A randomized study of coconut oil versus sunflower oil on cardiovascular risk factors in patients with stable coronary heart disease

The Lipid-Heart Hypothesis and the Keys Equation Defined the Dietary Guidelines but Ignored the Impact of Trans-Fat and High Linoleic Acid Consumption

In response to a perceived epidemic of coronary heart disease, Ancel Keys introduced the lipid-heart hypothesis in 1953 which asserted that high intakes of total fat, saturated fat, and cholesterol lead to atherosclerosis and that consuming less fat and cholesterol, and replacing saturated fat with polyunsaturated fat, would reduce serum cholesterol and consequently the risk of heart disease. Keys proposed an equation that would predict the concentration of serum cholesterol (ΔChol.) from the consumption of saturated fat (ΔS), polyunsaturated fat (ΔP), and cholesterol (ΔZ): ΔChol. = 1.2(2ΔS - ΔP) + 1.5ΔZ. However, the Keys equation conflated natural saturated fat and industrial trans-fat into a single parameter and considered only linoleic acid as the polyunsaturated fat. This ignored the widespread consumption of trans-fat and its effects on serum cholesterol and promoted an imbalance of omega-6 to omega-3 fatty acids in the diet. Numerous observational, epidemiological, interventional, and autopsy studies have failed to validate the Keys equation and the lipid-heart hypothesis. Nevertheless, these have been the cornerstone of national and international dietary guidelines which have focused disproportionately on heart disease and much less so on cancer and metabolic disorders, which have steadily increased since the adoption of this hypothesis.

Assessment of virgin coconut oil in a balanced diet on indicators of cardiovascular health in non-obese volunteers: A human metabolic study

BACKGROUND AND AIMS

Consumption of coconut oil is implicated in cardiovascular disease risk. On the contrary, virgin coconut oil (VCO) is believed to offer better health benefits, however, the evidence to support such claims is lacking, particularly in humans. Therefore, this study aimed at assessing the impact of VCO in a balanced diet on HDL-C and some of the anthropometric and biochemical parameters associated with human cardiovascular health before and after the feeding experiment.

METHODS

In a crossover observational study, apparently healthy non-obese male volunteers (n = 22) aged between 28 and 50years with a mean body weight of 67.5 kg were inducted into a two-arm controlled feeding experiment one after another for eight weeks with a six-week washout period. In the first arm, the diets were prepared with VCO, whereas peanut oil was used in the second arm (∼35g/day) as the control.

RESULTS

Compared to baseline, the consumption of VCO did not affect HDL-C and anthropometric measures at the end of the 8th week, whereas plasma total cholesterol (TC) and LDL-C levels (Means±standard error; 172 ± 5.6 mg/dL versus 186 ± 5.9 mg/dL and 113 ± 4.29 mg/dL versus 126 ± 4.17 mg/dL respectively) increased significantly. However, plasma triglycerides and some of the cardiovascular risk markers (namely, vascular cell-adhesion molecules, serum amyloid proteins and C-reactive protein) remained unaltered. Further, most of the changes in the VCO arm were comparable to the peanut oil regimen.

CONCLUSION

The consumption of VCO in a balanced diet displayed neutral effects on most parameters related to cardiovascular risk. However, the rise in TC and LDL-C must be tested in a larger sample size over longer periods.

Coconut oil: an overview of cardiometabolic effects and the public health burden of misinformation

Recent data from meta-analyses of randomized clinical trials (RCTs) suggest that dietary intake of coconut oil, rich in saturated fatty acids, does not result in cardiometabolic benefits, nor in improvements in anthropometric, lipid, glycemic, and subclinical inflammation parameters. Nevertheless, its consumption has surged in recent years all over the world, a phenomenon which can possibly be explained by an increasing belief among health professionals that this oil is as healthy as, or perhaps even healthier than, other oils, in addition to social network misinformation spread. The objective of this review is to present nutritional and epidemiological aspects related to coconut oil, its relationship with metabolic and cardiovascular health, as well as possible hypotheses to explain its high rate of consumption, in spite of the most recent data regarding its actual effects.

Inflammatory crosstalk between saturated fatty acids and gut microbiota-white adipose tissue axis

PURPOSE

High-fat diets have different metabolic responses via gut dysbiosis. In this review, we discuss the complex interaction between the intake of long- and medium-chain saturated fatty acids (SFAs), gut microbiota, and white adipose tissue (WAT) dysfunction, particularly focusing on the type of fat.

RESULTS

The evidence for the impact of dietary SFAs on the gut microbiota-WAT axis has been mostly derived from in vitro and animal models, but there is now also evidence emerging from human studies. Most current reports show that, in response to high long- and medium-chain SFA diets, WAT functions are altered and can be modulated from microbial metabolites in several manners; and it appears to be also modified under conditions of obesity. SFAs overconsumption can reduce bacterial content and disrupt the gut environment. Both long- and medium-chain SFAs may contribute to proinflammatory cytokines release and TLR4 cascade signaling, either by regulation of endotoxemia markers or myristoylated protein. Palmitic and stearic acids have pathological effects on the intestinal epithelium, microbes, and inflammatory and lipogenic WAT profiles. While myristic and lauric acids display somewhat controversial outcomes, from probiotic effects and contribution to weight loss to cardiometabolic alterations from WAT inflammation.

CONCLUSION

Identifying an interference of distinct types of SFA in the binomial gut microbiota-WAT may elucidate essential mechanisms of metabolic endotoxemia, which may be the key to triggering obesity, innovating the therapeutic tools for this disease.

Coconut Oil and Cardiovascular Disease Risk

Purpose of Review

This narrative review summarizes the current peer-reviewed literature and mechanisms surrounding the cardiovascular health impact of coconut oil.

Recent Findings

No randomized controlled trials (RCTs) and/or prospective cohort studies have investigated the effect or association of coconut oil with cardiovascular disease. Evidence from RCTs indicated that coconut oil seems to have less detrimental effects on total and LDL-cholesterol compared to butter, but not compared to cis-unsaturated vegetable oils, such as safflower, sunflower, or canola oil. The isocaloric replacement (by 1% of energy intake) of carbohydrates with lauric acid (the predominant fatty acid in coconut oil) increased total cholesterol by 0.029 mmol/L (95% CI: 0.014; 0.045), LDL-cholesterol by 0.017 mmol/L (0.003; 0.031), and HDL-cholesterol by 0.019 mmol/L (0.016; 0.023).

Summary

The current evidence from shorter term RCTs suggests that replacement of coconut oil with cis-unsaturated oils lowers total and LDL-cholesterol, whereas for the association between coconut oil intake and cardiovascular disease, less evidence is available.

The In Vitro, Ex Vivo, and In Vivo Effect of Edible Oils: A Review on Cell Interactions

Consumption of edible oils is a significant part of the dietary pattern in the developed and developing world. Marine and vegetable oils are assumed to be part of a healthy food pattern, especially if one takes into account their potential role in protecting against inflammation, cardiovascular disease, and metabolic syndrome due to the presence of polyunsaturated fatty acids and minor bioactive compounds. Exploring the potential effect of edible fats and oils on health and chronic diseases is an emerging field worldwide. This study reviews the current knowledge of the in vitro, ex vivo, and in vivo effect of edible oils in contact with various cell types and aims to demonstrate which nutritional and bioactive components of a variety of edible oils present biocompatibility, antimicrobial properties, antitumor activity, anti-angiogenic activity, and antioxidant activity. Through this review, a wide variety of cell interactions with edible oils and their potential to counteract oxidative stress in pathological conditions are presented as well. Moreover, the gaps in current knowledge are also highlighted, and future perspectives on edible oils and their health benefits and potential to counteract a wide variety of diseases through possible molecular mechanisms are also discussed.

Coconut oil consumption and bodyweight reduction: a systematic review and meta-analysis

INTRODUCTION

Due to the composition and biological properties of coconut oil, there is still considerable debate regarding potential benefits for the management of obesity, including the specific impact on body weight (BW) reduction. This systematic review and meta-analysis of clinical trials aims to assess the impact of coconut oil on BW reduction in comparison to other oils and fats.

EVIDENCE ACQUISITION

The databases, PubMed^®, Web of Science^®, EMBASE^®, and SciVerse Scopus^® were systematically searched. A combination of medical subject headings and words linked to coconut oil and obesity parameters were utilized. Any clinical trials comparing coconut oil to any other form of oil or fat, with more than one month feeding period among adults were considered.

EVIDENCE SYNTHESIS

From the 540 potentially relevant papers, 9 were included. The period of coconut oil intake varied from four to twelve weeks, apart from one long-term trial where coconut oil was consumed for two years. When compared to other oils and fats, coconut oil substantially decreased BW (N.=546), Body Mass Index (BMI) (N.=551), and percentage of fat mass (FM%) (N.=491) by 0.75 kg (P=0.04), 0.28 kg/m² (P=0.03), and 0.35% (P=0.008), respectively. Coconut oil consumption did not result in any significant alteration in waist circumference (WC) (N.=385) (-0.61 cm; P=0.30), waist-to-hip ratio (WHR) (N.=330) (-0.01; P=0.39) and FM (N.=86) (-0.25 kg; P=0.29).

CONCLUSIONS

Results indicate a small statistically significant reduction in BW, BMI, and FM% in the coconut oil group. In contrast, consumption of coconut oil had no statistically significant effect on WC, WHR, or FM.

Saturated fat: villain and bogeyman in the development of cardiovascular disease?

AIMS

Cardiovascular disease (CVD) is the leading global cause of death. For decades, the conventional wisdom has been that the consumption of saturated fat (SFA) undermines cardiovascular health, clogs the arteries, increases risk of CVD, and leads to heart attacks. It is timely to investigate whether this claim holds up to scientific scrutiny. The purpose of this paper is to review and discuss recent scientific evidence on the association between dietary SFA and CVD.

