Coconut oil has been praised in some corners and demonized in other circles. Some see coconut oil as a health-promoting superfood. Others see it as another saturated fat that is linked to heart disease. These leaves the typical consumer confused? Do I buy the big gallon bucket or not? Coconut oil is widely used in tropical cultures where heart disease is not as big of a deal as it is in the USA, so it can’t be that bad, can it?
In the middle of this debate is whether coconut oil is truly different from other saturated fats, especially when it comes to its role in cholesterol levels and cardiovascular disease (CVD) risk. In this article I will explore the science behind coconut oil. The explanation may get a bit technical for a minute or two, but in the end you will understand where it fits into a heart-healthy diet.
Understanding Coconut Oil’s Composition (The Tech Part)
Coconut oil is composed of approximately 90% saturated fatty acids, a higher proportion than butter (around 60%) or lard. Unlike other saturated fats, which are dominated by long-chain fatty acids (14 to 18 carbons), coconut oil is rich in medium-chain triglycerides (MCTs), particularly lauric acid (C12:0), which accounts for nearly 50% of its fatty acids. MCTs are absorbed and metabolized more rapidly than long-chain fatty acids which leads to lead to less fat storage and a different impact on cholesterol. However, lauric acid’s behavior complicates this picture, as we’ll explore later.
Head-to-Head Comparison: Butter, Virgin Coconut Oil, and Extra Virgin Olive Oil (The Scientific Study Part)
An enlightening 2018 randomized controlled trial (RCT) by Khaw et al., published in BMJ Open, did a head-to-head comparison that hadn’t been done before or repeated since. (This study was initiated because coconut oil was lumped together with other saturated fats in the 2017 American Heart Association Presidential advisory on dietary fats and cardiovascular disease. The BBC sponsored this study to find out the answer about coconut oil and CVD risk.) The research recruited 91 healthy adults who consumed 50 grams daily (approximately 3 tablespoons) of virgin coconut oil, unsalted butter, or extra virgin olive oil for 4 weeks. The results were striking:
Butter significantly increased LDL cholesterol (LDL-C, the “bad” cholesterol) by 16.2 mg/dL compared to coconut oil and 14.7 mg/dL compared to olive oil (P<0.0001 for both).
Coconut oil and olive oil showed no significant difference in LDL-C change (−1.5 mg/dL, P=0.74). (This was a VERY interestingresults indicatet oil raised HDL cholesterol (HDL-C, the “good” cholesterol) more than butter (+7.0 mg/dL) and olive oil (+6.2 mg/dL).
These results show that coconut oil’s effects on cholesterol are closer to those of heart-healthy olive oil than butter, challenging the notion that all saturated fats are equally harmful.
What Else Do Other Studies Say about Coconut Oil? (Corroborating Evidence Part)
Of course, the study by Khaw and coworkers above isn’t the only study on coconut oil. Other studies have found similar, but not exactly the same results:
Nikooei and coworkers published their findings from a randomized controlled trial in 2021 in Nutrition, Metabolism and Cardiovascular Diseases. They studied 48 individuals with metabolic syndrome who consumed 30 grams of virgin coconut oil daily for 4 weeks. Coconut oil increased HDL-C (+7.3 mg/dL) but also raised LDL-C (+22.0 mg/dL) and total cholesterol (+36.7 mg/dL) compared to a no-oil control group, showing possible drawbacks in people with metabolic syndrome or type 2 diabetes.
Voon and coworkers published their randomized, cross-over intervention in the European Journal of Clinical Nutrition in 2015. This trial with 45 healthy Malaysian participants, compared diets enriched with coconut oil, palm oil, or olive oil. Coconut oil increased HDL-C by 3.5 mg/dL more than olive oil (P < 0.05) and showed no significant LDL-C changes, consistent with Khaw et al.’s findings.
