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FOR HEALTH PROFESSIONALS ONLY: For scientific and medical informational purposes.
Material not intended for Consumers
Coconut Oil and Heart Disease
by Dr. Alexander J. Rinehart, DC, MS, CCN, CNS
The association between dietary saturated fat and coronary heart disease has been
controversial, with reports consistently showing correlations between the two (1; 2). Dietary
saturated fats have been correlated with hypercholesterolemia, and hypercholesterolemia
has been correlated with increased cardiovascular mortality, but evidence directly linking
dietary saturated fat and mortality has been less clear (2; 3; 4; 5; 6; 7; 8; 9; 10).
For instance, total dietary fat and saturated fat intake may have a protective relationship
with stroke (11; 12); and, a 1994 article in Lancet demonstrated that the fatty acid
composition of plaque associated with arteriosclerosis is comprised of mostly unsaturated
fat (74%) (13).
Coconut oil is comprised of 64% medium chain saturated fatty acids, 28% long-chain
saturated fatty acids, 6% monounsaturated fats, and 2% polyunsaturated fats. Despite its
high saturated fat content, coconut oil has been shown to have little effecton total
cholesterol, and may improve total cholesterol (TC):high density lipoprotein (HDL) and
LDL:HDL (14; 15; 16; 17; 18). Authors attribute the positive cholesterol effectto a more
pronounced lipid-raising effecton HDLs than TC and LDL alone. Lauric acid, the primary
medium chain saturated fatty acid found in coconut oil has been proven to decrease
TC:HDL more so than other fatty acids studied (19).
While both animal and human studies have failed to find a definitive relationship between
coconut oil, saturated fats and abnormal lipids, the research suggests that the few studies
which have linked coconut oil to hyperlipidemia and hypercholesterolemia, used
hydrogenated coconut oil as the source of fat. When total fat as a percentage of diet is held
the same, higher intakes of coconut oil and saturated fats will lead to a relative deficiency in
essential fatty acids which may be the cause of high lipids and cholesterol seen in these few
studies (3; 14; 20; 21; 22). Some of the studies also used coconut oil intakes that are
unlikely to be consumed in everyday life (16; 17; 23). Additionally, the supportive effects of
short, medium, and long-chain saturated fats on HDL and key ratios such as TC:HDL have
been generally underappreciated in the research literature.
Positive changes in levels of other key risk factors for heart disease such as tissue
plasminogen activator antigen (t-PA) concentration - affecting fibrinolysis and lp(a) have
also been seen (24). Even though dietary intake of cholesterol has a small effecton
systemic levels, coconut oil contains only trace amounts of cholesterol (0-14 ppm),
compared to 3000 ppm cholesterol found in butter and lard (15).
2
Ultimately, consumption of coconut oil and/or MCTs may yield a net protective effecton
overall risk of heart disease despite potential increases in total cholesterol and total LDL.
Coconut Oil Intake and Heart Disease
Sri Lanka, Polynesia, Philippines, Indonesia, and New Guinea have lower incidences of
cardiovascular disease compared to more developed countries even though they have the
highest consumption of coconut oil (1; 25; 26; 27).
While the prevalence of cardiovascular disease is rising in Sri Lanka and India (28; 29; 30),
a 1998 review in the Journal of the Indian Medical Association suggests that the increase
may be due to the recent dietary transition from ghee, coconut oil, and mustard oil to
polyunsaturated fats such as corn, sunflower, or safflower oils (4). It is estimated that while
total fat intake has remained the same in Sri Lanka, intake of fat from coconut decreased
25-30%. During this same period, deaths from cardiovascular disease increased (31). A
similar trend is occurring in Indonesia yet a correlation between dietary coconut and heart
disease has not been reported (32).
While controversy continues on the link between saturated fats (coconut-derived or
otherwise) and heart disease, the effectof lifestyle factors such intake of refined
carbohydrates (33), smoking and obesity may be more harmful and of more public concern
(5; 34; 35).