METHODS AND RESULTS

PubMed, Google scholar, and Scopus were searched for articles published between 2010 and 2021 on the association between SFA consumption and CVD risk and outcomes. A review was conducted examining observational studies and prospective epidemiologic cohort studies, randomized controlled trials (RCTs), systematic reviews and meta-analyses of observational studies and prospective epidemiologic cohort studies, and long-term RCTs. Collectively, neither observational studies, prospective epidemiologic cohort studies, RCTs, systematic reviews, and meta-analyses have conclusively established a significant association between SFA in the diet and subsequent cardiovascular risk and coronary artery disease, myocardial infarction, or mortality nor a benefit of reducing dietary SFAs on CVD rick, events, and mortality. Beneficial effects of replacement of SFA by polyunsaturated or monounsaturated fat or carbohydrates remain elusive.

CONCLUSION

Findings from the studies reviewed in this paper indicate that the consumption of SFA is not significantly associated with CVD risk, events, or mortality. Based on the scientific evidence, there is no scientific ground to demonize SFA as a cause of CVD. SFA naturally occurring in nutrient-dense foods can be safely included in the diet.

Oxidative Stability and Protective Effect of the Mixture between Helianthus annuus L. and Oenothera biennis L. Oils on 3D Tissue Models of Skin Irritation and Phototoxicity

The present study was aimed to evaluate the oxidative stability as well as to assess the protective effect of the mixture of Helianthus annuus L. (HAO) and Oenothera biennis L. (OBO) oils on 3D tissue models of skin irritation and phototoxicity. The following methods were used: GS analysis (fatty acids composition), thiobarbituric acid-reactive substances assay (TBA) (lipid oxidation degree of tested samples), 3D EpiDerm models (skin irritation and phototoxicity). For HAO the detected saturated fatty acids (SFA) were palmitic acid (7.179%), stearic acid (3.586%), eicosanoic (0.138%) and docosanoic acid (0.548%) The monounsaturated acids (MUFA) were palmitoleic acid (0.158%) and oleic acid (28.249%) and the polyunsaturated acids (PUFA) were linoleic acid (59.941%) and linolenic acid (0.208%). For OBO the detected SFA were myristic acid (0.325%), pentadecylic acid (0.281%), palmitic (7.2%), stearic (2.88%), and arachidic acid (0.275%). Regarding MUFA, even a lower proportion (8.196%) was observed, predominantly being oleic acid, cis form (7.175%), oleic (n10) (0.558%) and 11-eicosenoic (0.210%) acids. The higher content was found for PUFA (82.247%), the most significant proportions being linoleic acid (72.093%), arachidonic acid (9.812%) and linolenic (0.233%). Obtained data indicate a good oxidative stability and biocompatibility of the mixture on the 3D EpiDerm models with no irritant and no phototoxic effects. Oenothera biennis L. oil may be an excellent natural choice in order to delay or prevent oxidative damage of Helianthus annuus L. oil.

A Pilot Study on the Effect of Virgin Coconut Oil On Serum Lipid Profile and HS CRP Level Among Post Acute Coronary Syndrome Patients: A Randomized Controlled Trial

ABSTRACT Introduction: Acute coronary syndrome (ACS) is a leading cause of death in Malaysia and worldwide. Besides, teh current treatment which involves teh prescription of statins is found to TEMPhas several side TEMPeffects on ACS patients. Those side TEMPeffects TEMPhas guided teh author to introduce virgin coconut oil (VCO) as supplemental management of ACS. However, its benefits TEMPhas not been widely tested on humans. Methodology: dis study examines teh use of VCO among ACS patients via a crossover trial. It seeks to ascertain teh TEMPeffect of VCO on serum lipid profile and hs-CRP level among ACS patients. Result: VCO was found to be statistically significant in reducing serum lipid level and hs-CRP level (p<0.001). These findings measured from small to moderate Cohen’s d TEMPeffect size, thus proving teh results from dis study as statistically and clinically significant. Conclusion: These findings suggest dat dietary intake wif saturated fatty acid (C6 to C12) can improve health condition. Keywords: virgin coconut oil, acute coronary syndrome, saturated fatty acid, medium-chain triglycerides

Effect of Olive Pomace Oil on Cardiovascular Health and Associated Pathologies

Background: olive pomace oil (OPO) is a nutritionally relevant fat due to its high oleic acid content (C18:1) and the presence of a wide range of minor bioactive components. Although numerous in vitro and preclinical studies have been developed to study some of its characteristic components, the health effect of prolonged OPO consumption is unknown. Methods: a randomised, blinded, cross-over, controlled clinical trial was carried out in 31 normocholesterolemic and 37 hypercholesterolemic subjects. Participants consumed 45 g/day of OPO or sunflower oil (SO) for 4 weeks, each preceded by a 3-week run-in/wash-out phase with corn oil (CO). Results: regular consumption of OPO and SO had no statistically significant effect on any of the markers related to lipid profile, blood pressure, and endothelial function in both groups, except for eNOS levels, which were close to statistical significance due to the effect of oil (OPO and SO) (p = 0.083). A decrease in visceral fat (p = 0.028) in both groups was observed after OPO intake, accompanied by an increment of leptin (p = 0.017) in the hypercholesterolemic group. Conclusion: reducing visceral fat after prolonged OPO intake might contribute to improve cardiometabolic status, with a potentially positive effect on the vascular tone. Further clinical trials are needed to confirm the present results.

The effects of coconut oil on the cardiometabolic profile: a systematic review and meta-analysis of randomized clinical trials

Background

Despite having a 92% concentration of saturated fatty acid composition, leading to an apparently unfavorable lipid profile, body weight and glycemic effect, coconut oil is consumed worldwide. Thus, we conducted an updated systematic review and meta-analysis of randomized clinical trials (RCTs) to analyze the effect of coconut oil intake on different cardiometabolic outcomes.

Methods

We searched Medline, Embase, and LILACS for RCTs conducted prior to April 2022. We included RCTs that compared effects of coconut oil intake with other substances on anthropometric and metabolic profiles in adults published in all languages, and excluded non-randomized trials and short follow-up studies. Risk of bias was assessed with the RoB 2 tool and certainty of evidence with GRADE. Where possible, we performed meta-analyses using a random-effects model.

Results

We included seven studies in the meta-analysis (n = 515; 50% females, follow up from 4 weeks to 2 years). The amount of coconut oil consumed varied and is expressed differently among studies: 12 to 30 ml of coconut oil/day (n = 5), as part of the amount of SFAs or total daily consumed fat (n = 1), a variation of 6 to 54.4 g/day (n = 5), or as part of the total caloric energy intake (15 to 21%) (n = 6). Coconut oil intake did not significantly decrease body weight (MD -0.24 kg, 95% CI -0.83 kg to 0.34 kg), waist circumference (MD -0.64 cm, 95% CI -1.69 cm to 0.41 cm), and % body fat (-0.10%, 95% CI -0.56% to 0.36%), low-density lipoprotein cholesterol (LDL-C) (MD -1.67 mg/dL, 95% CI -6.93 to 3.59 mg/dL), and triglyceride (TG) levels (MD -0.24 mg/dL, 95% CI -5.52 to 5.04 mg/dL). However, coconut oil intake was associated with a small increase in high-density lipoprotein cholesterol (HDL-C) (MD 3.28 mg/dL, 95% CI 0.66 to 5.90 mg/dL). Overall risk of bias was high, and certainty of evidence was very-low. Study limitations include the heterogeneity of intervention methods, in addition to small samples and short follow-ups, which undermine the effects of dietary intervention in metabolic parameters.

Conclusions

Coconut oil intake revealed no clinically relevant improvement in lipid profile and body composition compared to other oils/fats. Strategies to advise the public on the consumption of other oils, not coconut oil, due to proven cardiometabolic benefits should be implemented.

Registration

PROSPERO CRD42018081461.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12944-022-01685-z.

Virgin coconut oil: A comprehensive review of antioxidant activity and mechanisms contributed by phenolic compounds

Virgin coconut oil (VCO) is obtained by processing mature coconut cores with mechanical or natural methods. In recent years, VCO has been widely used in the food, pharmaceutical, and cosmetic industries because of its excellent functional activities. VCO has biological functions such as antioxidant, anti-inflammatory, antibacterial, and antiviral, and also has potential therapeutic effects on many chronic degenerative diseases. Among these functions, the antioxidant is the most basic and important function, which is mainly determined by phenolic compounds and medium-chain fatty acids (MCFAs). This review aims to elucidate the antioxidant functions of each phenolic compound in VCO, and discuss the antioxidant mechanisms of VCO in terms of the role of phenolic compounds with fat, intestinal microorganisms, and various organs. Besides, the composition of VCO and its application in various industries are summarized, and the biological functions of VCO are generalized, which should lay a foundation for further research on the antioxidant activity of VCO and provide a theoretical basis for the development of food additives with antioxidant activity.

