From Villain to Victor


Many folks have been raised to think coconut oil is the central culprit in the cast of dietary characters responsible for heart disease and chronic disease. Coconut oil can be a powerfully effective nutritional tool in our quest to improve body composition and reverse diseases. Medical student, Nihaal Karnik  reviews the research behind coconut oil, and then our clinical dietician Prerna Uppal and I will share some of our experiences from the clinic at the end.


Like every young Indian kid in America there is nothing I dreaded more than the blue bottle: yes….the coconut oil bottle my mother would heat on a weekly basis.

No, mom was not ahead of the curve with regards to consuming coconut oil. Like every other Indian mom she was absolutely hell bent on heating that greasy stuff and working it into our hair for a good 45 minutes. And like all children, I fussed, squirmed, and went to bed with a grease soaked scalp promising I would never ever buy this stuff when I am an adult. Fast forward 20 years and I am at the grocery store about once every two months buying a massive jar of coconut oil for myself.

Am I using it for my hair? Well….moms are always right, so yes. But the majority of that oil goes towards my daily cooking. Whether I am frying eggs or heating up some ground turkey, I cannot remember the last meal I cooked without some coconut oil.

Although a variety of misconceptions exist about the safety of coconut oil with regards to diet, scientific literature has begun to emerge that supports the use of coconut oil.

Let’s explore everything coconut: from the beginning of the theory concerning its health hazard to modern research which proves otherwise.

Key Terms and Background
Before exploring the science of coconut oil, it is important to look at some terms that will be used throughout this post:

Saturated Fats-Simply put, saturated fats refer to any fat that remains a solid at room temperature. Traditional nutrition has decried the use of saturated fats in one’s diet, however they are not the devil of a healthy diet. In fact, when processed sugars and excessive carbohydrates are replaced with saturated fats we tend to eat a diet more in line with those of our early ancestors. Remember, coconut oil is technically a saturated fat.

Medium Chain Triglycerides (MCTs)-These refer to a class of fatty acids that are intermediate in length. For instance, most fat in the body is long chain form; most fats from cow’s milk is short chain. A growing body of evidence suggests MCTs (such as coconut oil) help burn body fat and lead to weight loss.

Coconut Oil. Let’s dig a bit deeper into this MCT.  Unfortunately, the recent trend to incorporate more coconut oil in the diet has led to a slew of cheap alternatives which are not good forms of coconut oil. Like all foods we eat, not all coconut oil is created equally. If you are going to use coconut oil, then don’t skip out on spending an extra $1 or $2; it’s well worth the investment. Prerna Uppal, a dietician suggests “virgin coconut oil (VCO) as it is the least refined and has the higher number of antioxidants.” She recommends “Nutiva organic virgin coconut oil.”

So Why Has Coconut Oil Been Labeled as a Bad Thing
Thomas Brennan, a professor of nutritional sciences at Cornell University, offers a simple explanation of why it has been implicated as a heart disease risk factor. In a 2011 interview with the New York Times, he tells us, “Most of the studies involving coconut oil were done with partially hydrogenated coconut oil, which researchers used because they needed to raise the cholesterol levels of their rabbits in order to collect certain data.” This simply means there was a pre-conceived bias since researchers were using processed coconut oil (remember what we said about all coconut oil not being equal?” He further states, “Virgin coconut oil, which has not been chemically treated, is a different thing in terms of a health risk perspective.

And maybe it isn’t so bad for you after all.”

It is clear that improper science, a lack of using proper coconut oil, and repeated misinformation has labeled coconut oil as a villain to any advocate of a healthy lifestyle.

From Villain to Victor: Emerging Research Supporting the Use of Coconut Oil
I could devote pages upon pages to emerging research about potential benefits. Instead, I will try to highlight the main points by presenting a simple list.

Lipid Maintenance and Fat Burning.  Researchers at the University of Kerala recently published a study in the British Journal Of Nutrition. In this study the group points out that VCO 1) helped improve lipid panel results and 2) directly reduced fat formation. The group further concluded that these two findings suggest that a diet in coconut oil could reduce one’s risk for coronary heart disease (CHD).

Anti-Inflammatory/Antioxidant Properties

Anti-inflammatory and antioxidant rich foods are important for a healthy diet. Both are essential in maintaining a body free of cellular damage.

