June 2013, Volume 63, Issue 6

Letter to the Editor

Does coconut oil reduce the risk of coronary artery diseases?

Ailya Inayat  ( Abbasi Shaheed Hospital, Dow Medical College, Dow University of Health Sciences, Karachi. )
Shoukat Ali Baig  ( 4th Year Medical Student, Dow Medical College, Dow University of Health Sciences, Karachi. )
Tooba Baqai  ( 4th Year Medical Student, Dow Medical College, Dow University of Health Sciences, Karachi. )

Madam, being a consequence of atherosclerosis, which itself is a progressive disease caused by the build-up of fatty plaques in the heart vessels, coronary artery disease (CAD) figures prominently as public health problem and it is unsurprising that it is now the leading cause of death worldwide. Multifactorial inheritance factors, age, male gender, sedentary life style, junk food consumption, high intake of stimulants and alcohol are some of the known to be possible culprits leading to CAD.1
A low-fat diet is considered one way to reduce the risk of CAD. However, a low-fat diet does not mean that it has no fat at all. Diets high in saturated and trans-fatty acids increase low density lipoprotein (LDL) levels, and in turn, increase the mortality rate from CAD.
Having an abundance of lauric acid, coconut oil has less effect on total serum cholesterol and LDL levels, and has proved to be a better alternative for butter and hydrogenated vegetable fats.2 Being a source of fatty acids with 95 percent of them being saturated fats, it was previously thought that coconut and its oil were strongly atherogenic. However several recent studies report that hyperlipidaemia and heart diseases are not common among populations who consume coconut oil and concluded that there is no role of coconut and its oil in the causation CAD.3
The oil extracted from coconut meat is considered as a good source of medium chain fatty acids (MCFAs). Thus, due to little or no long chain fatty acid (LCFA) content, it is an ideal food source for risk reduction. MCFAs are rapidly absorbed in the intestines without getting catalyzed by the pancreatic lipase and are rapidly oxidized for energy production. They do not enter the cholesterol cycle, and nor are they deposited in fat depots.4
National Nutrition Survey conducted in Philippines back in 2003 revealed  relatively low incidence of hypercholesterolaemia, hypertension, stroke and angina in the Bicol Region where diets have high levels of coconut oil consumption compared to the other regions.5 Diets based on coconut oil lower the postprandial tissue plasminogen and lipoprotein - a blood marker associated with the risk of heart attack, reducing the risk of CAD.6
With increasing urbanization, the prevalence pool of CAD is rising. This highlights the need to understand the risks and determinants of disease for preventive strategies.2 It should be our utmost priority to educate the general population regarding the merits of coconut oil in order to reduce the incidence and prevalence of CAD.

References

1. Gupta M, Singh N, Verma S. South Asians and cardiovascular risk: what clinicians should know. Circulation 2006; 113: e924-9.
2. de Roos NM, Schouten EG, Katan MB. Consumption of a solid fat rich in lauric acid results in a more favorable serum lipid profile in healthy men and women than consumption of a solid fat rich in trans-fatty acids. J Nutr 2001; 131: 242-5.
3. Prior IA, Davidson F, Salmond C, Czochanska Z. Cholesterol, coconuts and diet on Polynesian atolls: a natural experiment: the Pukapuka and Tokelau island studies. Am J Clin Nutr 1981; 34: 1552-61.
4. Hashim SA, Bergen SS, Krell K, van Itallie TB. Intestinal absorption and mode of transport in portal vein of medium chain fatty acids. J Clin Invest 1964; 43: 1238.
5. Prior I, Davidson F, Salmond C, Czochanska Z. Cholesterol, coconuts and diet on Polynesian atolls: a natural experiment: The Pukapula and Tokelau Island Studies. Am J Clin Nutr 1981; 34: 1442-61.
6. Cox C, Mann J, Sutherland W, Chisholm A, Skeaff M. Effects of coconut oil, butter, and safflower oil in lipids and lipoproteins in persons with moderately elevated cholesterol levels. J Lipid Res 1995; 36: 1787-95.

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