Olive Pomace Oil versus High Oleic Sunflower Oil and Sunflower Oil: A Comparative Study in Healthy and Cardiovascular Risk Humans

Olive pomace oil (OPO) is mainly a source of monounsaturated fat together with a wide variety of bioactive compounds, such as triterpenic acids and dialcohols, squalene, tocopherols, sterols and aliphatic fatty alcohols. To date, two long-term intervention studies have evaluated OPO’s health effects in comparison with high oleic sunflower oil (HOSO, study-1) and sunflower oil (SO, study-2) in healthy and cardiovascular risk subjects. The present study integrates the health effects observed with the three oils. Two randomized, blinded, cross-over controlled clinical trials were carried out in 65 normocholesterolemic and 67 moderately hypercholesterolemic subjects. Each study lasted fourteen weeks, with two four-week intervention phases (OPO versus HOSO or SO), each preceded by a three-week run-in or washout period. Regular OPO consumption reduced total cholesterol (p = 0.017) and LDL cholesterol (p = 0.018) levels as well as waist circumference (p = 0.026), and only within the healthy group did malondialdehyde (p = 0.004) levels decrease after OPO intake versus HOSO. Contrarily, after the SO intervention, apolipoprotein (Apo) B (p < 0.001) and Apo B/Apo A ratio (p < 0.001) increased, and to a lower extent Apo B increased with OPO. There were no differences between the study groups. OPO intake may improve cardiometabolic risk, particularly through reducing cholesterol-related parameters and waist circumference in healthy and hypercholesterolemic subjects.

Contemporary Developments and Emerging Trends in the Application of Spectroscopy Techniques: A Particular Reference to Coconut (Cocos nucifera L.)

The number of food frauds in coconut-based products is increasing due to higher consumer demands for these products. Rising health consciousness, public awareness and increased concerns about food safety and quality have made authorities and various other certifying agencies focus more on the authentication of coconut products. As the conventional techniques for determining the quality attributes of coconut are destructive and time-consuming, non-destructive testing methods which are accurate, rapid, and easy to perform with no detrimental sampling methods are currently gaining importance. Spectroscopic methods such as nuclear magnetic resonance (NMR), infrared (IR)spectroscopy, mid-infrared (MIR)spectroscopy, near-infrared (NIR) spectroscopy, ultraviolet-visible (UV-VIS) spectroscopy, fluorescence spectroscopy, Fourier-transform infrared spectroscopy (FTIR), and Raman spectroscopy (RS) are gaining in importance for determining the oxidative stability of coconut oil, the adulteration of oils, and the detection of harmful additives, pathogens, and toxins in coconut products and are also employed in deducing the interactions in food constituents, and microbial contaminations. The objective of this review is to provide a comprehensive analysis on the various spectroscopic techniques along with different chemometric approaches for the successful authentication and quality determination of coconut products. The manuscript was prepared by analyzing and compiling the articles that were collected from various databases such as PubMed, Google Scholar, Scopus and ScienceDirect. The spectroscopic techniques in combination with chemometrics were shown to be successful in the authentication of coconut products. RS and NMR spectroscopy techniques proved their utility and accuracy in assessing the changes in coconut oil’s chemical and viscosity profile. FTIR spectroscopy was successfully utilized to analyze the oxidation levels and determine the authenticity of coconut oils. An FT-NIR-based analysis of various coconut samples confirmed the acceptable levels of accuracy in prediction. These non-destructive methods of spectroscopy offer a broad spectrum of applications in food processing industries to detect adulterants. Moreover, the combined chemometrics and spectroscopy detection method is a versatile and accurate measurement for adulterant identification.

Are We Nuts Over Coconuts? Studying the Effects of Coconut Oil on Low-Density Lipoprotein and Cardiovascular Diseases: A Systematic Review

Coconut oil has been gaining popularity recently, especially with health enthusiasts claiming it to be the best fat for consumption. What is the ideal cooking fat? The answer that we are all looking for is just not solely based on one health consequence but several. Our study focuses on the cardiovascular aspects of using coconut oil by its influence on low-density lipoprotein (LDL). Cardiovascular diseases (CVDs) are the major cause of death and mortality worldwide. Hence, they are the focus of this study. For centuries, coconut oil has been used by several populations worldwide who consume it as part of their staple diets. However, they have also been consuming the flesh/meat of coconuts and decreased processed foods. One such population is the pacific islanders, who had increased LDL and decreased high-density lipoprotein (HDL) when they moved out of their natural habitat and accepted a more westernized diet. Even though coconut oil has a stronghold on the LDL aspect of the lipid parameters, which is our study's focus, it also increases HDL, whose effects on cardiovascular health are still controversial although it is called "good cholesterol."

Cardiologists now utilize the ratio of total to HDL cholesterol to assess CVD risk more reliably. There have not been many human studies to support coconut oil's LDL and CVD advantages, considering all these variables. A thorough search of five databases, including PubMed, PubMed Central, Google Scholar, Cochrane Library, and ScienceDirect, was done. The last search was done on October 8th, 2021. Studies were selected based on the following criteria: last five years, English language, human studies, randomized controlled trials (RCTs), systematic reviews and meta-analysis, narrative reviews, and cross-sectional studies were included using medical subject headings (MeSH) search and keyword search. Eight hundred and ninety-nine articles were found, and eight papers were picked after quality appraisal. These included one narrative review, three RCTs, one cross-sectional study, and three systematic reviews and meta-analyses. The results showed that coconut oil did not behave differently than other saturated fats to reduce LDL. One study showed that coconut oil did not increase LDL compared to additional saturated fat like butter or lard. Coconut oil also has antioxidant properties that may prevent oxidative stress that affects cardiovascular health. However, studies in this sector are limited.

Effects of consumption of coconut oil or coconut on glycemic control and insulin sensitivity: A systematic review and meta-analysis of interventional trials

BACKGROUND AND AIMS

The often purported claim that coconut fat is beneficial for cardiovascular health and was disputed in several recent meta-analyses. However, the evidence on the effects of coconut fat intake on glycemic control remains equivocal. We conducted a systematic review and meta-analysis in accordance with the PRISMA guidelines to determine the effects of dietary coconut fats on markers of acute and long-term glycemic control.

METHODS AND RESULTS

PubMed, Scopus, ProQuest, and Web-of-Science databases were searched and the records were screened by three independent reviewers to identify interventional studies examining acute and long-term (i.e., >10 days) effects of coconut fat on glycemic control. DerSimonian-Laird random-effects meta-analyses were performed using the meta-package in R (4.0.2). Seven interventional studies on acute effects and 11 interventional studies on long-term effects of coconut fat were included. Meals with coconut fat acutely increased the incremental area under the curve (AUC) of glucose (p = 0.046) and decreased the incremental AUC of insulin (p = 0.037) vs. control meals. Long-term coconut fat intake increased HOMA-IR (p = 0.049), but did not significantly affect fasting glucose, insulin, or HOMA-β vs. control meals.

CONCLUSIONS

Coconut fat in meals seems to be associated with a diminished postprandial insulin response, resulting in a subtle increase in the postprandial glycemic response. Long-term intake of coconut fat seems to increase insulin resistance, yet does not seem to be beneficial for long-term glycemic control. Thus, our results disprove the popular claim that coconut fat improves glycemic control.

REGISTRATION

PROSPERO registry (CRD42020183450).

Non alcoholic palm nectar from Cocos nucifera as a promising nutraceutical preparation

Nonalcoholic Palm Nectar from Cocos nucifera (NPNC), a bio-refresher obtained from the juvenile inflorescence of coconut palm; is prominent as a nutritional health drink. The aim of this study was to investigate the nutritional and medicinal properties of NPNC and its products; sugar (NPNCS) and honey (NPNCH). The collected samples were subjected to physicochemical evaluations such as pH, Titrable Acidity, Total Soluble Solids, and Ash value, using standard techniques. The analysis revealed the suitability of NPNC as a natural health drink over conventionally available beverage. The elemental compositions of the samples were determined by using Inductive Coupled Plasma-Atomic Emission Spectrometry and demonstrated that NPNCH is enriched with iron and NPNCS with calcium. Vitamin C present in the samples was determined by using 2,6-Dichlorophenol indophenol redox titration method. Hydrolysable polyphenols, tannins, and flavonoids are determined by Folin-Ciocalteu, by Folin-Denis's technique and by aluminium chloride colorimetric methods, respectively. In NPNC, the dominance of Vitamin C as antioxidant is observed. Diuretic activity of samples was determined by Lipschitz method, and the results revealed that NPNC exhibited significant diuretic activity, comparable with furosemide. Immunomodulatory activities of the samples were evaluated by using indirect hemagglutination test and by using delayed type hypersensitivity (DTH) response. NPNC, NPNCS, and NPNCH exhibited stimulatory effect on humoral and cell-mediated immunity, which is comparable with that of standard immunomodulator levamizole. Subacute toxicity studies of selected samples were done in Wistar rats and the results proved the boicompatibility of the samples without systemic toxic effects. PRACTICAL APPLICATIONS: The use of commercially available carbonated beverages and energy drinks in young adults are associated with negative health outcomes with increased incidence of diabetes, sleep disturbances, and dental problems. Even though, such complications are there, the energy drink industries have grown dramatically accounting for major percentage of market sale. Researchers are in search for natural health drinks with some medicinal value to avoid the negative impact on consumers' health. Nonalcoholic Palm Nectar from Cocos nucifera (NPNC) is considered as zero alcoholic natural health drink. The focus of this study is to reveal the potential medicinal properties of NPNC and its products; honey (NPNCH) and sugar (NPNCS). If the nutritional and medicinal values of the selected preparations from natural sources can be proved with scientific evidence, its ability to beat commercially available carbonated beverages and energy drinks with negative health consequences may get widespread acceptance.

Long-term effects of increasing omega-3, omega-6 and total polyunsaturated fats on inflammatory bowel disease and markers of inflammation: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND AND AIM

Effects of long-chain omega-3 (LCn3) and omega-6 fatty acids on prevention and treatment of inflammatory bowel diseases (IBD, including Crohn's Disease, CD and ulcerative colitis, UC), and inflammation are unclear. We systematically reviewed long-term effects of omega-3, omega-6 and total polyunsaturated fats (PUFA) on IBD diagnosis, relapse, severity, pharmacotherapy, quality of life and key inflammatory markers.

