In mid-2012, Nestlé Health Science acquired a stake in Accera®, the U.S. maker of Axona®, a medical food targeted at people with mild to moderate Alzheimer’s. Aside from the fact that the purchase shows that Nestlé is placing a strategic bet on the future direction of medical food demand, this acquisition also is interesting for its potential validation of a tropical oil that alternately has been damned and praised for its role in health: coconut oil.
On the one hand, there are those who still maintain that coconut oil, a source of more saturated fat than butter, lard or beef tallow, is the devil incarnate for brain and heart health. On the other hand, current science is in the process of validating the high regard that the coconut oil enjoys in the Ayurvedic and Chinese traditions of healing.
Indeed, coconut oil bears a striking overlap in its metabolic
implications, in this case for Alzheimer’s disease, with medical
foods designed to provide the brain alternate fuel sources. A
nice introduction to this topic is Alzheimer’s Disease: What If
There Was a Cure? by Mary Newport, MD.
The scientific backtracking regarding coconut oil recently
was put in a nutshell in a New York Times interview of Thomas
Brenna, a professor of nutritional sciences at Cornell University.1
Dr. Brenna observed that coconut oil’s bad reputation for
cardiovascular health rested mostly on partially hydrogenated
coconut oil, oil designed specifically to raise cholesterol levels
in the rabbits being used in experiments. Virgin coconut oil
differs dramatically in a large number of ways from the trans-fat
laden partially hydrogenated item. Even the health dangers of
the saturated aspect of coconut oil currently are being debated.
As Dr. Brenna remarks in the interview, “I think we in the
nutrition field are beginning to say that saturated fats are not
so bad, and the evidence that said they were is not so strong.”
Coconut Oil—A “Good” Saturated Fat
Coconut oil is saturated (it is solid up to 76° F), consisting
of 86.5 percent saturated fatty acids and 5.8 percent monounsaturated
fatty acids.2 Lauric acid makes up approximately
46 percent of coconut oil and generally is considered to be the
villain in terms of serum cholesterol. However, in clinical trials,
the effects of dietary supplementation with coconut oil usually
have been found to be either no effect or a small increase in
LDL cholesterol and a significant increase in HDL cholesterol,
meaning that the ratio—and cardiovascular risk—improves
Moreover, extra virgin coconut oil consists mostly of
medium-chain fatty acids (MCFA), with 50 percent being
lauric acid. Medium-chain fatty acids have been used for
many years for special health purposes. They have attracted
attention as part of a healthful diet because they are absorbed
and transported directly into the liver via the portal vein
and thereafter metabolized rapidly by beta-oxidation, thus
increasing diet-induced thermogenesis.5
One derivative of coconut MCFA is medium-chain
triglyceride (MCT) oil, which is 75 percent caprylic and 25
percent capric acids, fatty acids very similar to lauric acid and
present in virgin coconut oil in smaller amounts. MCT oil
often is found in the hospital nutrient mixtures for bedridden
patients who are dependent upon intravenous nutrition. These
fats were developed in part because they do not require the
action of bile for digestion, but rather are absorbed directly
through the walls of the small intestine and transported to the
liver to be used immediately as fuel.
The special characteristics of coconut MCFA mean that
the body prefers to burn it for fuel rather than to store it. You
might say that the body treats coconut fatty acids more like it
does carbohydrates, but without getting involved with insulin.
Scientists know this because of experience with MCT oils. In
my book Anti-Fat Nutrients (revised 4th edition, Basic Media), I
discuss MCT oil at length. In seriously catabolic patients, MCT
oil was found to help prevent the body from depleting lean and
muscle tissues. Again, MCT fatty acids are not readily stored
as body fat, but rather they are preferentially burned in the
mitochondria of the cells to provide energy.6 For some athletes and bodybuilders, this quality has proved useful since excess
training depletes the glycogen stores of the muscles, and
continued training after that point can only take place partially
through the break down of muscle protein for fuel.7 Coconut oil medium-chain fatty acids have properties similar to those of
MCT oil, but not as pronounced.
Does this mean that coconut oil can help dieters? Yes,
as long as there are not too many expectations. Indeed, the
nutrition author Ray Peat, PhD, has remarked that in the
1940s farmers attempted to use coconut oil for fattening
their animals, but they found that it made them lean, active
and hungry instead! The fatty acids found in coconut seem to
promote the burning of fat for fuel and, as already noted, have
a pronounced thermogenic effect. However, the thermogenic
and fat-burning qualities of medium-chain fatty acids seem
to be more significant for healthy subjects of normal weight
and for those moderately overweight than for those who are
clinically obese (fortunately, a category that excludes most of
us). Moreover, medium-chain fatty acids serve to protect the
body’s protein in the lean tissues during the use of low calorie
and low carbohydrate diets.8
Immune and Digestive Benefits
Coconut oil has many other benefits. Two names are closely
associated with the research in this area. These are Jon J.
Kabara, PhD, one of the primary researchers into the benefits
of lauric acid, and Mary G. Enig, PhD, the great researcher in
the area of fats and one of the first (literally decades before
the mainstream medical researchers) to point out the health
dangers of trans-fatty acids.
Dr. Enig was the keynote speaker in 2001 at the 36th
Annual Conference of the Asian Pacific Coconut Community.
There she gave her talk on the benefits of the coconut as a
functional food. She noted that approximately 50 percent of
the fatty acids in coconut fat are lauric acid, which has the
additional beneficial function of being formed into monolaurin
in the human body. Monolaurin is a monoglyceride used by
the human metabolism to destroy lipid-coated (that is, fat-coated)
viruses and a number of other undesirable organisms.