Other Proposed Cardiovascular Benefits of Coconut Oil
Due to their unique metabolism, the MCTs in coconut oil may also offer an energy source
that promotes general heart health, and may improve clinical symptoms of heart disease
such as cardiomyopathy (36).
Coconut MCTs may help improve lipids (37), oxidized LDLs (38), fat deposition (39; 40; 41),
triglycerides (42), and inflammation (43), while also raising HDLs as discussed previously
(44).
Coconut oil constituents may offer anti-microbial properties and support the immune
response to such infections. Low-grade bacterial and viral infections have also been
associated with coronary heart disease, particularly Helicobacterpylori (45), Chlamydia
pneumoniae and cytomegalovirus (46; 47) which may be inactivated by the medium chain
triglycerides and monoglycerides in coconut oil (48; 49).
3
References:
1.) Kromhout D, Menotti A, Bloemberg B, et al. Dietary saturated fat and trans fatty acids
and cholesterol and 25-year mortality from coronary heart disease: the Seven Countries
Study. Prev Med. 1995;24(3):308-15.
2.) Kaunitz H. Adaptive changes in aging and arteriosclerosis-role of cholesterol. Mech
Ageing Dev. 1988;44(1):35-43.
3.) Blackburn GL, Kater G, Mascioli EA, et al. A reevaluation of coconut oil’s effecton
serum cholesterol and atherogenesis. J Philipp Med Assoc.1988;64(4):144-52.
4.) Sircar S. Kansra U. Choice of cooking oils - myths and realities. J Indian Med Assoc.
1998;96(10):304-7.
5.) Ravnskov U. The questionable role of saturated and polyunsaturated fatty acids in
cardiovascular disease. J Clin Epidemiol.1998;51(6):443-460.
6.) Hu FB, Manson JE, Willett WC. Types of dietary fat and risk of coronary heart disease: a
critical review. J Am Coll Nutr. 2001;20(1):5-19.
7.) Renaud S, Lanzmann-Petithory D. Coronary heart disease: dietary links and
pathogenesis. Public Health Nutr. 2001;4(2B):459-474.
8.) Knopp RH, Retzlaff BM. Saturated fat prevents coronary artery disease? An American
paradox. Am J Clin Nutr. 2004;80(5):1102-1103.
9.) Hu FB, Stampfer MJ, Manson JE, et al. Dietary fat intake and risk of coronary heart
disease in women. N Eng J Med. 1997;337:1491-1499.
10.) Hu FB, Stampfer MJ, Manson JE, et al. Dietary saturated fats and their food sources in
relation to the risk of coronary heart disease in women. Am J Clin Nutr. 1999;70:1001-1008.
11.) Gillman MW, Cupples LA, Millen BE, Ellison RC, Wolf PA. Inverse association of
dietary fat with development of ischemic stroke in men. JAMA 1997;278(24):2145-2150.
12.) He K, Merchant A, Rimm EB, et al. Dietary fat intake and risk of stroke in male US
healthcare professionals: 14 year prospective cohort study. BMJ. 2003;327(7418):777-82.
13.) Felton CV, Crook D, Davies MJ, Oliver MF. Dietary polyunsaturated fatty acids and
composition of human aortic placques. Lancet. 1994;344(8931):1195-1196.
14.) Dayrit CS. Coconut oil: atherogenic or not? Phillipp J Cardiol.2003: 31(3):97-104.
15.) Dayrit CS. 2005. The truth about coconut oil: the drugstore in a bottle. Anvil Publishing:
Phillippines.
4
16.) Mendis S, Kumarasunderam R. The effectof daily consumption of coconut fat and
soya-bean fat on plasma lipids and lipoproteins of young normolipidaemic men. Br J Nutr.
1990;63(3):547-552.
17.) Cox C, Mann J. Sutherland W, Chisholm A, Skeaff M. Effects of coconut oil, butter, and
safflower oil on lipids and lipoproteins in persons with moderately elevated cholesterol
levels. J Lipid Res. 1995;36(8):1787-1795.
18.) German JB, Dillard CJ. Commentary: Saturated fats: what dietary intake? Am J Clin
Nutr. 2004; 80(3): 550-9.