METHODS

We searched Medline, Embase, Cochrane CENTRAL, and trials registries, including RCTs in adults with or without IBD comparing higher with lower omega-3, omega-6 and/or total PUFA intake for ≥ 24 weeks that assessed IBD-specific outcomes or inflammatory biomarkers.

RESULTS

We included 83 RCTs (41,751 participants), of which 13 recruited participants with IBD. Increasing LCn3 may reduce risk of IBD relapse (RR 0.85, 95% CI 0.72-1.01) and IBD worsening (RR 0.85, 95% CI 0.71-1.03), and reduce erythrocyte sedimentation rate (ESR, SMD - 0.23, 95% CI - 0.44 to - 0.01), but may increase IBD diagnosis risk (RR 1.10, 95% CI 0.63-1.92), and faecal calprotectin, a specific inflammatory marker for IBD (MD 16.1 μg/g, 95% CI - 37.6 to 69.8, all low-quality evidence). Outcomes for alpha-linolenic acid, omega-6 and total PUFA were sparse, but suggested little or no effect where data were available.

CONCLUSION

This is the most comprehensive meta-analysis of RCTs investigating long-term effects of omega-3, omega-6 and total PUFA on IBD and inflammatory markers. Our findings suggest that supplementation with PUFAs has little or no effect on prevention or treatment of IBD and provides little support for modification of long-term inflammatory status.

Chemical composition and health benefits of coconut oil: an overview

Coconut oil is an integral part of Sri Lankan and many South Asian diets. Initially, coconut oil was classified along with saturated fatty acid food items and criticized for its negative impact on health. However, research studies have shown that coconut oil is a rich source of medium-chain fatty acids. Thus, this has opened new prospects for its use in many fields. Beyond its usage in cooking, coconut oil has attracted attention due to its hypocholesterolemic, anticancer, antihepatosteatotic, antidiabetic, antioxidant, anti-inflammatory, antimicrobial and skin moisturizing properties. Despite all the health benefits, consumption of coconut oil is still underrated due to a lack of supportive scientific evidence. Even though studies done in Asian countries claim a favorable impact on cardiac health and serum lipid profile, the limitations in the number of studies conducted among Western countries impede the endorsement of the real value of coconut oil. Hence, long-term extensive studies with proper methodologies are suggested to clear all the controversies and misconceptions of coconut oil consumption. This review discusses the composition and functional properties of coconut oils extracted using various processing methods. © 2020 Society of Chemical Industry.

The Influence of Interesterification on the Thermal and Technological Properties of Milkfat-Rapeseed Oil Mixture and Its Potential Use in Incorporation of Model Meat Batters

Enzymatic interesterification gives the possibility to obtain a wide range of lipids with a modified structure. In the present study, model meat batters were produced from chicken breast muscles and enzymatically interesterified fats: milkfat:rapeseed oil (3:2 w/w). Fatty acids composition and their positional distribution in triacylglycerol, melting profile and oxidative stability have been determined in fats used for interesterification, after interesterification and extracted from meat batters. In meat batters, the physiochemical parameters were determined. Interesterified fats were characterized by significantly lower induction times than noninteresterified fat (85.29 and 18.21 min, respectively). Meat batters were also characterized by a lower oxidative stability of lipid fraction (24.90 and 13.67 min) than lipids used to their production. A higher content of unsaturated fatty acids was found in meat batters with noninteresterified and interesterified fats (69.40% and 70.03%, respectively) than in the control meat batter with a pork jowl (58.63%). In comparison to the control product, meat batter prepared with interesterified mixture was characterized by significantly lower apparent viscosity. In the analyzed meat batters, there were no differences in thermal drip and penetration force. The incorporation of interesterified milkfat with rapeseed oil in model meat batters can be a strategy to improve the nutritional quality without adversely affecting the quality characteristics.

The Glucose-Lowering Effects of Coconut Oil: A Case Report and Review of the Literature

Background

Coconut oil, a saturated fat comprised mostly of the medium-chain fatty acid, lauric acid, has become increasingly popular over the past few decades due to its touted anti-inflammatory, metabolic, and lipid-lowering properties. There have been many studies with mixed results evaluating the effects of coconut oil consumption on lipid metabolism and cardiometabolic risk. However, the effects on glucose metabolism are less clear. There are few trials on the effects of coconut oil on glucose homeostasis but no case reports prior to the current one.

Case

We present a case of a 66-year-old man with a history of type 2 diabetes managed with insulin who developed recurrent hypoglycemia and required reduction in insulin therapy quickly after consuming coconut oil supplementation.

Conclusion

This is the first known case report of coconut oil supplementation in a diabetic patient on insulin resulting in hypoglycemia. Review of the literature shows that coconut oil supplementation can have a favorable effect on glycemic control, possibly through phenolic compounds mediating anti-inflammatory effects. This effect is inconsistent throughout the studies reviewed, likely due to variations in types of coconut oil supplementation and scarcity of trials. Further research is required both in animal models and in humans before coconut oil intake is widely advised and popularized. This is especially true in patients with diabetes, who are at increased risk of cardiovascular disease, and in whom reduction in saturated fat intake is advised.

Effect of coconut oil on cardio-metabolic risk: A systematic review and meta-analysis of interventional studies

BACKGROUND AND AIMS

High total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) could be major risk factors for cardiovascular disease burden among high risk populations especially in South Asians. This systematic review and meta-analysis aimed to quantify the effects of coconut oil compared with other oils and fats on cardio-metabolic parameters.

METHODS

PubMed, Scopus and Web of Science were systematically searched. The main outcomes included are lipid and glycemic parameters. Subgroup analyses were performed to evaluate individual comparisons of vegetable oils and animal fat with coconut oil. Data were pooled using random-effects meta-analysis.

RESULTS

Coconut oil consumption significantly increased TC by 15.42 mg/dL (95% CI, 8.96-21.88, p < 0.001), LDL-C by 10.14 mg/dL (95% CI, 4.44-15.84, p < 0.001) and high density lipoprorein cholesterol (HDL-C) by 2.61 mg/dL (95% CI, 0.95-4.26, p = 0.002), and significantly decreased glycosylated hemoglobin (HbA1c) by 0.39 mg/dL (95% CI, -0.50 to -0.27, p < 0.001) but, it had no effects on triglycerides (TG), (4.25 mg/dL; 95% CI, -0.49-8.99, p = 0.08) when compared with the control group. Sub-group analysis demonstrated that coconut oil significantly increased TC and LDL-C over corn, palm, soybean and safflower oils and not over olive oil. Compared with butter, coconut oil showed a better pattern in cardio-metabolic markers by significantly increasing HDL-C (4.38 mg/dL, 95% CI, 0.40 to 8.36, p = 0.03) and decreasing LDL-C (-14.90 mg/dL, 95% CI, -23.02 to-6.77, p < 0.001).

CONCLUSIONS

Our results suggest that coconut oil consumption results in significantly higher TC, LDL-C and HDL-C than other oils. Consumption of coconut oil can be one of the risk factors for CVDs in South Asians.

Oilseed crop sunflower (Helianthus annuus) as a source of food: Nutritional and health benefits

The use of biofertilizers in developing environmentally friendly agriculture as an alternative to chemical-based fertilizers in enhancing food production is promising in sustainable agriculture for the improvement in the yield of some commercial crops such as sunflowers and other oilseed crops in terms of quality and quantity. Sunflower is an important oilseed crop native to South America and currently cultivated throughout the world. Generally, the sunflower is considered important based on its nutritional and medicinal value. Due to its beneficial health effects, sunflower has been recognized as functional foods or nutraceutical, although not yet fully harnessed. Sunflower contains mineral elements and phytochemicals such as dietary fiber, manganese, vitamins, tocopherols, phytosterols, triterpene glycosides, α-tocopherol, glutathione reductase, flavonoids, phenolic acids, carotenoids, peptides, chlorogenic acid, caffeic acid, alkaloids, tannins, and saponins; and these compounds contribute to their functional and nutraceutical development. The extract from sunflower is known to be a potential source of antimicrobial, anti-inflammatory, antitumor, and antioxidants agents that protect human cells against harmful reactive oxygen molecules and pathogenic microorganisms. Also, the pharmacological survey on sunflower had revealed its curative power to different kinds of diseases. The health benefits of sunflower include blood pressure and diabetic control, skin protection, and lowering cholesterol and other functions. This review is written with appropriate referencing to previously published work and provides updated information regarding the new method of organic farming for sunflower production, nutritional and health benefits, and its by-products as human diet and livestock feed. Also, the constraints of sunflower production are elucidated.

Foliar Spray of Fe-Asp Confers Better Drought Tolerance in Sunflower as Compared with FeSO4: Yield Traits, Osmotic Adjustment, and Antioxidative Defense Mechanisms

Different techniques are being employed to reduce the adverse effects of water stress on seed yield and quality of crop plants. The current study aimed to improve the water stress tolerance of field-grown sunflower by foliar-supplied ecofriendly iron-chelated aspartate (Fe-Asp) in comparison with FeSO4. Water stress decreased the plant growth and yield, accompanied with disturbed water relations, nutrient acquisition, accumulation of amino acids, and antioxidative defense mechanisms. However, lipid peroxidation, total anthocyanin, and photosynthetic pigments were increased. Fertigation of FeSO4 and Fe-Asp as foliar sprays proved effective to reduce the negativities of limited irrigation on biomass production and seed yield, accompanied with a reduction in lipid peroxidation and improvements in water relations, antioxidative defense mechanisms, and leaf photosynthetic pigments. In comparison with FeSO4, foliary applied Fe-Asp better improved the plant water relations with more accumulation of essential amino acids and nutrient acquisition, especially leaf aspartate (Asp) and Fe accumulation which showed better translocation. Overall, foliary applied Fe-Asp proved better for induction of drought tolerance in sunflower plants as compared with FeSO4. The study recommended the use of the ecofriendly Fe-Asp as a foliar spray for better growth and production of sunflower under limited irrigation.

