Coconut oil, olive oil, butter & LDL-cholesterol

Executive summary

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One of my favourite parts of one of my favourite books (The Great Cholesterol Con) is this: “How can eating saturated fat raise LDL levels? It is not merely biologically implausible; it is biologically impossible. It always was and it always will be. (Boy does that statement make me a hostage to fortune!)” Dr Malcolm Kendrick.

I read this in 2008 and it inspired me to seek and meet with a biochemist, which I did at a local university. I asked the biochemist whether he thought it was possible that consuming saturated fat could raise LDL levels and he couldn’t see how but he said he didn’t understand the dietary process sufficiently. He suggested that we ask a dietician to join us, at which point I thought – if we’re relying on a dietician to exonerate saturated fat for anything, we’re in trouble!

I have not since found any evidence that saturated fat can raise LDL-cholesterol, let alone that it does. This brings us to a classic article for this week’s note, which was published in January 2018 (Ref 1). The study also featured on a BBC programme around that time. The article was called “Randomised trial of coconut oil, olive oil or butter on blood lipids and other cardiovascular risk factors in healthy men and women”, which makes it rare and important in our world. Not many randomised controlled trials are undertaken in the field of nutrition and this one was also conducted on healthy people and so is generalisable to healthy people.

The study

The opening sentence of the abstract was: “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.” No reference for this was given. It’s one of those deeply held beliefs – rather like the calorie theory (Ref 2).


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