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Miscellaneous diet and health topics

Coconut oil

In recent years coconut oil has been heavily promoted as a "miracle food" for both humans and their pet birds.  But there is very little that has actually been substantiated, so we don't know how valid the claims are.  There is no clear evidence on whether coconut oil is either beneficial or harmful to humans.  Coconut oil is composed primarily of fats that most birds do not eat in the wild, which means that their evolution may not have equipped them to deal with these fats. Although a small amount once in a while isn't likely to do any harm, there is a risk that consistently consuming these fats on a long term basis could be harmful to their health.

The health claims tout the curative power of coconut oil for diabetes, cancer, Alzheimers, Parkinsons, autism, kidney and liver problems, digestive problems, immune function, infection prevention, weight loss, as a skin and hair conditioner, and more. Any time you see a long list of claims like this it's a red flag that there is probably a lot of exaggeration going on, and you should do some checking before you accept it as true. There's no doubt that it really does work well as a skin and hair oil.  But all the other claims are based on small short-term studies that found a modest benefit at best. Marketers are making massive assumptions and huge leaps of faith about long term benefits on the basis of a very limited amount of data.

Websites belonging to representatives of the coconut industry at Coconut Research Center and CoconutOil.com have lists of studies purporting to prove the benefits of coconut oil.  A number of the links at the first site have no visible relationship to coconut oil at all. The second site is more on topic, but many of the studies listed here were on medium chain triglycerides (MCT), not on coconut oil itself.  Eyres et al point out that "Research on manufactured medium-chain triglycerides in the [scientific] literature cannot be applied to coconut oil because the triglycerides predominant in coconut oil are different in their structure, absorption, and metabolism."

In addition, these studies used MCT in a way that is very different from the way people would use coconut oil in real life, and it should not be assumed that eating coconut oil will produce the same results as purified medical-grade MCT in a laboratory setting. There don't seem to be any long term studies on MCTs or coconut oil at all, and there isn't enough data to make any assumptions about significant benefits or long term effects. As NeurologicaBlog explains, preliminary studies of traditional "natural" cures have a strong favorable bias that results in a large number of false positives.  Substances that look promising at first turn out to be ineffective most of the time when the more serious longer-term studies are performed.

The best information we have at present comes from a 2016 review by Eyres et al, which concluded that the scientific studies to date have had somewhat inconsistent results, but do not support the idea that coconut oil has a beneficial effect on the lipid profile of human blood.  In general it was found to be better than animal fat like butter, but worse than other types of vegetable oil like corn, soybean, and olive. They stated that

"No convincing evidence that consumption of coconut oil, as opposed to consumption of unsaturated oils, led to improved lipid profiles and a decreased risk of CVD [cardiovascular disease] was discovered during the literature search. Overall, the weight of the evidence to date suggests that replacing coconut oil with cis unsaturated fats would reduce CVD risk. Therefore, this review does not support popular claims purporting that coconut oil is a healthy oil in terms of reducing the risk of CVD. There was no evidence that coconut oil acted consistently different from other saturated fats in terms of its effects on blood lipids and lipoproteins."

"In summary, this review found no evidence that coconut oil should be viewed differently from other sources of dietary saturated fat with regard to dietary recommendations. This is in line with recommendations from the American Heart Association and the US Department of Agriculture’s Dietary Guidelines for Americans, 2010, which suggest that coconut oil is not preferable to other saturated fats."

"it appears that consuming cis unsaturated fat in place of coconut oil is likely to result in substantial reductions in the risk of CVD."

Nutritional Content and Fat Types  

All oils are a processed food. The oil extraction process strips away most of the nutrients in the original seed/nut, leaving you with a product that is essentially 100% pure fat with relatively small amounts of a few other nutrients. The dramatic difference in nutritional content can be seen in the USDA listings for coconut meat and coconut oil.  It seems more sensible to eat coconut meat than coconut oil; the meat has the oil in it plus a lot of nutrients that you don't get with plain oil.  In the real world, obesity and atherosclerosis are major health problems for both humans and pet birds.  Adding more fat to the diet is not going to solve the problem and will most likely make it worse, and claims to the contrary are unsubstantiated marketing hype.    

