Proponents of the increasingly popular high-fat and purportedly natural diets often promote coconut oil as a heart-healthy ingredient. To examine the evidence for cardiovascular effects of coconut oil, investigators conducted a meta-analysis of clinical trials published by June 2019 that compared coconut oil, consumed for at least 2 weeks, with other vegetable oils, and that assessed cardiovascular risk factors.

Pooled results of 17 trials involving 730 participants indicated that, compared with other non-tropical vegetable oils, coconut oil was associated with significantly increased LDL by a mean of 10.5 mg/dL and HDL by a mean of 4 mg/dL. Similarly, in four studies comparing coconut oil with palm oil, another oil high in saturated fat, coconut oil was associated with higher total and LDL cholesterol. In a subset of studies that reported other cardiovascular risk factors, no association was found between coconut oil consumption and measures of adiposity, fasting glucose, or inflammatory markers.

This study confirms our dietary guidelines for the prevention of cardiovascular disease that recommend limiting saturated fat intake. However, although coconut oil increases cholesterol (both LDL and HDL), there are no data showing that this is associated with increased cardiovascular events. Coconut oil, despite being aggressively marketed and perceived as a “natural” and “healthy” fat source, is composed of 90% saturated fat. Although other sources of coconut fat (i.e., coconut milk) were not considered in this analysis, patients are to be counselled to consume all sources of saturated fat sparingly.