The truth about cholesterol revisited
Melissa Southern-Garcia, Dietitian, Jakarta, SouthernDietitian@yahoo.com
It is always a pleasure to have an open debate on scientific issues. For centuries, health care professionals and scientists have debated topics that have later been proved or disproved as our knowledge has increased. At the same time, scientific facts have historically been manipulated and misused for the benefit of a particular cause or organization.
As a health professional, it has always been my intention to take the most responsible and unbiased look at all of the scientific information and present a clear assessment of the most reliable information available in a simple and direct way to my clients and readers. It is with the same intention that I now respond to the Asian and Pacific Coconut Community's letter published at The Jakarta Post on June 18, 2003.
In the March 19 edition of the paper I wrote an article discussing important facts about cholesterol. One of the major points mentioned in this article was that many products claim on their label that they have "no cholesterol" in order to indicate they are healthy. However, these same products can actually be harmful by increasing the cholesterol in your blood because they contain saturated fats.
Since the publication of that article, I have been in e-mail contact with the Asian and Pacific Coconut Community which is concerned about a possible decrease in sales and profit from coconut oil due to the statements in my article. It is natural for an association of coconut producers to want to protect their financial interests. In fact, most commodities have some type of organization in place which tries to disseminate positive information about their product and often finances scientific studies in hopes of finding more positive research results. To that end, hundreds of thousands of "scientific studies" are performed every year around the world.
The problem is that all scientific studies are not created equal. In order to determine if the results of a scientific study are credible, it is necessary to look at several different components. These include: who has performed the study, if the study was backed by a reputable organization or funded by someone with financial interests in the results, if there was a large enough number of subjects to make the results of the study significant to apply to the population as a whole, and what time frame was used for the study.
The most reliable scientific studies use what is called a longitudinal design which does not just look at a group of subjects for a few weeks or months, but instead, follows these subjects through a period of several years to study long-term effects. These types of studies are particularly important when discussing cardiovascular problems and their relation to diet since we are specifically examining life-long patterns of eating and their long-term effects on the body as we age.
As a dietitian who specializes in these issues, I have carefully studied the bulk of the research available on the subject of saturated fats -- specifically coconut and palm oils and have found the majority of reliable research indicates that coconut oil is a major cause of increased LDL, or bad cholesterol.
In the first paragraph of their letter, the Asian and Pacific Coconut Community mentions four studies claiming that coconut oil does not increase cholesterol.
So, let us examine each one: The first study compares a small group of indigenous Cook Islanders to the rest of New Zealand. Differences in lifestyle, exercise, genetics and other dietary factors -- all of which have been proven to significantly affect cardiovascular health -- were not taken into account in this study.
The next study looks at data from the Central Bank of Sri Lanka -- not necessarily a scientific source -- and bases its results on the number of people checking into hospitals in 1992 as compared to 50 years ago. One can only assume that the level of reporting as well as the number of hospitals in Sri Lanka has increased with modern times. It is certainly more logical to assume the number of people being admitted to hospital for heart attacks has increased in Sri Lanka today because there are more hospitals available to the population as compared to 50 years ago rather than to assume it is related to a decrease in consumption of coconut on the island.
And finally, the last two studies to which they refer involved only 10 people -- a number far to small to achieve any kind of significant scientific data. Studies of this nature only indicate that perhaps other larger studies need to be done.
The second section the Asian and Pacific Coconut Community's letter discusses the health benefits of Capric and Lauric acid. The fact that these fatty acids can act as possible anti- microbial and anti-viral agents is interesting but serves only to distract from the issue at hand: cholesterol.
In fact, a multitude of studies have directly named the C12 lauric and C14 myristic acids found abundantly in coconut and palm kernel oils as the specific actors of LDL cholesterol increases.
In their final paragraph, the authors claim that vegetable oils do, in fact, contain cholesterol. According to the table they present, coconut oil contains an insignificant amount of cholesterol (5-24 parts per million) as opposed to butter which contains 2200-4100 parts per million. Although the saturated fats in coconut oil and butter are more of a concern than their actual cholesterol content, it is interesting to note the Asian and Pacific Coconut Community has data that indicates coconut oil contains minimal quantities of cholesterol, and continues to print the words "No Cholesterol" across the labels of bottles of coconut oil in our supermarkets.
On a final note, I stand by all of the information written in my article of March 19, 2003. Saturated fatty acids have been shown through various respected, unbiased epidemiological studies to increase LDL cholesterol, and of all comestible oils on the market, coconut has the highest level of saturated fat (92 percent).
The following quotes may be found on the web sites of their respective medical organizations and are only a sample of the many reputable scientific institutions that support the view that coconut oil is directly related to an increase in serum cholesterol:
* "Vegetable oils such as coconut oil and palm oil contain a high percentage of saturated fats. Saturated fats increase LDL and total cholesterol" -- Irish Heart Foundation
* "Different saturated fatty acids vary in their propensity to raise blood cholesterol. Studies have shown that saturated fatty acids with 12, 14 and 16 carbons (lauric acid, myristic acid, and palmitic acid, respectively) are the primary contributors to elevated LDL cholesterol. These fatty acids are present in meat fats, butter fat and tropical oils (i.e. coconut and palm)" - University of Vermont College of Medicine.
* "Saturated fat (animal fat) and some vegetable oils, e.g., coconut, palm oil, increase the risk of cholesterol. This causes narrowing or furring of the arteries and increases the risk of a heart attack or stroke. This risk is greater if you have high blood pressure. Fat also contains lots of calories and increases your weight. Eating saturated fats increases the amount of LDL cholesterol in your blood." - UK Blood Pressure Association
* "These fatty acids fall into three categories: saturated, monounsaturated and polyunsaturated. Of these three, saturated fatty acids are the main culprit in raising blood cholesterol. Foods high in saturated fat come from both animals and plants. Animal-based foods containing lots of saturated fat include butter, beef tallow, lard and poultry fat. Seafood contains a small amount. Plant-based oils containing saturated fat include coconut oil, palm kernel oil, palm oil and cocoa butter." - American Heart Association
* "Saturated fats are found mainly in animal foods such as meat, butter, cream, cheese, dripping and lard. Two vegetable oils, coconut and palm oil, are high in saturated fat, and are often used in commercially-baked biscuits and cakes. Saturated fats in the diet increase LDL cholesterol and lower HDL cholesterol." -- Monaghan Hospital, Ireland.