Four main categories of fats are found in foods, with several types of fatty acids in each category.  Omega 3 and Omega 6 fats are the polyunsaturated fats. They are essential nutrients; they can not be synthesized in the body and must be obtained from the diet. The Omega 9 fats are the monounsaturated fats, and the fourth category is saturated fat, which does not have an Omega number.  Saturated and monounsaturated fats are not essential nutrients because they can be synthesized in the body. Conventional wisdom says that polyunsaturated and monounsaturated fats are good fats and saturated fat is bad because of its role in heart disease, but this simplistic notion is currently being questioned and more research on the issue is needed.

Coconut oil is roughly 90% saturated fat; the precise percentage varies according to which source you look at (NutritionData, ChemPro, ChartsBin, Wikipedia). That's considerably more than butter, which is about 50% saturated fat (NutritionData) and lard, which is about 40% (NutritionData). Animal fat contains cholesterol and plant fat does not, but for humans at least it's believed that cholesterol in foods has considerably less impact on your blood cholesterol level than the amount of saturated fat in your diet does. The types and amount of carbohydrates in the diet may also have an influence since the body uses them to make cholesterol.

According to Butter Through the Ages, butter contains 0.8% caprylic acid, 1.6% capric acid, and 5.8% lauric acid. Caprylic and capric acid are medium chain triglycerides, and lauric acid is sometimes called an MCT by promoters. Technically speaking it was designated as an MCT a long time ago when fatty acids weren't as well understood. Nowadays it can be classified as either an MCT or an LCT (long chain triglyceride), and it's often called a pseudo-MCT. Eyres et al report that in the body it mostly behaves like an ordinary saturated fat not an MCT:

"In terms of digestion and metabolism, however, it [lauric acid] behaves more as a long-chain fatty acid because the majority of it (70%–75%) is absorbed with chylomicrons. In comparison, 95% of medium-chain fatty acids [capyrlic and capric acid] are absorbed directly into the portal vein... It is therefore inaccurate to consider coconut oil to contain either predominantly medium-chain fatty acids or predominantly medium-chain triglycerides. Thus, the evidence on medium-chain triglycerides cannot be extrapolated to coconut oil."

Coconut oil is 7.1% caprylic acid, 6% capric acid, 47.1% lauric acid, and 30.4% other saturated fats according to this chart. If we are generous and assume that 30% of the lauric acid will behave as an MCT and 70% as an LCT, this means that coconut oil is roughly 27% MCTs and 63% LCTs which are not considered to be desirable. Don't forget that we said earlier that the MCTs in coconut oil are chemically different than the pure MCTs used in scientific experiments, and may not perform the same way. So we don't know how desirable the natural MCTs in coconut oil really are. Forks Over Knives has a fun article on how the "bad" fat prevails in coconut oil, using much less precise figures.

Caprylic, capric, and lauric acid are unusual fats with some unusual properties. Butterfat has about 8% total content of these saturated fats, versus 60% in coconut oil. It is known that different human ethnic groups tend to vary in their ability to tolerate different foods, for example many groups are lactose intolerant while people of European ancestry can usually digest lactose. This is an evolutionary difference based on the need to eat what was available in the local area. People who couldn't survive and reproduce using the available food resources were eliminated from the gene pool. There are many cultures in Southeast Asia and Polynesia whose ancestors have been eating a coconut-heavy diet for centuries. Europeans did not have access to coconut and relied on animal fat instead, or olive oil in the Mediterranean region.  They may be better adapted to the lower or nonexistent MCT levels in the fats their ancestors ate.

What about birds? Most of the fat in seeds and grains is polyunsaturated and monounsaturated.  The saturated fat content is usually less than 20% (often considerably less), and the MCT content is virtually nonexistent (chart). This is the type of food that most parrots are evolved to eat; I haven't looked into the type of fat that insectivorous birds consume. Some of the larger cockatoos are known to eat young coconut in the wild, but young coconut has much less fat and much more carbohydrates than mature coconut (Coco Jack). So young coconut is really a very different type of food, with a nutrient profile more like a grain than an oil seed. It doesn't seem wise to feed significant amounts of a radically different type of fat than what your birds would eat in the wild.

