Cracking Open the Truth About Coconut Oil
Is its Brain Health Halo Deserved?
THE SYNAPSE SUMMARY
Coconut oil became a wellness darling about a decade ago, marketed as a fat loss aid, brain health booster, and beauty cure-all. Its popularity was fueled by blogs, bestsellers, and David Asprey’s Bulletproof coffee, all built on the promise that this was a fat set apart from the rest.
The reality is more complicated, and nuanced – which, as you know by now, is typical when it comes to anything nutrition-related.
Despite its “superfood” reputation, coconut oil raises LDL cholesterol more than other plant oils, including palm oil (a saturated fat ubiquitous in ultra-processed foods). While medium-chain triglycerides (MCTs) have distinct metabolic properties and have been studied in Alzheimer’s disease, coconut oil is not synonymous with MCT oil.
For heart health, the evidence remains clear: replacing saturated fats – even from coconut – with unsaturated fats (olive, avocado, nuts, and seeds) consistently reduces cardiovascular risk.
Topically, coconut oil does deliver: studies confirm benefits for skin hydration, eczema, and hair strength. And yes, Pacific Island cultures have consumed coconut for generations – but within a larger dietary pattern rich in fish and lots of fiber, not alongside soda and processed food.
The bottom line: coconut oil can be enjoyed in small amounts – like butter – for flavor, or used on skin and hair. But for your heart and brain, unsaturated oils like olive and canola remain the better choice.
Let’s get into the deets…
UPFRONT: COCONUT OIL VS MCT OIL
Coconut oil and the popular-in-wellness-circles MCT oil are often conflated, but they’re not interchangeable.
Coconut oil is about 90 percent saturated fat, with lauric acid and myristic acid dominating its chemical profile. These fatty acids are absorbed more slowly, packaged into lipoproteins, and raise LDL cholesterol.
MCT oils used in clinical research are not the same as a jar of coconut oil – and not always identical to every commercial bottle on the shelf. Research-grade MCT oil is specifically refined to contain only caprylic acid (C8) and capric acid (C10). These shorter chains follow a different route in the body. Instead of being absorbed through the lymphatic system and entering circulation in chylomicrons (like long-chain fats), they travel directly through the portal vein to the liver. There, they’re rapidly oxidized and converted into ketones.
That difference matters. MCTs are still saturated fats, but unlike the longer ones in coconut oil, they do not seem to raise LDL cholesterol. A 2021 meta-analysis of randomized controlled trials found neutral effects on total, LDL, and HDL cholesterol, with a small increase in triglycerides overall. The contrast is important: coconut oil reliably raises LDL cholesterol, whereas purified MCT oil hasn’t in research.
Ketones can act as an alternative energy source to glucose (the brain’s preferred fuel). In Alzheimer’s disease, one of the earliest hallmarks is impaired glucose metabolism in the brain. In this context, ketones can partially bypass the brain’s energy gap. That’s why purified MCT oils have been studied in small, randomized trials of Alzheimer’s disease: to see if raising ketones could temporarily improve cognition.
The results so far are modest and limited to very specific contexts, often showing the greatest effect in patients without the APOE4 gene variant. And crucially, these studies used purified C8/C10 MCT oil – not coconut oil. Commercial MCT products vary, but the ones most aligned with research specify C8 and/or C10 only.
It’s also important to emphasize what the science does not show.
MCT oil is not recommended for enhancing cognition in healthy adults. The evidence we have is context-specific: in Alzheimer’s disease and mild cognitive impairment, where the brain is glucose-compromised, ketones may fill an energy gap. In a healthy brain, the benefits don’t extend to everyday use for memory or focus.
This distinction is especially relevant in midlife. Dr. Lisa Mosconi’s neuroimaging work has shown that during the menopause transition, women often experience reductions in brain glucose metabolism. This raises questions about whether ketones could help buffer that temporary energy stress. Currently, we have no clinical trials testing MCT oil in perimenopausal women. The physiology is different, and we can’t assume benefits without evidence.
Coconut oil, meanwhile, contains only small amounts of C8 and C10. The majority of its fatty acids are lauric and myristic, which behave metabolically more like butter.
Portraying coconut oil as “rich in MCTs” is marketing sleight of hand – blurring the distinction for consumers. The science, however, has been consistent: MCT oil and coconut oil are not the same, and their effects in the body are very different.
HEART HEALTH: THE STRONGEST SIGNAL
For all the romanticism around coconut oil, its effect on cholesterol is unambiguous.
Ancel Keys, PhD., the physiologist who helped establish the connection between diet and cardiovascular disease, observed as early as the 1950s that fatty acids longer than 10 carbons raise blood cholesterol most potently. Coconut oil’s dominant fatty acids – lauric (C12) and myristic (C14) – fall squarely into this category.
Modern trials bear this out. A 2020 meta-analysis of randomized trials found that coconut oil raised LDL cholesterol by ~10 mg/dL compared with nontropical vegetable (“seed”) oils.
