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

Systematic review and meta-analysis of randomized clinical trials in adults. Included participants were men and women with mixed health status, including healthy adults and people with overweight or obesity, abdominal obesity, dyslipidemia, hypercholesterolemia, or cardiovascular disease, studied across Europe, Asia, New Zealand, the United States, and Brazil.

Coconut oil was the active supplement, given orally in a variety of regimens across the included trials, including 6 g capsules, 15 to 54.4 g/day, 25 to 30 ml/day, 39 to 50 g/day, or as 17.5% to 21% of daily calories. Intervention periods were generally short, ranging from 3 to 12 weeks, and coconut oil was compared with other fats or oils, placebo-like controls, or diet substitution conditions.

Coconut oil did not show superiority over other oils or fats for body weight, waist circumference, body fat, LDL-C, triglycerides, or lipid ratios. A small increase in HDL-C was seen in some comparisons, but the certainty of evidence was very low and the risk of bias was high. The overall evidence does not support encouraging replacement of PUFA- or MUFA-rich oils with coconut oil in populations not accustomed to it. Findings were limited by heterogeneous regimens, small samples, and short follow-up.

The evidence base was limited by small trial sizes, short intervention durations, and substantial heterogeneity in coconut oil dose, formulation, and comparator. Risk of bias was high and the certainty of evidence was very low, which weakens confidence in the HDL-C finding and in the overall null effects. Generalizability is limited, especially for populations not regularly consuming coconut oil.