How healthy are coconut-eating human populations?

The health claims for coconut oil include statements like "populations that eat a LOT of coconut are among the healthiest people on the planet". Does this reflect reality? The populations that are usually cited to support this claim are two obscure Polynesian tribes, the Kitavans (population 2300) and the Tokelauans (population 1400).  It's true that they are healthy, possibly due to the aforementioned "weeding out" effect where the people who lived to breeding age were the folks who could stay healthy on a diet consisting mostly of coconut and fish (the primary food resources in Tokelau according to this website; apparently the Kitavans eat more root vegetables than coconut).  Eyres et al points out that neither tribe uses processed coconut oil, and get their coconut fat from coconut meat and coconut cream (aka coconut milk).  They also say,

"It has been hypothesized that the more favorable lipid profiles and lower mortality rates observed in coconut-consuming populations are due to the foods that constitute the rest of their traditional diets... Studies suggest that the consumption of coconut products that contain fiber, such as coconut flesh and coconut flour, within a traditional dietary pattern that includes sufficient polyunsaturated fats (omega-3) in the absence of excessive calories from refined carbohydrates does not pose a risk for heart disease. In contrast, the excessive use of coconut oil as the major lipid in the typical Western diet produces effects similar to those of other saturated fats. Despite claims that coconut oil may reduce cardiovascular risk factors, this review found no evidence indicating that coconut oil is preferable to other unsaturated plant oils."

"The extraction and use of coconut oil in edible applications is a relatively recent phenomenon. Furthermore, when earlier data were collected, coconut products were consumed as part of a traditional diet, which was characterized by a low intake of processed foods. Subsequent to this, a large shift toward the Western diet has occurred among many indigenous populations"

In other words, it's other things in the diet that are providing the benefit, not the coconut oil. The paper points out a variety of inherent limitations in studies like this that make it difficult to rely on the results.  But even if we assume that the studies on these indigenous diets are 100% accurate, why are coconut proponents using these tiny tribes as their example anyway? There are hundreds of millions  of people in Southeast Asia who use coconut oil as their primary cooking oil and eat a lot of coconut in other forms. A large population is a more persuasive example than a small one, but when we look at the big picture the results aren't so pretty.  

Check out the  World Life Expectancy website to look at a series of "cause of death" charts for every nation in the world, to see how the coconut belt compares to the United States or any other nation/region. Looking at diseases where coconut is said to provide benefits or where saturated fat may play a role, we see the following: the US has a higher rate of Alzheimers and Parkinsons and is generally higher for cancer.  The coconut belt has a higher rate of heart disease, high blood pressure (hypertension), stroke, ulcers, kidney disease, liver disease, and diabetes.

The World Health Organization's obesity chart shows that the US has a much higher obesity rate than the coconut belt, with the exception of some Polynesian islands that also have a high rate. WHO's tobacco use chart shows that some coconut belt nations have a higher smoking rate than the US and others have a lower rate.  Wikipedia's life expectancy map shows that the US life expectancy is 5 to 25 years greater than life expectancy in the coconut belt. Alzheimers, Parkinsons and cancer are diseases that are more likely to occur in older people, so our higher rate of these diseases might be due to our longer life expectancy rather than any protective effect of coconut oil. 

   
The first map at left from the World Health Rankings website shows coronary heart disease mortality rates based on 2011 WHO statistics, with "coconut belt" markings added by me (click on the thumbnails to see a larger image). The second map shows updated rates based on 2014 WHO statistics. It looks like the obesity epidemic in the US is helping us catch up to the heart disease rates in some coconut belt nations, but there are quite a few that are still worse than us. Side note:  look at the heart disease rate in Africa while you're at it.  Red palm oil is used a lot in Africa.  It's high in palmitic acid, which has been implicated as a factor in heart disease.  The high smoking rates in Russia and Eastern Europe are probably a major factor in the high heart disease rates there.