19.) Mensink RP, Zock PI, Kester AD, Katan MB. Effects of dietary fatty acids and
carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and
apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr. 2003:77(5):1146-
1155.
20.) Kaunitz H. Nutritional properties of coconut oil. J Amer Oil Chem Soc.
1970;47(10):462A-465A.
21.) Hayes KC. Medium-chain triacylglycerols may not raise cholesterol. Am J Clin Nutr.
2000;72(6):1583.
22.) Elson CE. Tropical oils: nutritional and scientific issues. Crit Rev Food Sci Nutr.
1992;31(1-2):79-102.
23.) Icayan EE, Lagua RT, Martires F, Batungbacal R, Pamintuan CL. Effects of feeding
different levels of coconut oil on the serum lipids of normal medical students. J Phillipp Med
Assoc. 1967;43*4):296-302.
24.) Muller H. Lindman AS, Blomfeldt A, Seljeflot I, Pedersen JI. A diet rich in coconut oil
reduces diurnal postprandial variations in circulating tissue plasminogen activator antigen
and fasting lipoprotein (a) compared with a diet rich in unsaturated fat in women. J Nutr.
2003;133(11):3422-3427.
25.) Lipoeto NI, Agus Z, Oenzil F, et al. Dietary intake and the risk of coronary heart disease
among the coconut consuming Minangkabau in West Sumatra, Indonesia. Asia Pac J Clin
Nutr. 2004:13(4):377-84.
26.) Khoo KL, Tan H, Liew YM, Deslypere JP, Janus E. Lipids and coronary heart disease
in Asia. Atherosclerosis.2003;169(1):1-10.
27.) Kaunitz H. Medium chain triglycerides (MCT) in aging and arteriosclerosis. J Environ
Pathol Toxicol Oncol.1986;6(3-4):115-121.
28.) Amarasiri WA, Dissanayake AS, Coconut fats. Ceylon Med J. 2006;51(2):47-51.
5
29.) Kumar PD. The role of coconut and coconut oil in coronary heart disease in Kerala,
south India. Trop Doct. 1997;27(4):215-217.
30.) Padmavati S. Epidemiology of cardiovascular disease in India. II. Ischemic heart
disease. Circulation.1962;25:711-717.
31.) Abeywardena MY. Dietary fats, carbohydrates and vascular disease: Sri Lankan
perspectives. Atherosclerosis.2003;171(2):157-61.
32.) Hanafiah A, Karyadi D, Lukito W, Muhilal, Supari F. Desirable intakes of
polyunsaturated fatty acids in Indonesian adults. Asia Pac J Clin Nutr. 2007;16(4):632-40.
33.) Hu FB. Are refined carbohydrates worse than saturated fat? Am J Clin Nutr.
2010;91(6):1541-2.
34.) Ravnskov U. A hypothesis out of date: the diet-heart idea. J Clin Epidemiol.
2002;55(11):1057-63.
35.) Ravsnkov U. Is atherosclerosis caused by high cholesterol? QJM. 2002;95:397-403
36.) Labarthe F, Gelinas R, Des Rosiers C. Medium-chain fatty acids as metabolic therapy
in cardiac disease. Cardiovasc Drugs Ther. 2008; 22(2):97-106.
37.) Trinidad TP, Loyala AS, Mallillin AC, et al. The cholesterol-lowering effectof coconut
flakes in humans with moderately raised serum cholesterol. J Med Food. 2004;7(2):136-
140.
38.) Nevin KG, Rajamohan T. Beneficial effects of virgin coconut oil on lipid parameters and
in vitro LDL oxidation. Clin Biochem.2003;37(9):830-835.
39.) Simon E, del Puy Portillo M, Fernandez-Quintela A, et al. Responses to dietary
macronutrient distribution of overweight rats under restricted feeding. Ann Nutr Metab.
2002;46(1):24-31.
40.) Baba N, Bracco EF, Seylar J, Hashim SA. Enhanced thermogenesis and diminished
deposition of fat in response to overfeeding with diets containing medium-chain
triglycerides. J Am Soc Clin Nutr 1981; 14:624.