Korrapati and coworkers published their findings in Clinical Nutrition in 2018. This metabolically-controlled randomized controlled trial (RCT) with 9 healthy men (BMI ≤25 kg/m²) who consumed diets providing approximately 35 grams of coconut oil or peanut oil for 8 weeks, with a 6-week washout period. Coconut oil significantly increased HDL-C (P≤0.047) and improved insulin sensitivity compared to peanut oil, though no significant LDL-C changes were reported. While it lacks a direct comparison to butter or olive oil, the HDL-C increase is consistent with Khaw et al.’s findings, though limited lipid data restricts broader comparisons.
A 2020 meta-analysis by Neelakantan et al. in Circulation reviewed 17 RCTs and found that coconut oil raises LDL-C by 8.5 mg/dL and HDL-C by 4.6 mg/dL compared to nontropical oils (e.g., olive, soybean). Compared to butter, coconut oil had a less pronounced effect on LDL-C, reinforcing its intermediate position.
These studies all point out coconut oil’s consistent ability to boost HDL-C, but its LDL-C effects depend on the comparison fat and population studied.
Here’s Why Coconut Oil Falls in the Middle
Coconut oil’s unique effects stem from its high lauric acid content. Many people believe that lauric acid acts primarily as a medium-chain triglyceride (MCT) that is absorbed directly via the portal vein to the liver for rapid energy production. However, a 1992 study by Denke and Grundy in the American Journal of Clinical Nutrition clarified that approximately 70% of lauric acid is incorporated into chylomicrons—lipoprotein particles that transport fats through the bloodstream—before reaching the liver. Only 30% of the lauric acid is metabolized directly as an MCT. Since most of the lauric acid is processed like other long-chain saturated fats it contributes to some LDL-C increases, though less than longer-chain fats like palmitic acid, which is prevalent in butter.
This dual metabolism explains why coconut oil occupies a middle ground: it raises LDL-C less than butter but more than unsaturated oils like olive oil, while its HDL-C benefits are more pronounced due to its MCT-like properties.
Practical Implications for Your Diet (The “What Does This Mean?” Part)
The evidence suggests that coconut oil isn’t as bad for your heart as other saturated fats like butter, but it isn’t as good for your heart as extra virgin olive oil or other vegetable oils. The Khaw and coworkers study and other supporting research indicates that replacing butter with coconut oil may improve your choleserol profile, especially for boosting HDL-C. It is likely to increase your LDL-C a bit also, which offsets some of its benefits. If you are already quite healthy, it won’t cause much of an issue. If you have metabolic syndrome or type 2 diabetes you may want to go for the best oil and best results you can get.
For those who want the benefits of MCT oil without any of the cholesterol-raising effects of lauric acid, you may want to try MCT oil, which is rich in C8 (caprylic acid) and C10 (capric acid). Unlike coconut oil, MCT oil is rapidly metabolized, does not boost cholesterol levels, and promotes ketone body production, which can support energy needs during fasting. If you are doing intermittent fasting with a short window for your meals, this can give you a morning boost without breaking your fast.
It isn’t wise to make coconut oil your only source of fat. It doesn’t have essential fats in it, which you can get from unrefined vegetable oils, like expeller pressed canola oil or grapeseed oil. But coconut oil certainly can be part of a wholesome diet. For optimal heart health, emphasize extra virgin olive oil as your primary food preparation fat and organic, unrefined vegetable oil for your salad dressings.
And it is worth reminding you that the most powerful fat for heart health is still fish oil. Don’t forget to take your fish oil. It is quite likely that making sure your omega 3 index is up above 8 percent will cover over a lot of other less-than-optimal oil choices along the way.
Conclusion
Coconut oil’s high lauric acid content sets it apart from other saturated fats, leading to a cholesterol profile that’s less harmful than butter but not as beneficial as olive oil. Its ability to raise HDL-C is a potential advantage, but its usually raises LDL-C as well. So, if your cholesterol levels are a cause for concern you should use coconut oil sparingly. And take fish oil. As research continues to increase our understanding, coconut oil remains a nuanced player in the world of dietary fats—neither a villain nor a hero. As always, use oils that were processed with human health in mind, not shelf life.
