear Reader: We're verging into legal territory with this question, but as medicine continues to advance in its ability to prolong life, this is an important topic for each of us.

A living will refers to a class of legal document that an individual uses to specify his or her wishes for end-of-life medical care. These documents are also referred to as health care advance directives, or simply advance directives.

The idea of a living will comes up most often among the elderly, but in fact, people of all ages can use this document to state what they do and do not want to be done in the instance of a medical emergency. If the time comes that a person is unable to make medical decisions on his own behalf, then the living will speaks for him.

While your dad is correct that you or your siblings can communicate his wishes to his care team, this can place a significant burden on the family. Despite knowing a loved one's wishes, making decisions with life-or-death consequences is not only a challenge, but can also be emotionally wrenching.

A living will often includes a health care proxy or power of attorney. This allows you to name the person who will communicate your wishes if you should become unable to do so yourself. It's understandably easy for family members to become overwhelmed in the midst of a medical crisis, and to agree to medical procedures or lifesaving measures that the patient would not have wanted.

With a living will to address medical specifics, and a health care proxy to name the person in charge of making decisions, those questions are addressed and a roadmap for treatment -- or for withholding treatment -- is clearly laid out.

What can this type of legal document address?

Everything from a person's wishes regarding resuscitation procedures, ventilation techniques and diagnostic tests, to life-prolonging treatments such as CPR, dialysis, blood transfusion, the administration of food, water or drugs, palliative care and surgery. Some people use their living wills to state their wishes regarding dying at home, donating their organs for transplantation or offering their bodies to science.

Individuals who decide to create a living will often begin by speaking with their families about the scope and specifics of the document they want to create. It's also common to consult with your physician, who can help to explain the choices you have and the decisions you are making.

A living will must be in writing and adhere to the legal requirements of the state in which it is being used. A lawyer can help you to create your living will, but it is not a requirement. Both the American Bar Association and the National Hospice and Palliative Care Organization offer links to state-specific forms.

(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.)

Dear Doctor: Are there natural remedies for arthritis? Exercises that could help? My pain is in the upper arms and shoulders.

Dear Reader: Osteoarthritis, the kind that you're describing, is caused by degeneration of the cartilage within a joint. Without the cartilage, one bone rubs upon the other, leading to pain and degeneration of the bone.

Doctors typically recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen and aspirin; acetaminophen; and, more rarely, opiates. But NSAIDs can increase the risk of stomach ulcers and kidney problems when used chronically; acetaminophen at high doses can cause liver problems when used chronically; and opiate medications can lead to addiction. So I can understand your desire to look for an alternative for the pain.

The supplements chondroitin sulfate and glucosamine have been used for osteoarthritis for years. Chondroitin is one of the building blocks of cartilage in our body, so many people naturally believe that taking chondroitin can decrease the pain of arthritis.

A 2015 review of 43 randomized trials compared the use of chondroitin alone or in combination with glucosamine against the use of a placebo. Most of these studies looked at treatment for arthritis of the knees, with some looking at arthritis of the hips and hands. The studies measured pain on a 100-point scale. The use of chondroitin was found to be beneficial, whether with or without glucosamine, showing a small 8-point difference in pain compared with placebo. It didn't ease the stiffness and lack of mobility associated with arthritis, however.

In another study, a randomized trial of 606 patients with pain from osteoarthritis of the knee compared the use of glucosamine with chondroitin against the anti-inflammatory drug celecoxib (Celebrex). After six months, both groups found a greater than 50 percent reduction in both pain and joint swelling. What was interesting about the study was that it took a while for the glucosamine/chondroitin to work. At one to four months, Celebrex was much better at improving pain, but at six months it was no different than the glucosamine/chondroitin combination. So with the use of glucosamine and chondroitin, it is important to be patient.

The supplements MSM (methylsulfonylmethane) and DMSO (dimethyl sulfoxide) are anti-inflammatory agents that have been studied in arthritis of the knees without evidence of benefit, but it's possible they could decrease pain in the joints of the hands. Arnica montana is a plant-based therapy that has some potential in topical use for pain relief, with one study finding a slight benefit for arthritis of the hands. Topical use of capsaicin cream, made from chili peppers, has shown potential as well, specifically for arthritis of the knee. Other natural remedies and supplements, such as fish oil, are touted for arthritis, but their use has not been well studied.

As for exercises, I would recommend physical therapy to increase your range of motion for your shoulder and to help increase your muscular strength. Yoga, Pilates and tai chi can also be beneficial, potentially increasing your range of motion without undue stress on your already aching joints. Over time, you may well see a difference in your ability to function with less pain.

(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.)