You’re on board with the modern movement towards a healthier lifestyle. You pride yourself on eating clean and thrive on fresh vegetables and quality protein. You exercise and limit your intake of sugar, carbs, and grains. You eat plenty of healthy fats like avocados and nuts, and use coconut oil as your go-to for cooking, skin care, and maybe even concentrated in your morning coffee.
You listen to advice from integrative leaders like Drs. Hyman, Davis, Perlmutter and Gundry. You feel on track – and really good.
Then the American Heart Association tells us that coconut oil is not good for us – it never has been, and that we should still be consuming polyunsaturated vegetable oils such as soybean, corn and canola.1
Ugh.
Anger and confusion set in, and you start questioning all this new advice from the integrative world.
The good news? Those doctors you have been following – actually, most in the integrative medicine world – disagree with this latest Presidential Advisory and consider the data, which is based on studies from the 1960s-70s, old news and a rehash of the same guidelines that led to the low fat craze and demise of America’s health today.
The new train of thought based on more recent research is summarized by Mark Hyman, MD, director of the Cleveland Clinic Center for Functional Medicine, chairman of the board of the Institute for Functional Medicine, and medical editor of The Huffington Post, as such:
Let me cut through this confusion. The very idea that vegetable oils are better than saturated fats comes from the belief that they lower total and LDL cholesterol, so they presumably reduce our overall risk of heart disease. Following this type of advice means swapping out butter, meat, and lard for vegetable oils including corn, soybean, sunflower, canola, and safflower oils, which are all omega 6-rich, inflammatory polyunsaturated fats.2 Counting evidence now makes it clear that in the absence of refined sugars and processed carbohydrates and starches, healthy fats [butter, lard, coconut] shut down cravings, accelerate weight loss and can help prevent and reverse disease…Fat is not the enemy; sugar and starchy or refined carbs and a high-glycemic, processed food diet are the real causes of weight gain, heart disease and type 2 diabetes.3
The web is full of rebuttals to the report and those in our community are speaking up as well. “It is amazing that the AHA is continuing this stance,” says Joseph Scherger, MD, vice president of primary care at Eisenhower Medical Center. “What is most disturbing here is the complete lack of recognition of the inflammatory effects of many processed polyunsaturated vegetable oils. This is a gift to the food industry.”
“These same recommendations were introduced by our government in 1977 as the ‘Dietary Goals of the United States,’” notes Jeralyn Brossfield, MD, in her latest Desert Health® column. “We are living with the results of this ‘grand experiment’ where the standard American dietary recommendations have promoted a low-fat diet and the over consumption of vegetable oils and grains, and they are not good.”
Most of us grew up on this advice and all the packaged, processed, low fat foods that followed. Today, many are turning back to natural grass-fed butter, animal fat, and coconut oil.
The new news for some?
It is in the absence of refined sugars and processed carbs and starches that these saturated fats are good for you. Those still eating Big Macs and bagels may want to bow out of the conversation; the AHA is right in that you should probably not be eating any additional fats. I recommend picking up Hyman’s Eat Fat, Get Thin or cardiologist William Davis’s Wheat Belly: Total Health and transitioning to a healthier lifestyle before consuming coconut oil for breakfast.
Here is what the Institute for Functional Medicine posted in response to the AHA report:
Every expert agrees that coconut oil can still be considered a health food due to its medium-chain triglycerides, lauric acid, and a general misunderstanding of saturated fat. It does, however, need to be consumed in an otherwise generally healthy diet in order not to cause additional inflammation in the body, and its status as a healthier cooking oil does not give carte blanche to eat tablespoons of it daily.
Others emphasize the importance of using extra virgin coconut oil and 100% coconut MCT.
“The AHA campaign is backfiring because of the millions of people who already know that adding undamaged saturated fats into their diets makes them feel better,” says Dave Asprey whose Bulletproof Coffee (traditionally made with grass-fed butter and the brand’s Brain Octane (coconut) Oil) has added to the increased consumption. “They can feel the difference in their energy, see it in the mirror, and measure it in their blood work.” Read more about butter coffee here.
What did the AHA report fail to consider?
The new standard for measuring good vs. bad cholesterol
The AHA recommends that your total cholesterol should be less than 200 mg/dL to put you at lower risk for heart disease.4 Integrative docs see it differently.
“It is the total cholesterol to HDL ratio, and the LDL particle number and size that are the most predictive of heart disease,” says Hyman in an online blog. “In fact, small LDL particles are associated with three times the risk of heart attacks. Evidence suggests the biggest [indicator] of cardiac disease is the triglyceride to HDL ratio, not total cholesterol or LDL cholesterol.”5
For example, if a person has total cholesterol of 300 mg/dL yet their HDL is 100 mg/dL, the ratio would be 3.0 and considered a lower risk of heart disease (under 5) than someone who has the same total number, but with HDL at 50 mg/dL as their ratio would be 6.