Virgin Coconut Oil Associated with High-Fat Diet Induces Metabolic Dysfunctions, Adipose Inflammation, and Hepatic Lipid Accumulation

Obesity reaches an epidemic level worldwide, and this condition is associated with chronic low-grade inflammation and secondary comorbidities, largely driven by global changes in lifestyle and diet. Various dietary approaches are proposed for the obesity treatment and its associated metabolic disorders. Good taste, antioxidant functions, and vitamins have been attributed to virgin coconut oil (VCO). However, VCO contains a large amount of saturated fatty acids, and the consumption of this fat is associated with a number of secondary diseases. We evaluate the effects of VCO supplementation on biochemical, inflammatory, and oxidative stress parameters in rats fed with high-fat diet (HFD). After feeding with HFD for 12 weeks, the animals were supplemented with VCO for 30 days. HFD+VCO group increased in diet intake, weight gain, low-density lipoprotein cholesterol level, and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. These findings were accompanied by increased in hepatic lipid profile and fat deposition in the liver. Adipocyte hypertrophy was observed in the HFD+VCO group, which was associated with elevated expression of tumor necrosis factor alpha (TNF-α) in adipose tissue. These results revealed that VCO associated with HFD induced important metabolic alterations, adipose inflammation, and hepatic lipid accumulation in rats.

Suplementação com óleos ricos em ácidos graxos poli-insaturados na dieta de leitões na fase de creche: efeitos no desempenho, na resposta inflamatória, no perfil lipídico e no “status” oxidativo

RESUMO Nos sistemas de produção, os produtos naturais vêm se destacando na substituição a produtos sintéticos, dentre eles podemos ressaltar os óleos vegetais ricos em ácido graxos poli-insaturados (PUFA), que são conhecidos, popularmente, por seus efeitos benéficos. Dessa forma, o objetivo com este trabalho foi avaliar os efeitos da suplementação dos óleos de pequi (Caryocar brasiliense) e girassol (Helianthus annus) sobre parâmetros fisiológicos em leitões na fase de creche. Foram utilizados 180 leitões alojados em granja comercial, distribuídos em três grupos (n=60) conforme suplementação alimentar: óleo de pequi, óleo de girassol e controle negativo. Amostras de sangue e o peso dos animais foram obtidos nos intervalos de quatro trocas de rações da fase de creche para avaliação do desempenho, da resposta inflamatória, do perfil lipídico e do “status” oxidativo. Os parâmetros fisiológicos mensurados demonstraram que os óleos interferiram positivamente na resposta inflamatória sistêmica, por meio dos leucócitos totais e da relação neutrófilo/linfócito (P<0,05); no equilíbrio oxidante-antioxidante, por mensuração de óxido nítrico e do malondialdeído (P<0,05); e no metabolismo lipídico, com a avaliação de colesterol total e triglicérides (P<0,05). Por outro lado, esses óleos vegetais interferiram no ganho de peso e no consumo de ração (P<0,05). Assim, concluí-se que a suplementação com óleos de pequi e girassol melhora a saúde dos animais, mas tem impacto negativo no desempenho zootécnico de leitões na fase de creche.

Heterotic Effect of Different Cytoplasmic Combinations in Sunflower Hybrids Cultivated Under Diverse Irrigation Regimes

The sunflower hybrids hold a narrow cytoplasmic diversity. Besides, the heterotic effect of wild cytoplasmic combinations of sunflower on important traits under water stress has not been explored in detail. Here, we evaluated the different sunflower cytoplasmic combinations in sunflower hybrids using cytoplasmic male sterile (CMS) sources as female parents. We used a total of sixteen sunflower genotypes representing twelve CMS lines from wild and conventional sources along with four restorer lines. Twelve CMS lines were crossed with four restorer lines to develop a total of 48 F₁ hybrid combinations. The hybrids were evaluated under two different environments (i.e., regular irrigation and water stress) for morphophysiological, yield, and biochemical traits over two years. Heterotic effect for various CMS sources was evaluated on all of the three possible scales, namely, better-parent heterosis (BPH), mid-parent heterosis (MPH), and heterosis as percent of check (PSH-996). For better-parent and mid-parent heterosis, the CMS sources Helianthus annuus, Helianthus argophyllus, and Helianthus debilis demonstrated positive better-parent heterosis for seed yield, oil content, and oleic acid irrespective of the environment. However, the hybrid combinations of different sources when using the genotype RCR8297 as the restorer parent recorded maximum average returns. Furthermore, chlorophyll meter (SPAD) reading positively correlated with days to 50% flowering, days to maturity, plant height, and number of leaves per plant in both the environments. Overall, this study identified and compared the heterotic effect of the different cytoplasmic combinations in sunflower under water stress as well as under normal irrigation environments.

Virgin Coconut Oil Ameliorates Colchicine Induced Cognitive Dysfunction- A Preclinical Study

Background : Virgin coconut oil (VCO) has been identified as a potential cognitive strengthener associated with Alzheimer’s disease (AD). It contains medium chain fatty acids (MCFA) which are absorbed and easily metabolized by the liver to form ketone bodies. Ketone bodies are converted to acetyl Co-A in the brain which then enters the citric acid cycle to provide ATP and also serves as precursors of acetylcholine in neurons. Sunflower oil (SO) contains poly unsaturated fatty acids which has both anti-inflammatory and neuroprotective actions. To compare the neuroprotective effects of VCO and SO on biochemical parameters involved in the cognitive dysfunction induced by colchicine through intracerebroventricular (i.c.v) route.To assess the role of polyphenols and MCFA present in VCO in preventing oxidative stress and its influence on in neuroprotection and memory enhancement. Methods: In the present study, we induced dementia through i.c.v injection of colchicine after giving the diet enriched VCO and SO in rats for 60 days. Rats were sacrificed on the 22nd day after the administration of colchicine. Behavioral parameters were assessed during the study period and biochemical estimations were performed using frontal cortex and hippocampus isolated from rat brain. Results: From the memory and learning tests by Morris water maze, VCO treated group performed better than SO treated rats. VCO reversed the antagonistic effects induced by colchicine by decreasing the acetylcholinesterase and malondialdehyde levels and increasing the levels of catalase and superoxide dismutase. SO only reduced malondialdehyde levels in cortex and hippocampus. Conclusion: The results demonstrated potential beneficiary effects of VCO in the cognitive dysfunction induced by colchicine by enhancing acetylcholine levels in the frontal cortex and hippocampus and also by reducing oxidative stress induced by physiological oxidants.

The Effect of Coconut Oil Consumption on Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis of Clinical Trials

BACKGROUND

Coconut oil is high in saturated fat and may, therefore, raise serum cholesterol concentrations, but beneficial effects on other cardiovascular risk factors have also been suggested. Therefore, we conducted a systematic review of the effect of coconut oil consumption on blood lipids and other cardiovascular risk factors compared with other cooking oils using data from clinical trials.

METHODS

We searched PubMed, SCOPUS, Cochrane Registry, and Web of Science through June 2019. We selected trials that compared the effects of coconut oil consumption with other fats that lasted at least 2 weeks. Two reviewers independently screened articles, extracted data, and assessed the study quality according to the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The main outcomes included low-density lipoprotein cholesterol (LDL-cholesterol), high-density lipoprotein cholesterol (HDL-cholesterol), total cholesterol, triglycerides, measures of body fatness, markers of inflammation, and glycemia. Data were pooled using random-effects meta-analysis.

RESULTS

16 articles were included in the meta-analysis. Results were available from all trials on blood lipids, 8 trials on body weight, 5 trials on percentage body fat, 4 trials on waist circumference, 4 trials on fasting plasma glucose, and 5 trials on C-reactive protein. Coconut oil consumption significantly increased LDL-cholesterol by 10.47 mg/dL (95% CI: 3.01, 17.94; I² = 84%, N=16) and HDL-cholesterol by 4.00 mg/dL (95% CI: 2.26, 5.73; I² = 72%, N=16) as compared with nontropical vegetable oils. These effects remained significant after excluding nonrandomized trials, or trials of poor quality (Jadad score <3). Coconut oil consumption did not significantly affect markers of glycemia, inflammation, and adiposity as compared with nontropical vegetable oils.

CONCLUSIONS

Coconut oil consumption results in significantly higher LDL-cholesterol than nontropical vegetable oils. This should inform choices about coconut oil consumption.

Comparison of the Effects of Brazil Nut Oil and Soybean Oil on the Cardiometabolic Parameters of Patients with Metabolic Syndrome: A Randomized Trial

Recent evidence suggests that replacing saturated fat with unsaturated fat is beneficial for cardiovascular health. This study compared the effects of Brazil nut oil (BNO) and soybean oil (SO) supplementation for 30 days on anthropometric, blood pressure, biochemical, and oxidative parameters in patients with metabolic syndrome (MS). Thirty-one patients with MS were randomly allocated to receive 30 sachets with 10 mL each of either BNO (n = 15) or SO (n = 16) for daily supplementation. Variables were measured at the beginning of the study and after 30 days of intervention. No change in anthropometric and blood pressure variables were observed (p > 0.05). Total (p = 0.0253) and low-density lipoprotein (p = 0.0437) cholesterol increased in the SO group. High-density lipoprotein cholesterol decreased (p = 0.0087) and triglycerides increased (p = 0.0045) in the BNO group. Malondialdehyde levels decreased in the BNO group (p = 0.0296) and total antioxidant capacity improved in the SO group (p = 0.0110). Although the addition of oils without lifestyle interventions did not affect anthropometric findings or blood pressure and promoted undesirable results in the lipid profile in both groups, daily supplementation of BNO for 30 days decreased lipid peroxidation, contributing to oxidative stress reduction.