Approximately 6–7 percent of the fatty acids in coconut fat
are capric acid. Dr. Enig points out that capric acid is another
medium-chain fatty acid that has a similar beneficial function
when it is formed into monocaprin in the human or animal
body. Monocaprin has beneficial effects similar to those found
The work of Dr. Jon Kabara and others shows that coconut
oil components exert their health benefits in a way that is
very safe to humans. In general, it is reported that the fatty
acids and monoglycerides produce their inactivating effects
by destabilizing the membrane that surrounds pathogens, for
instance, by causing the disintegration of the virus envelope.
Despite such sometimes quite potent actions against
unwanted microbes, there is no evidence of any negative effect
on probiotic organisms in the gastrointestinal tract.
In his accessible, yet thoroughly researched book, The
Healing Miracles of Coconut Oil (HealthWise), author Bruce
Fife, ND, ranges across a number of health topics for which
coconut oils has proven to be effective. He notes that coconut oil is so stable that it helps to preserve
other oils, thereby reducing antioxidant
requirements. Populations that eat large
amounts of coconut and coconut products,
such as the oil, are characterized
by low rates of heart disease. Lauric acid
and other medium-chain fatty acids are
found in mother’s milk, where among
other things, they improve the uptake
by the baby of nutrients such as amino
acids, calcium and magnesium. Similar
effects upon nutrient assimilation have
been found in the very ill and in the
elderly. Moreover, these health benefits
do not even take into account the long
accepted uses of coconut oil to nourish
the skin and the hair.
Benefits for Brain Health?
Let’s return to Nestlé Health Science
acquired a stake in Accera, the U.S.
maker of Axona, a medical food targeted
at people with mild to moderate
Alzheimer’s. The basic argument for this
medicinal food is that in Alzheimer’s
disease, the brain is starved for energy
because it has a reduced ability to metabolize
glucose. Reduced energy means
reduced levels of cognition and memory.
Fortunately, there is an alternative to glucose
known as ketone bodies. Axona is
a proprietary formulation of caprylic triglyceride
that is converted by the liver
into ketone bodies.
Recall that coconut oil is a good
source of medium-chain triglycerides
(MCTs), the fatty acids that are converted
in the liver to ketones. Ketones can
provide energy to cells without the
need for insulin. This is important for
several reasons, not the least being
that Alzheimer’s is related to insulin
resistance and the attempt to get glucose
to the brain with a high carbohydrate diet
is counterproductive.9 Moreover, access
to ketones may more generally promote
neurologic health—several neurologic
conditions have shown promising results
with ketogenic diets. Ketogenic diets
may help treat difficult cases of epilepsy
and Parkinson’s disease as well as other
neurological disorders, indeed perhaps
improve cognition and health in general.
The use of coconut oil with the
conditions above at this point is
promising, but hardly proven. Moreover,
there are not yet much in the way of set
rules or recommendations. Dr. Newport
was giving her husband as much as 11
tablespoonsful per day, with four to eight
tablespoonsful seeming to be a regular
recommendation. At 115 calories per
tablespoon, a coconut oil supplemented
diet should not otherwise continue to be
the standard American diet built upon
a foundation of refined carbohydrates.
Those wanting to add serious amounts
of coconut oil to their everyday diets, as
opposed to merely switching to it as a
cooking oil, might find it useful to explore
high protein/low carbohydrate options
more generally. The chief warning to
those who would try such diets is that
Paleolithic-type diets need to include
plenty of vegetables and reasonable
amounts of whole fruit (avoiding fruit
In his book, Bruce Fife asks the rhetorical
questions, “If there was [sic] an oil you
could use for your daily cooking needs
that helped protect you from heart
disease...other degenerative conditions,
improved your digestion, strengthened
your immune system, protected you from
infectious diseases, and helped you lose
excess weight, would you be interested?”
Surely this is a good question. Aside from
the record of traditional use, numerous
research papers and United States
Patents argue for the health-promoting
benefits of coconut oil. Now that organic
coconut oil/extra virgin coconut oil is
readily available in health food stores,
perhaps it is time for health-conscious
shoppers to give it a try.
- Melissa Clark, “Once a Villain, Coconut Oil Charms the Health Food World.” New York Times March 1, 2011.
- “Nutrient database, Release 24” (http://ndb.nal.usda.gov/) . United States Department of Agriculture. http://ndb.nal.usda.gov
- Assunção ML, Ferreira HS, dos Santos AF, Cabral CR Jr, Florêncio TM. Effects of dietary coconut oil on the biochemical and anthropometric profiles of women presenting abdominal obesity. Lipids. 2009 Jul;44(7):593-601.
- Mensink RP, Zock PL, Kester AD, Katan MB. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr. 2003 May;77(5):1146-55.
- Aoyama T, Nosaka N, Kasai M. Research on the nutritional characteristics of medium-chain fatty acids. J Med Invest. 2007 Aug;54(3-4):385-8.
- Babayan VK. Medium chain triglycerides and structured lipids. Lipids 1987 Jun;22(6):417-20.
- Nosaka N, Suzuki Y, Nagatoishi A, Kasai M, Wu J, Taguchi M. Effect of ingestion of medium-chain triacylglycerols on moderate-and high-intensity exercise in recreational athletes. J Nutr Sci Vitaminol (Tokyo). 2009 Apr;55(2):120-5.
- Dias VC, et al. Effects of medium-chain triglyceride feeding on energy balance in adult humans. Metabolism 1990;39:887-891.
- Seneff S, Wainwright G, Mascitelli L. Nutrition and Alzheimer’s disease: the detrimental role of a high carbohydrate diet. Eur J Intern Med. 2011 Apr;22(2):134-40.