The second consideration is the LDL particle size: big fluffy particles are healthy and lower your risk of heart disease; small dense LDL particles are dangerous and increase your risk of heart disease.
The AHA reports that saturated fat increases cholesterol and thus should be avoided. However, saturated fat increases LDL particle size (fluffy) while lowering triglycerides and raising HDL (good) cholesterol. In contrast, a low-fat, high-carb diet leads to smaller and more abundant LDL particles. In their report, the AHA did mention that the advice they and many doctors have offered for years to replace fats with carbohydrates does not work and may even increase cardiovascular risk. For some reason, that news didn’t make headlines.
Remember, cholesterol has an important job in your body as it helps to make hormones, vitamin D, and substances that help digest foods.
Unique and powerful properties of coconut oil
In Liz Moody’s online response posted on MindBodyGreen.com, integrative doctor Sara Gottfried, MD, notes that in the many years the AHA has been pushing low-fat diets, there has been a growing epidemic of obesity and diabetes. “Coconut oil is unusual in that it contains medium-chain triglycerides that are well-proven to speed metabolism and assist in fat loss,” she states. “Another component is lauric acid, found in breastmilk, which is antimicrobial.”6
In his book Eat Fat, Get Thin, Hyman further explains:
The saturated fat in coconut oil is a very rare, very beneficial type called medium-chain triglycerides (MCT). These saturated fats actually reduce the ratio of total cholesterol to HDL (a good thing) and promote weight loss, and can even heal fatty liver caused by obesity. MCTs…have been shown to possess antioxidant and antimicrobial properties which help support the immune system. In the body, MCTs convert easily to energy; therefore, very little MCT oil is stored in fat, because it is used for energy. This is how MCTs help you burn fat and lose weight.7
Other foods being consumed with coconut oil
The saturated fats you eat don’t increase blood levels of saturated fats; it’s what you eat with it, says Hyman:
There is evidence that saturated fats cause inflammation in humans and animals, and that is not a good thing because inflammation is the underlying cause of heart disease, obesity, type 2 diabetes, cancer and dementia. But there are some important caveats. It seems that saturated fats cause inflammation only in the context of two things: low levels of omega-3 fats and high levels of carbohydrates.8
He further explains that these fats in the blood are not coming from the fats you eat; they are produced by the liver in response to the carbs you eat.
So, once again, Healthy Ones, if you are eating a clean diet full of vegetables, nuts, seeds, fish (and/or an omega-3 supplement), grass-fed beef and the like, coconut oil can be very beneficial and contribute to the healthy cholesterol levels described above; however, if you are eating a high-sugar, high-refined-carb diet, the combination can contribute to inflammation and increase your bad cholesterol.
“The 40-year old advice to cut total fat, saturated fat, and cholesterol has backfired on an international scale, bringing with it unprecedented type 2 diabetes and obesity,” said Wheat Belly’s Bill Davis in an interview with Desert Health. “The original advice was based on flawed studies, misinterpretations, even misrepresentations. Then why did the American Heart Association recently–and incomprehensibly–reaffirm its position?”
In his online rebuttal Davis concludes, “Perhaps in another 10, 20, or 30 years, the AHA panel will be saying something like ‘Grains and sugars should be consumed in minimal amounts and, in the setting of strict carbohydrate limitation, the atherogenicity (heart disease-causing potential) of saturated fats is disabled. It is therefore clear that saturated fat consumption is benign and does not contribute to cardiovascular risk.’”9
References: 1) http://circ.ahajournals.org/content/early/2017/06/15/CIR.0000000000000510; 2) http://drhyman.com/blog/2016/01/29/why-oil-is-bad-for-you/); 3) http://drhyman.com/blog/2016/03/30/fat-what-i-got-wrong-what-i-got-right/; 4) https://www.goredforwomen.org/know-your-risk/factors-that-increase-your-risk-for-heart-disease/cholesterol-heart-disease/; 5) http://drhyman.com/blog/2016/03/30/fat-what-i-got-wrong-what-i-got-right/; 6) https://www.mindbodygreen.com/articles/is-coconut-oil-unhealthy-american-heart-association-study; 7) Mark Hyman, MD, Eat Fat, Get Thin (New York: Little, Brown and Company, 2016), 147; 8) Hyman, Eat Fat, Get Thin, 96.; 9) http://www.wheatbellyblog.com/2017/06/american-heart-association-saturated-fat/
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