Impact of coconut oil consumption on cardiovascular health: a systematic review and meta-analysis

Context

Coconut oil is rich in medium-chain fatty acids and has been claimed to have numerous health benefits.

Objective

This review aimed to examine the evidence surrounding coconut oil consumption and its impact on cardiovascular health.

Data Sources

A systematic literature search of the PubMed, Embase, the Cochrane Library, and CINAHL databases, up to May 2019, was performed.

Data Extraction

Study characteristics including study design, population, intervention, comparator, outcome, and source of funding were summarized.

Data Analysis

Meta-analyses included 12 studies to provide estimates of effects. Subgroup analyses were performed to account for any differences in the study-level characteristics. When compared with plant oils and animal oils, coconut oil was found to significantly increase high-density lipoprotein cholesterol (HDL-C) by 0.57 mg/dL (95%CI, 0.40–0.74 mg/dL; I2 = 6.7%) and 0.33 mg/dL (0.01–0.65 mg/dL; I2 = 0%), respectively. Coconut oil significantly raised low-density lipoprotein cholesterol (LDL-C) by 0.26 mg/dL (0.09–0.43 mg/dL; I2 = 59.7%) compared with plant oils and lowered LDL-C (−0.37 mg/dL; −0.69 to −0.05 mg/dL; I2 = 48.1%) compared with animal oils. No significant effects on triglyceride were observed. Better lipid profiles were demonstrated with the virgin form of coconut oil.

Conclusion

Compared with animal oils, coconut oil demonstrated a better lipid profile n comparison with plant oils, coconut oil significantly increased HDL-C and LDL-C.

Omega-6 fats for the primary and secondary prevention of cardiovascular disease

BACKGROUND

Omega-6 fats are polyunsaturated fats vital for many physiological functions, but their effect on cardiovascular disease (CVD) risk is debated.

OBJECTIVES

To assess effects of increasing omega-6 fats (linoleic acid (LA), gamma-linolenic acid (GLA), dihomo-gamma-linolenic acid (DGLA) and arachidonic acid (AA)) on CVD and all-cause mortality.

SEARCH METHODS

We searched CENTRAL, MEDLINE and Embase to May 2017 and clinicaltrials.gov and the World Health Organization International Clinical Trials Registry Platform to September 2016, without language restrictions. We checked trials included in relevant systematic reviews.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) comparing higher versus lower omega-6 fat intake in adults with or without CVD, assessing effects over at least 12 months. We included full texts, abstracts, trials registry entries and unpublished studies. Outcomes were all-cause mortality, CVD mortality, CVD events, risk factors (blood lipids, adiposity, blood pressure), and potential adverse events. We excluded trials where we could not separate omega-6 fat effects from those of other dietary, lifestyle or medication interventions.

DATA COLLECTION AND ANALYSIS

Two authors independently screened titles/abstracts, assessed trials for inclusion, extracted data, and assessed risk of bias of included trials. We wrote to authors of included studies. Meta-analyses used random-effects analysis, while sensitivity analyses used fixed-effects and limited analyses to trials at low summary risk of bias. We assessed GRADE quality of evidence for 'Summary of findings' tables.

MAIN RESULTS

We included 19 RCTs in 6461 participants who were followed for one to eight years. Seven trials assessed the effects of supplemental GLA and 12 of LA, none DGLA or AA; the omega-6 fats usually displaced dietary saturated or monounsaturated fats. We assessed three RCTs as being at low summary risk of bias.Primary outcomes: we found low-quality evidence that increased intake of omega-6 fats may make little or no difference to all-cause mortality (risk ratio (RR) 1.00, 95% confidence interval (CI) 0.88 to 1.12, 740 deaths, 4506 randomised, 10 trials) or CVD events (RR 0.97, 95% CI 0.81 to 1.15, 1404 people experienced events of 4962 randomised, 7 trials). We are uncertain whether increasing omega-6 fats affects CVD mortality (RR 1.09, 95% CI 0.76 to 1.55, 472 deaths, 4019 randomised, 7 trials), coronary heart disease events (RR 0.88, 95% CI 0.66 to 1.17, 1059 people with events of 3997 randomised, 7 trials), major adverse cardiac and cerebrovascular events (RR 0.84, 95% CI 0.59 to 1.20, 817 events, 2879 participants, 2 trials) or stroke (RR 1.36, 95% CI 0.45 to 4.11, 54 events, 3730 participants, 4 trials), as we assessed the evidence as being of very low quality. We found no evidence of dose-response or duration effects for any primary outcome, but there was a suggestion of greater protection in participants with lower baseline omega-6 intake across outcomes.Additional key outcomes: we found increased intake of omega-6 fats may reduce myocardial infarction (MI) risk (RR 0.88, 95% CI 0.76 to 1.02, 609 events, 4606 participants, 7 trials, low-quality evidence). High-quality evidence suggests increasing omega-6 fats reduces total serum cholesterol a little in the long term (mean difference (MD) -0.33 mmol/L, 95% CI -0.50 to -0.16, I² = 81%; heterogeneity partially explained by dose, 4280 participants, 10 trials). Increasing omega-6 fats probably has little or no effect on adiposity (body mass index (BMI) MD -0.20 kg/m², 95% CI -0.56 to 0.16, 371 participants, 1 trial, moderate-quality evidence). It may make little or no difference to serum triglycerides (MD -0.01 mmol/L, 95% CI -0.23 to 0.21, 834 participants, 5 trials), HDL (MD -0.01 mmol/L, 95% CI -0.03 to 0.02, 1995 participants, 4 trials) or low-density lipoprotein (MD -0.04 mmol/L, 95% CI -0.21 to 0.14, 244 participants, 2 trials, low-quality evidence).

AUTHORS' CONCLUSIONS

This is the most extensive systematic assessment of effects of omega-6 fats on cardiovascular health, mortality, lipids and adiposity to date, using previously unpublished data. We found no evidence that increasing omega-6 fats reduces cardiovascular outcomes other than MI, where 53 people may need to increase omega-6 fat intake to prevent 1 person from experiencing MI. Although benefits of omega-6 fats remain to be proven, increasing omega-6 fats may be of benefit in people at high risk of MI. Increased omega-6 fats reduce serum total cholesterol but not other blood fat fractions or adiposity.

Polyunsaturated fatty acids for the primary and secondary prevention of cardiovascular disease

BACKGROUND

Evidence on the health effects of total polyunsaturated fatty acids (PUFA) is equivocal. Fish oils are rich in omega-3 PUFA and plant oils in omega-6 PUFA. Evidence suggests that increasing PUFA-rich foods, supplements or supplemented foods can reduce serum cholesterol, but may increase body weight, so overall cardiovascular effects are unclear.

OBJECTIVES

To assess effects of increasing total PUFA intake on cardiovascular disease and all-cause mortality, lipids and adiposity in adults.

SEARCH METHODS

We searched CENTRAL, MEDLINE and Embase to April 2017 and clinicaltrials.gov and the World Health Organization International Clinical Trials Registry Platform to September 2016, without language restrictions. We checked trials included in relevant systematic reviews.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) comparing higher with lower PUFA intakes in adults with or without cardiovascular disease that assessed effects over 12 months or longer. We included full texts, abstracts, trials registry entries and unpublished data. Outcomes were all-cause mortality, cardiovascular disease mortality and events, risk factors (blood lipids, adiposity, blood pressure), and adverse events. We excluded trials where we could not separate effects of PUFA intake from other dietary, lifestyle or medication interventions.

DATA COLLECTION AND ANALYSIS

Two review authors independently screened titles and abstracts, assessed trials for inclusion, extracted data, and assessed risk of bias. We wrote to authors of included trials for further data. Meta-analyses used random-effects analysis, sensitivity analyses included fixed-effects and limiting to low summary risk of bias. We assessed GRADE quality of evidence.

MAIN RESULTS

We included 49 RCTs randomising 24,272 participants, with duration of one to eight years. Eleven included trials were at low summary risk of bias, 33 recruited participants without cardiovascular disease. Baseline PUFA intake was unclear in most trials, but 3.9% to 8% of total energy intake where reported. Most trials gave supplemental capsules, but eight gave dietary advice, eight gave supplemental foods such as nuts or margarine, and three used a combination of methods to increase PUFA.Increasing PUFA intake probably has little or no effect on all-cause mortality (risk 7.8% vs 7.6%, risk ratio (RR) 0.98, 95% confidence interval (CI) 0.89 to 1.07, 19,290 participants in 24 trials), but probably slightly reduces risk of coronary heart disease events from 14.2% to 12.3% (RR 0.87, 95% CI 0.72 to 1.06, 15 trials, 10,076 participants) and cardiovascular disease events from 14.6% to 13.0% (RR 0.89, 95% CI 0.79 to 1.01, 17,799 participants in 21 trials), all moderate-quality evidence. Increasing PUFA may slightly reduce risk of coronary heart disease death (6.6% to 6.1%, RR 0.91, 95% CI 0.78 to 1.06, 9 trials, 8810 participants) andstroke (1.2% to 1.1%, RR 0.91, 95% CI 0.58 to 1.44, 11 trials, 14,742 participants, though confidence intervals include important harms), but has little or no effect on cardiovascular mortality (RR 1.02, 95% CI 0.82 to 1.26, 16 trials, 15,107 participants) all low-quality evidence. Effects of increasing PUFA on major adverse cardiac and cerebrovascular events and atrial fibrillation are unclear as evidence is of very low quality.Increasing PUFA intake probably slightly decreases triglycerides (by 15%, MD -0.12 mmol/L, 95% CI -0.20 to -0.04, 20 trials, 3905 participants), but has little or no effect on total cholesterol (mean difference (MD) -0.12 mmol/L, 95% CI -0.23 to -0.02, 26 trials, 8072 participants), high-density lipoprotein (HDL) (MD -0.01 mmol/L, 95% CI -0.02 to 0.01, 18 trials, 4674 participants) or low-density lipoprotein (LDL) (MD -0.01 mmol/L, 95% CI -0.09 to 0.06, 15 trials, 3362 participants). Increasing PUFA probably has little or no effect on adiposity (body weight MD 0.76 kg, 95% CI 0.34 to 1.19, 12 trials, 7100 participants).Effects of increasing PUFA on serious adverse events such as pulmonary embolism and bleeding are unclear as the evidence is of very low quality.