41.) Geliebter A, Torbay N, Bracco E Hashim SA, Van Itallie TB. Overfeeding with medium-
chain triglyceride diet results in diminished deposition of fat. Am J Clin Nutr. 1983; 37:1-4.
42.) Calabrese C, Myer S, Munson S, Turet P, Birdsall TC. A cross-over study of the effect
of a single oral feeding of medium chain triglyceride oil vs. canola oil on post-ingestion
plasma triglyceride levels in healthy men. Altern Med Rev. 1999;4(1):23-28.
43.) Blackburn GL. Nutrition and inflammatory events: highly unsaturated fatty acids
(omega-3 vs omega-6) in surgical injury. Proc Soc Biol Med. 1992;200(2):183-8.
44.) Mini S, Rajamohan T. Influence of coconut kernel protein on lipid metabolism in alcohol
6
fed rats. Indian J Exp Biol. 2004; 42(1):53-57.
45.) Strachan DP. Non-gastrointestinal consequences of Helicobacterpylori infection.
British Medical Bulletin 1998; 54(1):87-93.
46.) Mallika V, Goswami B, Rajappa M. Atherosclerosis pathophysiology and the role of
novel risk factors: a clinicobiochemical perspective. Angiology.2007;58(5):513-22.
47.) Muhlestein JB, Anderson JL. Chronic infection and coronary heart disease. Cardiol
Clin. 2003;21(3):333-362.
48.) Bergsson G, Arnfinnsson J, Karlsson SM, et al. In vitro inactivation of Chlamydia
trachomatis by fatty acids and monoglycerides. Antimicrob Agents Chemotherap.
1998;42:2290-4.
49.) Omura Y, O’Young B, Jones M, Pallos A, Duwwi H, Shimotsuura Y. Caprylic acid in
the effective treatment of intractable medical problems of frequent urination, incontinence,
chronic upper respiratory infection, root canalled tooth infection, ALS, etc. caused by
asbestos & mixed infections of Candida albicans, Helicobacter pylori & cytomegalovirus
with or without other microorganisms & mercury. AcupunctElectrother Res. 2011;36(1-
2):19-64.

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Coconut Oil and Heart Disease

  • 1. FOR HEALTH PROFESSIONALS ONLY: For scientific and medical informational purposes. Material not intended for Consumers Coconut Oil and Heart Disease by Dr. Alexander J. Rinehart, DC, MS, CCN, CNS The association between dietary saturated fat and coronary heart disease has been controversial, with reports consistently showing correlations between the two (1; 2). Dietary saturated fats have been correlated with hypercholesterolemia, and hypercholesterolemia has been correlated with increased cardiovascular mortality, but evidence directly linking dietary saturated fat and mortality has been less clear (2; 3; 4; 5; 6; 7; 8; 9; 10). For instance, total dietary fat and saturated fat intake may have a protective relationship with stroke (11; 12); and, a 1994 article in Lancet demonstrated that the fatty acid composition of plaque associated with arteriosclerosis is comprised of mostly unsaturated fat (74%) (13). Coconut oil is comprised of 64% medium chain saturated fatty acids, 28% long-chain saturated fatty acids, 6% monounsaturated fats, and 2% polyunsaturated fats. Despite its high saturated fat content, coconut oil has been shown to have little effecton total cholesterol, and may improve total cholesterol (TC):high density lipoprotein (HDL) and LDL:HDL (14; 15; 16; 17; 18). Authors attribute the positive cholesterol effectto a more pronounced lipid-raising effecton HDLs than TC and LDL alone. Lauric acid, the primary medium chain saturated fatty acid found in coconut oil has been proven to decrease TC:HDL more so than other fatty acids studied (19). While both animal and human studies have failed to find a definitive relationship between coconut oil, saturated fats and abnormal lipids, the research suggests that the few studies which have linked coconut oil to hyperlipidemia and hypercholesterolemia, used hydrogenated coconut oil as the source of fat. When total fat as a percentage of diet is held the same, higher intakes of coconut oil and saturated fats will lead to a relative deficiency in essential fatty acids which may be the cause of high lipids and cholesterol seen in these few studies (3; 14; 20; 21; 22). Some of the studies also used coconut oil intakes that are unlikely to be consumed in everyday life (16; 17; 23). Additionally, the supportive effects of short, medium, and long-chain saturated fats on HDL and key ratios such as TC:HDL have been generally underappreciated in the research literature. Positive changes in levels of other key risk factors for heart disease such as tissue plasminogen activator antigen (t-PA) concentration - affecting fibrinolysis and lp(a) have also been seen (24). Even though dietary intake of cholesterol has a small effecton systemic levels, coconut oil contains only trace amounts of cholesterol (0-14 ppm), compared to 3000 ppm cholesterol found in butter and lard (15).
