"Ever since I started using coconut oil, my cholesterol has spiked," writes this week's house call. "I'm afraid coconut oil with all that saturated fat is creating more harm than good. Should I continue to use it?"
Since I expressed my love for medium-chain triglyceride oil or MCT oil, I've received this question several times.
I call MCTs (found in coconut oil) a super fuel for your cells because your body uses this kind of fat very efficiently. Your cells burn MCTs for energy while storing very little as fat, boosting your metabolism and supporting your immune system.
MCTs also help balance many hormones, including the ones that control your appetite. They keep you feeling full and satisfied. They actually improve your cholesterol profile.
They also help your body burn fat. One study found that consuming MCT oils helped reduce body fat and triglycerides more than omega 6 vegetable oils. After eight weeks, the experiment showed the MCT oil group lost more weight, body fat and subcutaneous fat, all while experiencing a 15 percent drop in triglycerides and LDL.
At the same time, as MCT-rich coconut oil becomes more popular, it also becomes a concern among some folks because of its high amounts of saturated fat and potential for raising cholesterol.
The reality is, cholesterol is not black and white. Classifying it as "good" or "bad" vastly oversimplifies this molecule, which among its duties helps synthesize vitamin D and hormones while maintaining cell structure.
Some fats do raise cholesterol, whereas others lower cholesterol. Even when saturated fat does raise your cholesterol, the type of cholesterol becomes more important than cholesterol itself.
As a doctor, I tell patients that abnormal cholesterol can become a problem when it is the small dense LDL particles, accompanied by high triglycerides. In fact small LDL particles actually triple your risk of heart disease. This is caused by high-carb, low-fat diets and is improved when you add fat back to the diet, including saturated fat.
Studies show saturated fat raises LDL (your so-called "bad" cholesterol) but it improves the quality of the LDL and increases its size making it less likely to promote heart disease. It also raises HDL ("good" cholesterol). On the other hand, sugar lowers HDL. Ultimately, the ratio of total to LDL cholesterol and particle number and size are a far bigger predictor of heart attacks than LDL itself.
That brings us back to coconut oil, which can contain up to 40 percent saturated fat. Interestingly, countries with the highest intakes of coconut oil have the lowest rates of heart disease.
While research shows coconut oil contains higher amounts of saturated fat and does increase total cholesterol, those amounts do not increase your heart attack or stroke risk.
In fact, one study among lean, heart disease- and stroke-free Pacific Islanders who consumed up to 63 percent of their calories from coconut fat found total cholesterol rose but so did their "good" HDL.
Other studies found lipid profiles improve on high-fat diets containing coconut oil. Researchers concluded it wasn't saturated fat from coconuts that negatively impacted cholesterol profile. Instead, the coconut oil's overall effect raised HDL while lowering triglycerides and small LDL cholesterol particles, which is definitely a good thing.
Coconut oil provides other benefits such as lowering insulin levels, protecting against heart disease. The predominant fatty acid in coconut oil is lauric acid, which provides antimicrobial, antibacterial and antiviral benefits.
There is a huge difference between quality saturated fat in coconut oil or MCT oils, as compared with what you get in a fast food cheeseburger. Lumping them all together becomes like putting cauliflower and a cupcake under the carbohydrate category.
Don't be afraid of saturated fat, but get it from healthy sources like coconuts and grass-fed beef, which automatically edges out unhealthy sources.
And total cholesterol is not an accurate predictor of heart disease or stroke. Inflammation is the culprit for most diseases, and coconut oil is highly anti-inflammatory.
To answer your question... if your doctor finds you have high cholesterol, ask him or her to dig deeper to see what's really going on. Ask the right questions and most importantly, get the right tests!
You should request a particle size test to check for cholesterol particle size and number. Other cholesterol tests are simply outdated. A routine, regular cholesterol test won't reveal particle size.
The tests you'll want to ask for are either an NMR Lipid Panel from LabCorp or the Cardio IQ Test from Quest Diagnostics. Those are the only tests to really know what's going on with your cholesterol. Optimal results will show plenty of safe, light, fluffy, big particles with minimal small, dense, artery-damaging particles.
Combine healthy fats with a no-added-sugar diet and you have an effective strategy to normalize cholesterol while reducing your risk for heart disease, obesity, type 2 diabetes and numerous other chronic conditions. Eliminating refined carbs and sugar and adding adequate omega 3 fats means saturated fat should not be a problem.
In one interventional trial, researchers showed even on a low-carb diet that was higher in saturated fats, blood levels of saturated fat were lower. That's because dietary saturated fats do not raise dangerous blood saturated fats -- sugar and refined carbs do! They also found people on a higher saturated-fat diet had lower levels of inflammation and oxidative stress, as well as a better cholesterol profile.
Other studies confirm carbs worsen blood levels of the even chained saturated-fats, which cause heart disease. These carbs drive your liver to create more fat in your blood, a process called lipogenesis triggered by alcohol, soda, sugar-sweetened drinks, starches and sugars. Whole, healthy-fat foods like butter, meat or cheese do not increase this process.
Note, too, that recent U.S. Dietary Guidelines finally stopped recommending lowering cholesterol and dietary fat. In fact, the new guidelines don't emphasize any limit on total dietary fat or cholesterol, which is a complete reversal on governmental advice from 35 years ago. Better late than never!
If you're curious to learn more, I dive deep into the benefits of coconut oil and saturated fat while busting cholesterol and other myths in my new book, Eat Fat, Get Thin.
Simply put, the real villain that robs our health and increases our waistlines is sugar and anything that breaks down to sugar like refined carbohydrates. Quality fats like coconut oil and more anti-inflammatory omega 3 fats help edge out those sugars and inflammatory refined omega 6 fat vegetable oils.
If you are interested in learning more and taking back your health, join our next Eat Fat, Get Thin challenge starting April 28, 2016.
Wishing you health and happiness,
Mark Hyman, MD.