AUTHORS' CONCLUSIONS

This is the most extensive systematic review of RCTs conducted to date to assess effects of increasing PUFA on cardiovascular disease, mortality, lipids or adiposity. Increasing PUFA intake probably slightly reduces risk of coronary heart disease and cardiovascular disease events, may slightly reduce risk of coronary heart disease mortality and stroke (though not ruling out harms), but has little or no effect on all-cause or cardiovascular disease mortality. The mechanism may be via TG reduction.

Polyunsaturated fatty acids for the primary and secondary prevention of cardiovascular disease

BACKGROUND

Evidence on the health effects of total polyunsaturated fatty acids (PUFA) is equivocal. Fish oils are rich in omega-3 PUFA and plant oils in omega-6 PUFA. Evidence suggests that increasing PUFA-rich foods, supplements or supplemented foods can reduce serum cholesterol, but may increase body weight, so overall cardiovascular effects are unclear.

OBJECTIVES

To assess effects of increasing total PUFA intake on cardiovascular disease and all-cause mortality, lipids and adiposity in adults.

SEARCH METHODS

We searched CENTRAL, MEDLINE and Embase to April 2017 and clinicaltrials.gov and the World Health Organization International Clinical Trials Registry Platform to September 2016, without language restrictions. We checked trials included in relevant systematic reviews.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) comparing higher with lower PUFA intakes in adults with or without cardiovascular disease that assessed effects over 12 months or longer. We included full texts, abstracts, trials registry entries and unpublished data. Outcomes were all-cause mortality, cardiovascular disease mortality and events, risk factors (blood lipids, adiposity, blood pressure), and adverse events. We excluded trials where we could not separate effects of PUFA intake from other dietary, lifestyle or medication interventions.

DATA COLLECTION AND ANALYSIS

Two review authors independently screened titles and abstracts, assessed trials for inclusion, extracted data, and assessed risk of bias. We wrote to authors of included trials for further data. Meta-analyses used random-effects analysis, sensitivity analyses included fixed-effects and limiting to low summary risk of bias. We assessed GRADE quality of evidence.

MAIN RESULTS

We included 49 RCTs randomising 24,272 participants, with duration of one to eight years. Eleven included trials were at low summary risk of bias, 33 recruited participants without cardiovascular disease. Baseline PUFA intake was unclear in most trials, but 3.9% to 8% of total energy intake where reported. Most trials gave supplemental capsules, but eight gave dietary advice, eight gave supplemental foods such as nuts or margarine, and three used a combination of methods to increase PUFA.Increasing PUFA intake probably has little or no effect on all-cause mortality (risk 7.8% vs 7.6%, risk ratio (RR) 0.98, 95% confidence interval (CI) 0.89 to 1.07, 19,290 participants in 24 trials), but probably slightly reduces risk of coronary heart disease events from 14.2% to 12.3% (RR 0.87, 95% CI 0.72 to 1.06, 15 trials, 10,076 participants) and cardiovascular disease events from 14.6% to 13.0% (RR 0.89, 95% CI 0.79 to 1.01, 17,799 participants in 21 trials), all moderate-quality evidence. Increasing PUFA may slightly reduce risk of coronary heart disease death (6.6% to 6.1%, RR 0.91, 95% CI 0.78 to 1.06, 9 trials, 8810 participants) andstroke (1.2% to 1.1%, RR 0.91, 95% CI 0.58 to 1.44, 11 trials, 14,742 participants, though confidence intervals include important harms), but has little or no effect on cardiovascular mortality (RR 1.02, 95% CI 0.82 to 1.26, 16 trials, 15,107 participants) all low-quality evidence. Effects of increasing PUFA on major adverse cardiac and cerebrovascular events and atrial fibrillation are unclear as evidence is of very low quality.Increasing PUFA intake slightly reduces total cholesterol (mean difference (MD) -0.12 mmol/L, 95% CI -0.23 to -0.02, 26 trials, 8072 participants) and probably slightly decreases triglycerides (MD -0.12 mmol/L, 95% CI -0.20 to -0.04, 20 trials, 3905 participants), but has little or no effect on high-density lipoprotein (HDL) (MD -0.01 mmol/L, 95% CI -0.02 to 0.01, 18 trials, 4674 participants) or low-density lipoprotein (LDL) (MD -0.01 mmol/L, 95% CI -0.09 to 0.06, 15 trials, 3362 participants). Increasing PUFA probably causes slight weight gain (MD 0.76 kg, 95% CI 0.34 to 1.19, 12 trials, 7100 participants).Effects of increasing PUFA on serious adverse events such as pulmonary embolism and bleeding are unclear as the evidence is of very low quality.

AUTHORS' CONCLUSIONS

This is the most extensive systematic review of RCTs conducted to date to assess effects of increasing PUFA on cardiovascular disease, mortality, lipids or adiposity. Increasing PUFA intake probably slightly reduces risk of coronary heart disease and cardiovascular disease events, may slightly reduce risk of coronary heart disease mortality and stroke (though not ruling out harms), but has little or no effect on all-cause or cardiovascular disease mortality. The mechanism may be via lipid reduction, but increasing PUFA probably slightly increases weight.

Omega-6 fats for the primary and secondary prevention of cardiovascular disease

BACKGROUND

Omega-6 fats are polyunsaturated fats vital for many physiological functions, but their effect on cardiovascular disease (CVD) risk is debated.

OBJECTIVES

To assess effects of increasing omega-6 fats (linoleic acid (LA), gamma-linolenic acid (GLA), dihomo-gamma-linolenic acid (DGLA) and arachidonic acid (AA)) on CVD and all-cause mortality.

SEARCH METHODS

We searched CENTRAL, MEDLINE and Embase to May 2017 and clinicaltrials.gov and the World Health Organization International Clinical Trials Registry Platform to September 2016, without language restrictions. We checked trials included in relevant systematic reviews.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) comparing higher versus lower omega-6 fat intake in adults with or without CVD, assessing effects over at least 12 months. We included full texts, abstracts, trials registry entries and unpublished studies. Outcomes were all-cause mortality, CVD mortality, CVD events, risk factors (blood lipids, adiposity, blood pressure), and potential adverse events. We excluded trials where we could not separate omega-6 fat effects from those of other dietary, lifestyle or medication interventions.

DATA COLLECTION AND ANALYSIS

Two authors independently screened titles/abstracts, assessed trials for inclusion, extracted data, and assessed risk of bias of included trials. We wrote to authors of included studies. Meta-analyses used random-effects analysis, while sensitivity analyses used fixed-effects and limited analyses to trials at low summary risk of bias. We assessed GRADE quality of evidence for 'Summary of findings' tables.

MAIN RESULTS

We included 19 RCTs in 6461 participants who were followed for one to eight years. Seven trials assessed the effects of supplemental GLA and 12 of LA, none DGLA or AA; the omega-6 fats usually displaced dietary saturated or monounsaturated fats. We assessed three RCTs as being at low summary risk of bias.Primary outcomes: we found low-quality evidence that increased intake of omega-6 fats may make little or no difference to all-cause mortality (risk ratio (RR) 1.00, 95% confidence interval (CI) 0.88 to 1.12, 740 deaths, 4506 randomised, 10 trials) or CVD events (RR 0.97, 95% CI 0.81 to 1.15, 1404 people experienced events of 4962 randomised, 7 trials). We are uncertain whether increasing omega-6 fats affects CVD mortality (RR 1.09, 95% CI 0.76 to 1.55, 472 deaths, 4019 randomised, 7 trials), coronary heart disease events (RR 0.88, 95% CI 0.66 to 1.17, 1059 people with events of 3997 randomised, 7 trials), major adverse cardiac and cerebrovascular events (RR 0.84, 95% CI 0.59 to 1.20, 817 events, 2879 participants, 2 trials) or stroke (RR 1.36, 95% CI 0.45 to 4.11, 54 events, 3730 participants, 4 trials), as we assessed the evidence as being of very low quality. We found no evidence of dose-response or duration effects for any primary outcome, but there was a suggestion of greater protection in participants with lower baseline omega-6 intake across outcomes.Additional key outcomes: we found increased intake of omega-6 fats may reduce myocardial infarction (MI) risk (RR 0.88, 95% CI 0.76 to 1.02, 609 events, 4606 participants, 7 trials, low-quality evidence). High-quality evidence suggests increasing omega-6 fats reduces total serum cholesterol a little in the long term (mean difference (MD) -0.33 mmol/L, 95% CI -0.50 to -0.16, I2 = 81%; heterogeneity partially explained by dose, 4280 participants, 10 trials). Increasing omega-6 fats probably has little or no effect on adiposity (body mass index (BMI) MD -0.20 kg/m2, 95% CI -0.56 to 0.16, 371 participants, 1 trial, moderate-quality evidence). It may make little or no difference to serum triglycerides (MD -0.01 mmol/L, 95% CI -0.23 to 0.21, 834 participants, 5 trials), HDL (MD -0.01 mmol/L, 95% CI -0.03 to 0.02, 1995 participants, 4 trials) or low-density lipoprotein (MD -0.04 mmol/L, 95% CI -0.21 to 0.14, 244 participants, 2 trials, low-quality evidence).