  • 2. 2 Ultimately, consumption of coconut oil and/or MCTs may yield a net protective effecton overall risk of heart disease despite potential increases in total cholesterol and total LDL. Coconut Oil Intake and Heart Disease Sri Lanka, Polynesia, Philippines, Indonesia, and New Guinea have lower incidences of cardiovascular disease compared to more developed countries even though they have the highest consumption of coconut oil (1; 25; 26; 27). While the prevalence of cardiovascular disease is rising in Sri Lanka and India (28; 29; 30), a 1998 review in the Journal of the Indian Medical Association suggests that the increase may be due to the recent dietary transition from ghee, coconut oil, and mustard oil to polyunsaturated fats such as corn, sunflower, or safflower oils (4). It is estimated that while total fat intake has remained the same in Sri Lanka, intake of fat from coconut decreased 25-30%. During this same period, deaths from cardiovascular disease increased (31). A similar trend is occurring in Indonesia yet a correlation between dietary coconut and heart disease has not been reported (32). While controversy continues on the link between saturated fats (coconut-derived or otherwise) and heart disease, the effectof lifestyle factors such intake of refined carbohydrates (33), smoking and obesity may be more harmful and of more public concern (5; 34; 35). Other Proposed Cardiovascular Benefits of Coconut Oil Due to their unique metabolism, the MCTs in coconut oil may also offer an energy source that promotes general heart health, and may improve clinical symptoms of heart disease such as cardiomyopathy (36). Coconut MCTs may help improve lipids (37), oxidized LDLs (38), fat deposition (39; 40; 41), triglycerides (42), and inflammation (43), while also raising HDLs as discussed previously (44). Coconut oil constituents may offer anti-microbial properties and support the immune response to such infections. Low-grade bacterial and viral infections have also been associated with coronary heart disease, particularly Helicobacterpylori (45), Chlamydia pneumoniae and cytomegalovirus (46; 47) which may be inactivated by the medium chain triglycerides and monoglycerides in coconut oil (48; 49).
  • 3. 3 References: 1.) Kromhout D, Menotti A, Bloemberg B, et al. Dietary saturated fat and trans fatty acids and cholesterol and 25-year mortality from coronary heart disease: the Seven Countries Study. Prev Med. 1995;24(3):308-15. 2.) Kaunitz H. Adaptive changes in aging and arteriosclerosis-role of cholesterol. Mech Ageing Dev. 1988;44(1):35-43. 3.) Blackburn GL, Kater G, Mascioli EA, et al. A reevaluation of coconut oil’s effecton serum cholesterol and atherogenesis. J Philipp Med Assoc.1988;64(4):144-52. 4.) Sircar S. Kansra U. Choice of cooking oils - myths and realities. J Indian Med Assoc. 1998;96(10):304-7. 5.) Ravnskov U. The questionable role of saturated and polyunsaturated fatty acids in cardiovascular disease. J Clin Epidemiol.1998;51(6):443-460. 6.) Hu FB, Manson JE, Willett WC. Types of dietary fat and risk of coronary heart disease: a critical review. J Am Coll Nutr. 2001;20(1):5-19. 7.) Renaud S, Lanzmann-Petithory D. Coronary heart disease: dietary links and pathogenesis. Public Health Nutr. 2001;4(2B):459-474. 