   
This map from a 2011 paper by Kim & Johnston shows the "disease burden" rate., which includes the losses from both death and disability. The death rate is expected to be higher in countries where good medical care is scarce, so the combined rate in this chart should give a more accurate picture than the death rate alone.  This paper indicates that the disease burden rate usually follows the same pattern as the death rate. The countries that use a lot of coconut oil or red palm oil tend to have a worse heart disease rate overall than the US or Western Europe.

There are many different factors that affect population health, so we can't assume that public health statistics (whether good or bad) are due to coconut oil consumption. But it seems safe to make one conclusion:  coconut oil apparently doesn't do much to protect people from the consequences of their own bad habits. If there's anything miraculous going on it's really hard to see it from here.

Cholesterol

The hype proudly proclaims that coconut oil increases your "good" HDL cholesterol, and it's true that it really does do this.  There's not as much publicity about the fact that it also increases your "bad" LDL cholesterol, for an overall increase in total cholesterol.  The good cholesterol increases proportionately more than the bad does, but it would be unwise to assume that this change in the balance is beneficial and that the increase in total cholesterol is harmless.  Calling HDL "good" is an oversimplification because HDL functionality is complicated.  There are several HDL subtypes; some are beneficial, some are neutral, and some have a negative effect. So having more HDL cholesterol isn't necessarily a good thing; a lot depends on the balance of the different HDL types, and higher HDL can actually lead to negative consequences sometimes (Sceptical Nutritionist, URMC, Harvard Health).

The American Heart Association issued an advisory document in 2017 (at the website, click the Download PDF button to see the complete document). They summarize the current state of research into dietary fats and cardiovascular disease.  Page 13 discusses coconut oil's effect on cholesterol and rejects the notion that it is a healthy fat.  They conclude with "because coconut oil increases LDL cholesterol, a cause of CVD, and has no known offsetting favorable effects, we advise against the use of coconut oil." The whole thrust of the AHA document is that you should eat less saturated fat and more unsaturated fat. In effect, they have thrown coconut oil into the same bucket as butter or lard, and are telling you not to go crazy with any of them.

60% Registered Pesticide

As mentioned earlier, most of the claims about coconut oil are a gross exaggeration of very modest preliminary research. However there is one claim about medium chain triglycerides that has been substantiated beyond a reasonable doubt, and that is their antibacterial properties. Coconut oil is 7.1% caprylic acid, 6% capric acid, and 47.1% lauric acid (chart), and these are the same medium chain triglycerides that everyone talks about so much. The first two are so effective that they’re registered as antimicrobial pesticides with the United States Environmental Protection Agency. Lauric acid is apparently not quite as strong; it’s registered as a pesticide with the state of California but not with the EPA. (EPA-caprylic, Pesticides Database-caprylic, EPA-capric, Pesticides Database-capric, Pesticides Database-lauric). That's 60% of the total content of coconut oil that is registered as a pesticide with a major government agency.

Caprylic acid is an industrial-strength commercial sanitizer according to Wikipedia:

"Caprylic acid is an antimicrobial pesticide used as a food contact surface sanitizer in commercial food handling establishments on dairy equipment, food processing equipment, breweries, wineries, and beverage processing plants. It is also used as disinfectant in health care facilities, schools/colleges, animal care/veterinary facilities, industrial facilities, office buildings, recreational facilities, retail and wholesale establishments, livestock premises, restaurants, and hotels/motels. In addition, caprylic acid is used as an algaecide, bactericide, and fungicide in nurseries, greenhouses, garden centers, and interiorscapes on ornamentals. Products containing caprylic acid are formulated as soluble concentrate/liquids and ready-to-use liquids."

Several other fats in coconut oil are said to have potential antimicrobial properties. But based on a not-too-thorough investigation, it looks like they are less potent than caprylic, capric, and lauric, and are not registered as pesticides anywhere. 

