Coconut oil intake and its effects on the cardiometabolic profile – A structured literature review Heitor O. Santos a, ⁎, Scott Howell b , Conrad P. Earnest c , Filipe J. Teixeira d a School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil b Tier 1 Health and Wellness, Center for Research, Chattanooga, TN, United States c Texas A&M University, Health and Kinesiology, College Station, TX, United States d CBIOS (Research Center for Biosciences & Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Campo Grande 376, 1749-024 Lisboa, Portugal abstract article info Keywords: Coconut oil Cocos nucifera HDL Lauric acid Lipids In recent years, health professionals and laypersons have disseminated misinformation regarding the consump- tion of coconut oil. Those encouraging the supplementation of coconut oil argue that it provides health benefits and protective cardiovascular effects. Our article examines the effects of coconut oil intake on the cardiometabolic profile by exploring various lipid indices, as well as potential non-lipid effects, such as weight loss. The majority of randomized controlled trials show that coconut oil intake or its supplementation increases low-density lipopro- tein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL \\ C), and total cholesterol when compared with other vegetable oils. Lauric acid, a medium-chain fatty acid and the main constituent of coconut oil, in- creases LDL-C and HDL-C concentrations, since it plays a main role as a substrate for apolipoprotein (apo)A1 and apoB synthesis, which are the key molecules in HDL-C and LDL-C particles, respectively.Despite some find- ings demonstrating an increase in HDL-C, definitive long-term clinical trials are imperative to ascertain whether this effect is clinically relevant. In addition, coconut oil intake has failed as a weight loss strategy and should not be considered as a supplementation strategy to increase satiety and/or thermogenesis.If one desires to include coconut oil in the diet, then we suggest that it should be limited and encompassed within the current recommen- dations of SFA intake, which are up to 10% of total caloric intake. © 2019 Elsevier Inc. All rights reserved. Contents Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 437 Results – lipids effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 437 Randomized controlled trials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 437 Effect on high LDL-C concentrations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 437 Healthy patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 437 Obesity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 438 Developed and developing countries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 438 Coconut oil coupled with a low-calorie diet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 438 Coconut fruit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 438 Coconut milk porridge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 438 HDL-C pathway . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 439 Lipoprotein(a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 439 Postprandial lipids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 439 Non-lipid effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 440 Thermogenesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 440 Progress in Cardiovascular Diseases 62 (2019) 436–443 Abbreviations and acronyms: Apo, apolipoprotein; ARIC, atherosclerosis Risk in Communities; ASCVD, atherosclerotic cardiovascular disease; CVD, cardiovascular disease; DXA, dual- energy X-ray absorptiometry; HDL-C, high-density lipoprotein cholesterol; HOMA-IR, Homeostasis Model Assessment of Insulin Resistance Index; hs-CRP, high-sensitivity C-reactive pro- tein; LCFA, long-chain fatty acids; Lp(a), lipoprotein(a); LDL-C, lipoprotein cholesterol; MCFA, medium-chain fatty acid; PURE, Prospective Urban Rural Epidemiology; SFA, saturated fatty acids; TC, total cholesterol; TG, triglycerides. ⁎ Address reprint requests to: Heitor O. Santos. Para Street, 1720, Umuarama, Block 2U, Uberlandia, MG 38400-902, Brazil. E-mail address: heitoroliveirasantos@gmail.com (H.O. Santos). https://doi.org/10.1016/j.pcad.2019.11.001 0033-0620/© 2019 Elsevier Inc. All rights reserved. Contents lists available at ScienceDirect Progress in Cardiovascular Diseases journal homepage: www.onlinepcd.com