8.) Knopp RH, Retzlaff BM. Saturated fat prevents coronary artery disease? An American paradox. Am J Clin Nutr. 2004;80(5):1102-1103. 9.) Hu FB, Stampfer MJ, Manson JE, et al. Dietary fat intake and risk of coronary heart disease in women. N Eng J Med. 1997;337:1491-1499. 10.) Hu FB, Stampfer MJ, Manson JE, et al. Dietary saturated fats and their food sources in relation to the risk of coronary heart disease in women. Am J Clin Nutr. 1999;70:1001-1008. 11.) Gillman MW, Cupples LA, Millen BE, Ellison RC, Wolf PA. Inverse association of dietary fat with development of ischemic stroke in men. JAMA 1997;278(24):2145-2150. 12.) He K, Merchant A, Rimm EB, et al. Dietary fat intake and risk of stroke in male US healthcare professionals: 14 year prospective cohort study. BMJ. 2003;327(7418):777-82. 13.) Felton CV, Crook D, Davies MJ, Oliver MF. Dietary polyunsaturated fatty acids and composition of human aortic placques. Lancet. 1994;344(8931):1195-1196. 14.) Dayrit CS. Coconut oil: atherogenic or not? Phillipp J Cardiol.2003: 31(3):97-104. 15.) Dayrit CS. 2005. The truth about coconut oil: the drugstore in a bottle. Anvil Publishing: Phillippines.
  • 4. 4 16.) Mendis S, Kumarasunderam R. The effectof daily consumption of coconut fat and soya-bean fat on plasma lipids and lipoproteins of young normolipidaemic men. Br J Nutr. 1990;63(3):547-552. 17.) Cox C, Mann J. Sutherland W, Chisholm A, Skeaff M. Effects of coconut oil, butter, and safflower oil on lipids and lipoproteins in persons with moderately elevated cholesterol levels. J Lipid Res. 1995;36(8):1787-1795. 18.) German JB, Dillard CJ. Commentary: Saturated fats: what dietary intake? Am J Clin Nutr. 2004; 80(3): 550-9. 19.) Mensink RP, Zock PI, Kester AD, Katan MB. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr. 2003:77(5):1146- 1155. 20.) Kaunitz H. Nutritional properties of coconut oil. J Amer Oil Chem Soc. 1970;47(10):462A-465A. 21.) Hayes KC. Medium-chain triacylglycerols may not raise cholesterol. Am J Clin Nutr. 2000;72(6):1583. 22.) Elson CE. Tropical oils: nutritional and scientific issues. Crit Rev Food Sci Nutr. 1992;31(1-2):79-102. 23.) Icayan EE, Lagua RT, Martires F, Batungbacal R, Pamintuan CL. Effects of feeding different levels of coconut oil on the serum lipids of normal medical students. J Phillipp Med Assoc. 1967;43*4):296-302. 24.) Muller H. Lindman AS, Blomfeldt A, Seljeflot I, Pedersen JI. A diet rich in coconut oil reduces diurnal postprandial variations in circulating tissue plasminogen activator antigen and fasting lipoprotein (a) compared with a diet rich in unsaturated fat in women. J Nutr. 2003;133(11):3422-3427. 25.) Lipoeto NI, Agus Z, Oenzil F, et al. Dietary intake and the risk of coronary heart disease among the coconut consuming Minangkabau in West Sumatra, Indonesia. Asia Pac J Clin Nutr. 2004:13(4):377-84. 26.) Khoo KL, Tan H, Liew YM, Deslypere JP, Janus E. Lipids and coronary heart disease in Asia. Atherosclerosis.2003;169(1):1-10. 27.) Kaunitz H. Medium chain triglycerides (MCT) in aging and arteriosclerosis. J Environ Pathol Toxicol Oncol.1986;6(3-4):115-121. 28.) Amarasiri WA, Dissanayake AS, Coconut fats. Ceylon Med J. 2006;51(2):47-51.
