The effects of coconut oil on the cardiometabolic profile: a systematic review and meta-analysis of randomized clinical trials
What this study found
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.
- Study & population
- Systematic review and meta-analysis of randomized clinical trials in adults.
- Intervention
- 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.
- Key limitation
- The evidence base was limited by small trial sizes, short intervention durations, and substantial heterogeneity in coconut oil dose, formulation, and comparator.
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Open PDFOriginal 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.