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Spiazzi BF, Duarte AC, Zingano CP, Teixeira PP, Amazarray CR, Merello EN, Wayerbacher LF, Farenzena LP, Correia PE, Bertoluci MC, Gerchman F, Colpani V. Coconut oil: an overview of cardiometabolic effects and the public health burden of misinformation. Arch Endocrinol Metab 2023; 67:e000641. [PMID: 37364144 PMCID: PMC10660992 DOI: 10.20945/2359-3997000000641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
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.
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Affiliation(s)
- Bernardo Frison Spiazzi
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Ana Cláudia Duarte
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Carolina Pires Zingano
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Divisão de Endocrinologia e Metabologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
| | - Paula Portal Teixeira
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Carmen Raya Amazarray
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Eduarda Nunes Merello
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Laura Fink Wayerbacher
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Laura Penso Farenzena
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Poliana Espíndola Correia
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Marcello Casaccia Bertoluci
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Divisão de Endocrinologia e Metabologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
| | - Fernando Gerchman
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Divisão de Endocrinologia e Metabologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
| | - Verônica Colpani
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil,
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Duarte AC, Spiazzi BF, Zingano CP, Merello EN, Wayerbacher LF, Teixeira PP, Farenzena LP, de Araujo C, Amazarray CR, Colpani V, Gerchman F. The effects of coconut oil on the cardiometabolic profile: a systematic review and meta-analysis of randomized clinical trials. Lipids Health Dis 2022; 21:83. [PMID: 36045407 PMCID: PMC9429773 DOI: 10.1186/s12944-022-01685-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/31/2022] [Indexed: 11/23/2022] Open
Abstract
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.
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Affiliation(s)
- Ana Cláudia Duarte
- Post-Graduate Program in Medical Sciences: Endocrinology, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Bernardo Frison Spiazzi
- Post-Graduate Program in Medical Sciences: Endocrinology, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.,Faculdade de Medicina, Departamento de Medicina Interna, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Carolina Pires Zingano
- Faculdade de Medicina, Departamento de Medicina Interna, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.,Division of Endocrinology and Metabolism, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Eduarda Nunes Merello
- Faculdade de Medicina, Departamento de Medicina Interna, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Laura Fink Wayerbacher
- Faculdade de Medicina, Departamento de Medicina Interna, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Paula Portal Teixeira
- Post-Graduate Program in Medical Sciences: Endocrinology, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Laura Penso Farenzena
- Faculdade de Medicina, Departamento de Medicina Interna, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Carina de Araujo
- Post-Graduate Program in Medical Sciences: Endocrinology, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Carmen Raya Amazarray
- Post-Graduate Program in Medical Sciences: Endocrinology, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Verônica Colpani
- Post-Graduate Program in Medical Sciences: Endocrinology, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.,Research Projects Office, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Fernando Gerchman
- Post-Graduate Program in Medical Sciences: Endocrinology, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil. .,Faculdade de Medicina, Departamento de Medicina Interna, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil. .,Division of Endocrinology and Metabolism, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil. .,Division of Endocrinology and Metabolism, Hospital Moinhos de Vento, Porto Alegre, Brazil.
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Duarte AC, Spiazzi BF, Merello EN, Amazarray CR, Sulzbach de Andrade L, Socal MP, Trujillo AJ, Brietzke E, Colpani V, Gerchman F. Misinformation in nutrition through the case of coconut oil: An online before-and-after study. Nutr Metab Cardiovasc Dis 2022; 32:1375-1384. [PMID: 35282978 DOI: 10.1016/j.numecd.2022.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/01/2022] [Accepted: 02/04/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Despite recent scientific evidence indicating absence of cardiometabolic benefit resulting from coconut oil intake, its consumption has increased in recent years, which can be attributed to a promotion of its use on social networks. We evaluated the patterns, reasons and beliefs related to coconut oil consumption and its perceived benefits in an online survey of a population in southern Brazil. METHODS AND RESULTS We conducted a before-and-after study using an 11-item online questionnaire that evaluated coconut oil consumption. In the same survey, participants who consumed coconut oil received an intervention to increase literacy about the health effects of coconut oil intake. We obtained 3160 valid responses. Among participants who consumed coconut oil (59.1%), 82.5% considered it healthy and 65.4% used it at least once a month. 81.2% coconut oil consumers did not observe any health improvements. After being exposed to the conclusions of a meta-analysis showing that coconut oil does not show superior health benefits when compared to other oils and fats, 73.5% of those who considered coconut oil healthy did not change their opinion. Among individuals who did not consume coconut oil, 47.6% considered it expensive and 11.6% deemed it unhealthy. CONCLUSIONS Coconut oil consumption is motivated by the responders' own beliefs in its supposed health benefits, despite what scientific research demonstrates. This highlights the difficulty in deconstructing inappropriate concepts of healthy diets that are disseminated in society.
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Affiliation(s)
- Ana C Duarte
- Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Bernardo Frison Spiazzi
- Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Interna, Porto Alegre, Brazil
| | - Eduarda Nunes Merello
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Interna, Porto Alegre, Brazil
| | - Carmen Raya Amazarray
- Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Laura Sulzbach de Andrade
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Interna, Porto Alegre, Brazil
| | - Mariana P Socal
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Antonio J Trujillo
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Elisa Brietzke
- Department of Psychiatry, Adult Division, Kingston General Hospital, Kingston, ON, Canada; Kingston General Hospital, Kingston Health Science Centre, Kingston, ON, Canada
| | - Verônica Colpani
- Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Gerchman
- Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Interna, Porto Alegre, Brazil; Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
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