Lately, food faddists have been claiming that coconut oil is a health food. They claim that it will help you lose weight. In reality, coconut oil is as fattening as any other fat. Some people even claim that coconut oil can cure Alzheimer’s disease. In reality, coconut oil can promote atherosclerosis, which is an important cause of vascular dementia. Also, fats of any kind tend to make your body less sensitive to insulin. For this reason, eating coconut oil would probably make type 2 diabetes worse. Coconut oil could even make Alzheimer’s disease worse. Alzheimer’s disease seems to be related to insulin resistance in the brain.
So why are people promoting coconut oil for brain health? They know that coconut oil is part of a diet for children with epilepsy. However, they do not understand why this diet is used.
What is epilepsy?
Epilepsy is a condition in which people suffer from seizures. A seizure is an electrical storm within the brain. In ancient times, epilepsy was called “the falling sickness” because it can make you pass out. However, “partial” seizures may simply cause altered mental states or uncontrolled movements of the body. Many ancient people thought that epilepsy was caused by evil spirits. However, the ancient Greek physician Hippocrates explained that epilepsy was an ordinary physical disease, with physical causes. The ancients knew that epileptics had fewer seizures while they were fasting. Of course, you cannot fast forever. You have to eat something eventually, or you will starve to death. Once the epileptic person started eating again, the seizures would start up again.
By the 1920s, physicians were looking for a way to mimic some of the effects of fasting, without starving the patient to death. They knew that fasting causes ketosis, which is the buildup of chemicals called ketone bodies in the bloodstream. But they knew that you could also get ketosis from eating an extremely low-carbohydrate diet. For reasons that are still unclear, ketosis suppresses seizures in many people with epilepsy. For this reason, an extremely high-fat, low-carbohydrate “ketogenic” diet has been used since the early 1920s for the management of treatment-resistant epilepsy in children.
What causes ketosis?
Why does an extremely low-carb diet cause ketosis? Even in the 1920s, it was obvious that ketosis meant that the liver was making huge amounts of sugar. The excess sugar in a diabetic person’s bloodstream did not result from eating a high-carbohydrate diet. Instead, much of it was made out of protein from the food and from the body’s tissues. If there is no insulin in the blood, the alpha cells in the pancreas assume that the blood sugar level must be low. As a result, the alpha cells will make huge amounts of a hormone called glucagon. Glucagon tells the liver to make glucose. Normally, this brings blood sugar levels back up to normal. An overdose of insulin kills people by preventing their pancreas from releasing glucagon. That’s why glucagon is used as an antidote to insulin overdose.
The liver makes a lot of glucose out of a starch called glycogen. However, the liver can also make glucose out of noncarbohydrates. In particular, it can make sugar out of some amino acids (the building blocks of protein). When the liver is making a lot of glucose, it may also start to use up a substance called oxaloacetate. However, it needs that material for burning fats efficiently. So if the liver is making sugar really fast, the body cannot burn fats well. As a result, the liver produces more ketone bodies as waste products. Ketosis means that these ketone bodies are building up in the bloodstream.
Is ketosis good or bad?
If you are fasting, a little bit of ketosis is a good thing. Your brain can use some ketone bodies as an alternative fuel source. But the severe ketosis caused by untreated type 1 diabetes is a life-threatening emergency. Diabetic ketoacidosis is a combination of severe ketosis, high blood sugar, dehydration, and electrolyte imbalances.
You can get ketosis from fasting. However, you can also get it from an extremely low-carbohydrate diet. Thus, children with severe epilepsy are sometimes fed an extremely low-carbohydrate (ketogenic) diet. This ketogenic diet has some important drawbacks. It stunt children’s growth. It can also lead to some severe side effects, including inflammation of the pancreas. Also, children often hate the diet. The food is yucky, and their choices are limited. Eating even a little bit of carbohydrate stops the ketosis. For this reason, it is hard to get children to stick to the diet well enough to get benefits.
Most of the fat in our food consists of triglycerides that contain long-chain fatty acids. However, short- and medium-chain fatty acids are better at producing ketosis. The shorter-chain fatty acids go straight to the liver from the intestine. The longer fatty acids go through a different pathway, which does not go through the liver before it reaches the general circulation. Coconut oil is a relatively rich source of medium-chain fatty acids. So if you add coconut oil to the ketogenic diet, you can let the child eat a little bit of carbohydrate and a bit more protein.
Since coconut oil is so good at generating ketone bodies, there has been some interest in it for patients with Alzheimer’s disease. In Alzheimer’s disease, the brain is having trouble with using glucose for energy. For this reason, some researchers suspect that having more ketone bodies in the bloodstream would help. Yet this theory remains unproven.
Societies that eat high-carb, low-fat diets have lower rates of Alzheimer’s disease. I explain this fact in my book Thin Diabetes, Fat Diabetes: Prevent Type 1, Cure Type 2.
Epilepsy in children
The ketogenic diet is useful in cases of childhood epilepsy that do not respond to any other treatment. However, it is not a health-promoting diet for the general public. No society on earth has ever subsisted on a ketogenic diet. Even Inuit (Eskimo) people, who lived on fatty meats and fish during the winter, did not go into ketosis unless they were fasting. Also, high-fat, low-carbohydrate diets lead to rapid aging and early death, even if they do not produce ketosis.
A ketogenic diet may be good for some children with epilepsy. However, it is not a healthy diet. Thus, it would be bad for people who do not have epilepsy. If you don’t have epilepsy, you would be better off eating a low-fat, high-carbohydrate diet of starches and vegetables.
Coconut vs coconut oil
The societies that eat lots of coconut tend to have low rates of heart disease. However, their overall intake of fat and cholesterol is low. Most of their calories come from carbohydrates (starches and sugars). Rice and starchy vegetables (such as sweet potatoes and poi) make up the bulk of their diet. Since these people live in the tropics, they also eat a lot of fruit and vegetables. Some Polynesians eat a lot of coconut. However, they mainly eat whole coconut, rather than coconut oil. The fiber in the coconut helps to lower their cholesterol. Fiber binds to cholesterol in the intestine. Thus, fiber can carry the cholesterol out of the body.
If you want to lose weight and protect your heart and brain, don’t eat coconut oil. Instead, remove oils and animal-source foods from your diet. The populations that eat a low-fat, plant-based diet have the best chance at a long and healthy life.