New research shows VCO may be such a potent anti-inflammatory agent, that it could help treat various forms of arthritis (remember, a lot of arthritic conditions are due to a pro or high inflammatory state). The biggest selling point of VCO is its antioxidant property. The problem with cooking with other media such as olive oil concerns high heat and oxidative damage. Simply put, when we fry things in olive oil, the olive oil is so hot that various chemicals become oxidized or rather damaged. So even though olive oil may be good for us, at high temperatures the chemical changes are actually damaging at a cellular level. Conversely, VCO does not oxidize or get damaged at high temperatures. In fact, current research shows that this lack of damage has heart healthy benefits.

Antimicrobial activity

One of the nastiest hospital infections is Clostridium Dificile (a really nasty bacteria). It is a major cause of severe diarrhea and a very hard pathogen to treat. That said, a study shows that laboratory testing (called in vitro) of this super nasty bug with VCO is effective. In other words, VCO is so potent as an antimicrobial agent it has promising abilities to treat tough bacterial infections.

Quality of Life Among Breast Cancer Patients

Another study found consuming VCO during chemotherapy improved functioning and quality of life among 60 patients who received VCO as part of the diet.

Final Thoughts
A brief review of history shows that coconut oil was unfairly cast as an evil oil due to misinformation and poor science. Dogmatic adherence to outdated studies still casts fear about its usage with doctors, patients, and wellness experts.

The growing body of literature surrounding VCO is promising. However, more laboratory and human trial research needs to be done.

Furthermore, one of the most important things to take away is knowing that not all coconut oils are created equally. Remember, try to buy organic and virgin coconut oil as it has the most antioxidants (the good stuff that protects our cells).

As a medical student I constantly evaluate the medical science of new advancements. As much as I am on board with the VCO train there are two things I would like to see. First, would be long term research in a large patient population using VCO. It is not that I am a skeptic; rather the gold standards of medical claims are supported by these types of studies. Second, I would like to see dietary research where VCOs replace carbohydrates, processed foods,and sugar as an energy source. To date, few if any studies assess this model.

Tips on getting nuttier with coconut oil. Remember, adding saturated fats and MCTs to the diet are only beneficial if we eliminate unnecessary carbohydrates, processed foods,  and sugar. Furthermore, make sure you buy the right stuff. Feel like reading this topic on your own? Then definitely look at any studies that assess VCO, not just any regular coconut oil.

So I guess, mom is always right. About once a week I squirm, fuss, and moan. This time it’s about pouring over textbooks (mainly because I have procrastinated) while I have a scalp soaking in greasy coconut oil. As I lie in bed tonight (with a towel over my pillow of course), I can go ahead and rest knowing that maybe coconut oil for everyday use is not so crazy after all.

Clinic Insights from Dr. Ron and Prerna
I know the information about coconut oil and saturated fat in general can be very confusing.  I suggest you follow our general principle of self-experimentation.  There is enough compelling evidence to suggest that safely using coconut oil in reasonable portions does not have harmful effects, and may in fact promote health benefits. As Nihaal mentioned, Prerna and I recommend it in conjunction with healthy anti-inflammatory foods and lifestyle habits. So many patients we see in the clinic have direct evidence of suffering from chronic inflammation, and simply adding coconut oil to an inflammatory diet and lifestyle not only is ineffective, but can be harmful as well.  Remember, even the highest quality fats are not immune to the dangerous process of oxidation which occurs from consuming unhealthy foods.  Once these foods are removed and coconut oil is added, we do not see cholesterol and inflammatory markers go up.

We see this effect in our Indian patients from regions like Kerala where coconut oil is a staple food. Although prior studies suggested coconut oil may be a potential cause of increased heart disease risk in Kerala and other parts of Southern India, in our experience we have noted that it is the excess carbohydrate consumption and sedentary lifestyle which are predominantly responsible.

We consistently see insulin resistance markers and metabolic syndrome reduce or resolve when our South Indians reintroduce coconut oil in the context of a healthier nutrition and lifestyle plan. Not only do risk numbers improve, but energy levels increase, and body composition trends in a healthier direction with reduced waistlines/visceral fat.

Ronesh Sinha, M.D. is a physician for the Palo Alto Medical Foundation who sees high risk South Asian patients, he blogs at, and co-hosts a South Asian radio show on health.

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