A comprehensive 2018 network meta-analysis comparing many oils reached the same conclusion: coconut oil performs worse than cis-unsaturated oils for LDL.
Individual RCTs echo the pattern – for example, a BMJ Open trial comparing coconut oil, butter, and olive oil found butter raised LDL most, while coconut oil was worse than olive oil.
These shifts are not trivial. LDL cholesterol is the causal driver of atherosclerosis; reducing LDL lowers cardiovascular risk in drug, diet, and genetic evidence alike.
No randomized trial has ever shown coconut oil reduces cardiovascular events such as heart attack or stroke; reviews note no advantage over unsaturated oils – its only “advantage” is relative: it raises LDL less than butter. But “better than butter” is not a meaningful benchmark. Heart health depends on choosing fats that actively reduce risk – olive, canola, soybean, safflower – and against those, coconut oil fares poorly.
This is why major dietary guidance continues to cap saturated fat: the World Health Organization recommends <10% of total calories from saturated fat, while the American Heart Association advises <6% for people who need to lower LDL. Coconut oil, despite its natural halo, is no exception.
CULTURAL CONTEXT: THE PACIFIC ISLAND EXAMPLE
Much of coconut oil’s modern appeal rests on the idea that Pacific Island populations consume large amounts of coconut without apparent cardiovascular disease. The truth is more complex.
Traditional diets in Polynesia and Melanesia were indeed rich in coconut flesh, milk, and cream. But they were also high in fish, providing omega-3 fatty acids; root vegetables like taro and yam providing resistant starch; fresh fruit providing vitamins and antioxidants; and abundant dietary fiber.
Additionally, these diets were low in refined sugar and free of ultra-processed foods. And physical activity was inseparable from daily life. Coconut is just one piece of a broader pattern that, taken as a whole, supports cardiovascular health.
When these populations migrated or adopted Westernized diets – with refined flour, sugar-sweetened beverages, processed meats, and high-saturated-fat foods – cardiovascular disease rates rose sharply. Coconut consumption did not disappear, but the protective context did.
SKIN AND HAIR: WHERE IT SHINES
If coconut oil has a legitimate evidence base, it is on the surface of the body.
Topically, coconut oil functions as an emollient. In randomized clinical trials, virgin coconut oil improved skin hydration as effectively as mineral oil, and in pediatric studies it reduced eczema severity while lowering colonization with Staphylococcus aureus, a common eczema trigger. Its benefits come from strengthening the skin barrier and offering mild antimicrobial action (not comparable to pharmaceutical antibiotics and should not be used in place of a doctor’s care for a skin infection).
Hair care is another area where coconut oil stands out. Studies comparing it to mineral and sunflower oil show that coconut oil reduces protein loss from both healthy and damaged hair when applied before or after washing. Its unique chemistry allows it to penetrate the hair shaft, reinforcing it from within and protecting against breakage. That penetration is what sets it apart from other oils that simply coat the surface.
These benefits are meaningful – but they are dermatologic, not cardiovascular. Coconut oil deserves a place in the bathroom cabinet, not at the center of a heart-healthy kitchen.
WHY THE MYTHS STUCK
Coconut oil’s wellness halo has been unusually durable, in part because it aligns with cultural desires as much as health claims. It is natural, tropical, and tied to imagery of traditional diets and ancestral wisdom. It surged in popularity at a moment of growing skepticism toward dietary guidelines and frustration with decades of “low-fat” messaging. And unlike many so-called health foods, it tastes rich and satisfying.
But slogans like “natural fats don’t clog arteries” are inaccurate. LDL cholesterol is the causal driver of atherosclerosis regardless of whether the source is butter, shortening, or coconut oil. And the claim that “it’s better than butter” is true – but misleading. Better than the worst-for-your-health option is not the same as protective.
The benchmark for brain and heart health is not butter, but unsaturated fats like olive and canola oil, which consistently lower LDL and reduce cardiovascular risk.
THE TAKEAWAY
Coconut oil’s rise as a “superfood” was fueled by marketing more than science. It raises LDL cholesterol, has never been shown to reduce cardiovascular risk, and is not equivalent to MCT oil. The Pacific Island diets so often cited in its defense were protective because of their overall balance, not because of coconut alone.
That doesn’t mean coconut oil doesn’t have a place. It can add flavor in baking or curries, and it has real evidence-based uses in skin and hair care. But for nourishing the heart and brain, the proven choice remains oils rich in unsaturated fats.
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This is perfect timing! I’m working on further lowering my LDL because of my elevated LPa. Turns out that my favourite protein powder contains MCTs “from coconut oil, acacia gum”. I went as far as writing to the manufacturers asking that they rethink their ingredients. The protein powder contains 2.5 g of saturated fat so it makes me wonder if I’ve made the right decision to ditch the powder or if it’s safe. How can I figure this out?