  • 5. 5 29.) Kumar PD. The role of coconut and coconut oil in coronary heart disease in Kerala, south India. Trop Doct. 1997;27(4):215-217. 30.) Padmavati S. Epidemiology of cardiovascular disease in India. II. Ischemic heart disease. Circulation.1962;25:711-717. 31.) Abeywardena MY. Dietary fats, carbohydrates and vascular disease: Sri Lankan perspectives. Atherosclerosis.2003;171(2):157-61. 32.) Hanafiah A, Karyadi D, Lukito W, Muhilal, Supari F. Desirable intakes of polyunsaturated fatty acids in Indonesian adults. Asia Pac J Clin Nutr. 2007;16(4):632-40. 33.) Hu FB. Are refined carbohydrates worse than saturated fat? Am J Clin Nutr. 2010;91(6):1541-2. 34.) Ravnskov U. A hypothesis out of date: the diet-heart idea. J Clin Epidemiol. 2002;55(11):1057-63. 35.) Ravsnkov U. Is atherosclerosis caused by high cholesterol? QJM. 2002;95:397-403 36.) Labarthe F, Gelinas R, Des Rosiers C. Medium-chain fatty acids as metabolic therapy in cardiac disease. Cardiovasc Drugs Ther. 2008; 22(2):97-106. 37.) Trinidad TP, Loyala AS, Mallillin AC, et al. The cholesterol-lowering effectof coconut flakes in humans with moderately raised serum cholesterol. J Med Food. 2004;7(2):136- 140. 38.) Nevin KG, Rajamohan T. Beneficial effects of virgin coconut oil on lipid parameters and in vitro LDL oxidation. Clin Biochem.2003;37(9):830-835. 39.) Simon E, del Puy Portillo M, Fernandez-Quintela A, et al. Responses to dietary macronutrient distribution of overweight rats under restricted feeding. Ann Nutr Metab. 2002;46(1):24-31. 40.) Baba N, Bracco EF, Seylar J, Hashim SA. Enhanced thermogenesis and diminished deposition of fat in response to overfeeding with diets containing medium-chain triglycerides. J Am Soc Clin Nutr 1981; 14:624. 41.) Geliebter A, Torbay N, Bracco E Hashim SA, Van Itallie TB. Overfeeding with medium- chain triglyceride diet results in diminished deposition of fat. Am J Clin Nutr. 1983; 37:1-4. 42.) Calabrese C, Myer S, Munson S, Turet P, Birdsall TC. A cross-over study of the effect of a single oral feeding of medium chain triglyceride oil vs. canola oil on post-ingestion plasma triglyceride levels in healthy men. Altern Med Rev. 1999;4(1):23-28. 43.) Blackburn GL. Nutrition and inflammatory events: highly unsaturated fatty acids (omega-3 vs omega-6) in surgical injury. Proc Soc Biol Med. 1992;200(2):183-8. 44.) Mini S, Rajamohan T. Influence of coconut kernel protein on lipid metabolism in alcohol
  • 6. 6 fed rats. Indian J Exp Biol. 2004; 42(1):53-57. 45.) Strachan DP. Non-gastrointestinal consequences of Helicobacterpylori infection. British Medical Bulletin 1998; 54(1):87-93. 46.) Mallika V, Goswami B, Rajappa M. Atherosclerosis pathophysiology and the role of novel risk factors: a clinicobiochemical perspective. Angiology.2007;58(5):513-22. 47.) Muhlestein JB, Anderson JL. Chronic infection and coronary heart disease. Cardiol Clin. 2003;21(3):333-362. 48.) Bergsson G, Arnfinnsson J, Karlsson SM, et al. In vitro inactivation of Chlamydia trachomatis by fatty acids and monoglycerides. Antimicrob Agents Chemotherap. 1998;42:2290-4. 49.) Omura Y, O’Young B, Jones M, Pallos A, Duwwi H, Shimotsuura Y. Caprylic acid in the effective treatment of intractable medical problems of frequent urination, incontinence, chronic upper respiratory infection, root canalled tooth infection, ALS, etc. caused by asbestos & mixed infections of Candida albicans, Helicobacter pylori & cytomegalovirus with or without other microorganisms & mercury. AcupunctElectrother Res. 2011;36(1- 2):19-64.