The One Thing We Need to Add to the Coconut Oil Conversation

The American Heart Association (AHA) released a 17-page review of the scientific literature on Dietary Fats and Cardiovascular Disease this week and the half-page that everyone seems to be fixated on is the section that ends with the statement, “we advise against the use of coconut oil.” Since 72% of the American public thinks coconut oil is a healthy food, this turned out to be a bit of a shocker.

I went on the CBC Eyeopener yesterday to discuss it, and I had to agree. If there isn’t high-quality evidence supporting the benefits claimed for coconut oil, and it raises LDL-cholesterol, a well-established heart-disease risk factor, why go out of your way to eat more of it? If you really prefer it in the occasional curry, enjoy. If you use it for cooking everything from cookies to eggs, it might be time to reconsider.

If you’re curious about what else I said, the CBC did a written story as well. If you prefer to listen, here’s the link to the podcast. It starts at the 18-minute mark.

Let’s not lose sight of the big picture

However, as often happens with these things, I had one key message I didn’t quite manage to slide in. It’s not scintillating or newsworthy, but it’s critically important for your health, physical and mental: Keep it in perspective.

One nutrient (saturated fat in this case) or food (coconut oil) won’t make or break your health. Coconut oil is not a miracle cure, but it’s not poison either.

It’s your overall dietary pattern that really matters. Cook more, eat out less, enjoy lots of whole, minimally processed plant foods like vegetables, fruit, nuts, seeds, beans. Go easy on the highly processed food, added sugar, and other refined carbohydrates. These are the key principles that virtually all nutrition experts agree on, but they aren’t controversial, so you won’t often see them on the front page.

And while we’re keeping it in perspective, remember that diet is only one part of the heart-health puzzle, complementing physical activity, smoke-free living and stress management.

That’s one reason a 2015 review showed that there was no relationship between saturated fat intake and heart disease, which is what prompted the flurry of “Butter is Back” headlines. (Interestingly, a Cochrane review, which looked at higher quality studies — randomized controlled trials vs observational studies — published earlier that year, found, “a small but potentially important reduction in cardiovascular risk on reduction of saturated fat intake,” but got nearly no press. Because agreeing with conventional wisdom isn’t interesting.)

The only trouble with the “saturated fat doesn’t matter” study is that it didn’t take into account what the subjects were eating instead, if there wasn’t much butter, beef, and bacon in the mix. Unfortunately, more often than not, people looking for “low-fat” end up with more foods that add sugar and other refined carbohydrates, taking them a step back in terms of heart health. Think frozen yogurt vs. ice cream, bagels vs. bacon, and spaghetti vs. steak. Turns out those outcomes are worse.

However, when researchers separate out those who eat a low-saturated fat diet but include more unsaturated fats, not more carbohydrates, their heart-health outcomes improve. Think olive oil instead of butter, salmon vs steak, avocado eggs vs the bagel. Think Mediterranean diet.

It’s not helpful to have a low-saturated fat diet if foods like Corn Flakes, white rice, and fat-free brownies are filling you up instead. (Researchers think this effect is due more to sugar and other refined carbohydrates, by the way, not whole grains.)

So let’s keep it in perspective. That’s what Canada’s Heart & Stroke Foundation said in their excellent response to the 2015 kerfuffle: “Heart disease prevention comes from whole food-based diets, filled with vegetables, fruit, whole grains, lean protein (including lower fat dairy and alternatives), fish, legumes, nuts and seeds – and fat is naturally found in this diet! Eating this way means not having to worry about any one nutrient in isolation. It’s the big picture that matters most.”

Amen. There will probably always be controversies in the headlines, but these fundamentals will serve you well. Meanwhile, I’ve heard coconut oil is great for your skin.

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