AUTHORS' CONCLUSIONS

This is the most extensive systematic assessment of effects of omega-6 fats on cardiovascular health, mortality, lipids and adiposity to date, using previously unpublished data. We found no evidence that increasing omega-6 fats reduces cardiovascular outcomes other than MI, where 53 people may need to increase omega-6 fat intake to prevent 1 person from experiencing MI. Although benefits of omega-6 fats remain to be proven, increasing omega-6 fats may be of benefit in people at high risk of MI. Increased omega-6 fats reduce serum total cholesterol but not other blood fat fractions or adiposity.

Randomised trial of coconut oil, olive oil or butter on blood lipids and other cardiovascular risk factors in healthy men and women

INTRODUCTION

High dietary saturated fat intake is associated with higher blood concentrations of low-density lipoprotein cholesterol (LDL-C), an established risk factor for coronary heart disease. However, there is increasing interest in whether various dietary oils or fats with different fatty acid profiles such as extra virgin coconut oil may have different metabolic effects but trials have reported inconsistent results. We aimed to compare changes in blood lipid profile, weight, fat distribution and metabolic markers after four weeks consumption of 50 g daily of one of three different dietary fats, extra virgin coconut oil, butter or extra virgin olive oil, in healthy men and women in the general population.

DESIGN

Randomised clinical trial conducted over June and July 2017.

SETTING

General community in Cambridgeshire, UK.

PARTICIPANTS

Volunteer adults were recruited by the British Broadcasting Corporation through their websites. Eligibility criteria were men and women aged 50-75 years, with no known history of cancer, cardiovascular disease or diabetes, not on lipid lowering medication, no contraindications to a high-fat diet and willingness to be randomised to consume one of the three dietary fats for 4 weeks. Of 160 individuals initially expressing an interest and assessed for eligibility, 96 were randomised to one of three interventions; 2 individuals subsequently withdrew and 94 men and women attended a baseline assessment. Their mean age was 60 years, 67% were women and 98% were European Caucasian. Of these, 91 men and women attended a follow-up assessment 4 weeks later.

INTERVENTION

Participants were randomised to extra virgin coconut oil, extra virgin olive oil or unsalted butter and asked to consume 50 g daily of one of these fats for 4 weeks, which they could incorporate into their usual diet or consume as a supplement.

MAIN OUTCOMES AND MEASURES

The primary outcome was change in serum LDL-C; secondary outcomes were change in total and high-density lipoprotein cholesterol (TC and HDL-C), TC/HDL-C ratio and non-HDL-C; change in weight, body mass index (BMI), waist circumference, per cent body fat, systolic and diastolic blood pressure, fasting plasma glucose and C reactive protein.

RESULTS

LDL-C concentrations were significantly increased on butter compared with coconut oil (+0.42, 95% CI 0.19 to 0.65 mmol/L, P<0.0001) and with olive oil (+0.38, 95% CI 0.16 to 0.60 mmol/L, P<0.0001), with no differences in change of LDL-C in coconut oil compared with olive oil (-0.04, 95% CI -0.27 to 0.19 mmol/L, P=0.74). Coconut oil significantly increased HDL-C compared with butter (+0.18, 95% CI 0.06 to 0.30 mmol/L) or olive oil (+0.16, 95% CI 0.03 to 0.28 mmol/L). Butter significantly increased TC/HDL-C ratio and non-HDL-C compared with coconut oil but coconut oil did not significantly differ from olive oil for TC/HDL-C and non-HDL-C. There were no significant differences in changes in weight, BMI, central adiposity, fasting blood glucose, systolic or diastolic blood pressure among any of the three intervention groups.

CONCLUSIONS AND RELEVANCE

Two different dietary fats (butter and coconut oil) which are predominantly saturated fats, appear to have different effects on blood lipids compared with olive oil, a predominantly monounsaturated fat with coconut oil more comparable to olive oil with respect to LDL-C. The effects of different dietary fats on lipid profiles, metabolic markers and health outcomes may vary not just according to the general classification of their main component fatty acids as saturated or unsaturated but possibly according to different profiles in individual fatty acids, processing methods as well as the foods in which they are consumed or dietary patterns. These findings do not alter current dietary recommendations to reduce saturated fat intake in general but highlight the need for further elucidation of the more nuanced relationships between different dietary fats and health.

TRIAL REGISTRATION NUMBER

NCT03105947; Results.

Dietary Fats and Oxidative Stress: A Cross-Sectional Study Among Coronary Artery Disease Subjects Consuming Coconut Oil/Sunflower Oil

Coconut oil has been used by the people of Kerala as a cooking medium for several decades. Due to its alleged hypercholesterolemic activity, general population in recent times is shifting to cooking oils rich in polyunsaturated fats, the most popular being sunflower oil. The effect of long-term consumption of sunflower oil on oxidative stress in humans is not well investigated. We studied oxidative stress among coronary artery disease (CAD) patients who were consuming coconut oil or sunflower oil as a part of their routine diet. Men, aged 35-70 years, with established CAD, who presented to the hospital for routine cardiac evaluations, were enrolled in this observational study. Group 1 and 2 consisted of 73 and 80 subjects consuming coconut oil and sunflower oil respectively for over a period of 2 years. Lipid profile and parameters for oxidative stress were evaluated among them. Conventional lipid parameters did not differ significantly between the two groups. Mean vitamin C concentration was significantly reduced for subjects on sunflower oil compared to those consuming coconut oil (P = 0.044). Malondialdehyde was higher for sunflower oil consumers compared to coconut oil consumers (P < 0.0001). Other parameters such as oxidized LDL, GSH, GPx and SOD were not found to be significantly different between the two groups. The results of the present study show that coconut oil did not induce hypercholesterolemia compared to sunflower oil. On the other hand, sunflower oil group had elevated oxidative stress compared to coconut oil group.

Effect of a Diet Enriched with Fresh Coconut Saturated Fats on Plasma Lipids and Erythrocyte Fatty Acid Composition in Normal Adults

OBJECTIVE

The objective of this study was to compare the effects of increased saturated fatty acid (SFA) (provided by fresh coconut) versus monounsaturated fatty acid (MUFA) intake (provided by a combination of groundnuts and groundnut oil) on plasma lipids and erythrocyte fatty acid (EFA) composition in healthy adults.

MATERIAL AND METHODS

Fifty-eight healthy volunteers, randomized into 2 groups, were provided standardized diet along with 100 g fresh coconut or groundnuts and groundnut oil combination for 90 days in a Yoga University. Fasting blood samples were collected before and after the intervention period for the measurement of plasma lipids and EFA profile.

RESULTS

Coconut diet increased low-density lipoprotein (LDL) and high-density lipoprotein (HDL) levels significantly. In contrast, the groundnut diet decreased total cholesterol (TC), mainly due to a decrease in HDL levels. There were no differences in the major SFA of erythrocytes in either group. However, coconut consumption resulted in an increase in C14:0 and C24:0 along with a decrease in levels of C18:1 n9 (oleic acid). There was a significant increase in levels of C20:3 n6 (dihomo-gamma linolenic acid, DGLA).

CONCLUSIONS

Consumption of SFA-rich coconut for 3 months had no significant deleterious effect on erythrocytes or lipid-related factors compared to groundnut consumption. On the contrary, there was an increase in the anti-atherogenic HDL levels and anti-inflammatory precursor DGLA in erythrocyte lipids. This suggests that coconut consumption may not have any deleterious effects on cardiovascular risk in normal subjects.

Effects of coconut oil consumption on energy metabolism, cardiometabolic risk markers, and appetitive responses in women with excess body fat

PURPOSE

Virgin coconut oil (VCO) is a medium-chain fatty acid source with popularly attributed benefits on obesity management. However, its role on obesity requires elucidation due to its saturated nature. In the study herein, we investigated acute effects of VCO consumption on energy metabolism, cardiometabolic risk markers, and appetitive responses in women with excess body fat.

METHODS

Fifteen adult women with excess body fat (37.43 ± 0.83%) participated in this randomized, crossover, controlled study. Two isocaloric mixed breakfasts containing 25 mL of VCO or control (extra-virgin olive oil-C) were evaluated. Resting energy expenditure (REE), fat oxidation rate (FOR), diet induced thermogenesis (DIT) and appetitive subjective responses were assessed at fasting and postprandial periods (up to 240 min). Cardiometabolic risk markers were assessed at fasting and up to 180 min postprandially.

RESULTS

VCO did not affect REE, FOR, and DIT compared to C. In addition, VCO did not cause deleterious change in triglycerides, total cholesterol, HDL-c, LDL-c, triglycerides/HDL-c ratio, uric acid, glucose and Homeostasis Model Assessment of Insulin Resistance Index (HOMA-IR) (P _{time×treatment} > 0.05). However, VCO suppressed less hunger (P _{time×treatment} = 0.003), total satiety (P _iAUC = 0.021) and total fullness (P _iAUC = 0.035) responses than C.

CONCLUSIONS

VCO consumption did not acutely change energy metabolism and cardiometabolic risk markers when added to a mixed breakfast but promoted less appetitive responses.