It should be noted that the antimicrobial effects occur when these fatty acids come into direct contact with microbes.  It hasn't been established whether they have the same effect while they're in place in the coconut oil rather than in isolated form, or whether they have the same effect in the body that they have in a laboratory dish or on a hard surface, which is a very different environment.  They might help to kill microbes in food, in the digestive tract, or on the skin when applied there.  But they shouldn't be expected to have an effect on microbes located elsewhere in the body, for example the bloodstream or the respiratory system.  Like any antimicrobial agent, they can not discriminate between good microbes and bad, and if they are effective in the digestive tract they may deplete the beneficial bacteria in the gut at the same time they're depleting the bad bacteria.

There are other foods with antimicrobial effects, like the capsaicin in chili peppers and the acid in vinegar or lemon juice.  So if you’re looking for a direct-contact antimicrobial without all the fat of coconut oil, you might want to consider one of these.  Keep in mind that all of them do have a downside and are harmful in excess.

Ketones and brain function

The brain normally uses blood sugar (glucose) as its energy supply, but when there's not enough glucose the body will use fat stores to produce ketones that the brain can use as an alternate energy source.  But medium chain triglycerides metabolize more easily than other types of fat, and tend to be transformed into ketones immediately and promptly burned for energy instead of being stored as body fat (Nutrition Review).

There is a reasonable amount of evidence that ketones can help improve brain function with certain types of neurological disorders including epilepsy (McNally & Hartman) and Alzheimer's disease, where an inability to process glucose normally may be involved (Henderson).  It is possible that ketones may be helpful with other types of neurological disease including Parkinsons disease, traumatic brain injury, and stroke (Maciej et al). It's been mentioned in connection with autism as well.

The traditional way to produce ketones is through a high-fat, low-carbohydrate ketogenic diet (Wikipedia), which keeps the glucose level low and forces the body to rely on ketones for energy. But medium chain triglycerides produce substantial amounts of ketones without the need for glucose suppression, which is a unique attribute; the metabolism of other fats doesn't normally have this result.

This is the only claim about coconut oil that currently looks like it might actually have some validity to it. Research is still in the early stages (Snopes) but there is hope that it will eventually lead to new medicines for the treatment of brain disorders.  In the meantime, the medical community and organizations like the Alzheimers Association do not encourage the use of coconut oil as a "do it yourself" treatment due to concerns about safety and effectiveness. As mentioned earlier, only about 27% of the fat in coconut oil is expected to behave like an MCT. So if MCTs turn out to be useful for brain disorders, a purified MCT oil will probably be preferred over coconut oil.

An excessively high level of ketones in the body can be dangerous or even fatal. Raspberry ketones are a recent weight-loss fad and it's pretty easy to find warnings that they may raise your blood pressure and your risk for heart attack and stroke, as well as making you feel nervous and jittery (Esupplements). However this is not the same type of ketone produced by MCT metabolism; the raspberry ketone is 4-(4-Hydroxyphenyl)butan-2-one and the coconut oil ketone is beta-hydroxybutyrate. It's difficult to find information on whether the consumption of coconut oil ketones is as dangerous as raspberry ketones.  People on this forum thread reported alarming heart symptoms from consuming as little as two tablespoons of coconut oil per day. But this is a forum for people who are already on a ketogenic diet, and adding coconut oil to this may have resulted in an undesirably high level of ketones in the body.  People with a more normal diet who consume coconut oil are probably less likely to have problems. But it would be wise to consider the potential risks along with the potential benefits, and to be alert for problems related to blood pressure and heart function.  It's very questionable whether inducing ketosis in the body could prevent neurological disease or improve the functioning of a healthy brain. 

The only natural foods that are known to contain significant amounts of medium chain triglycerides are coconuts, palm kernels, and milk (which contains much less than the coconut and palm kernel).  It would appear that MCT consumption has some benefit for infant mammals since it's a component of their mother's milk, and it may play a role in their brain development.  But the vast majority of birds don't consume MCTs at any time during their lives, and the effect that MCTs might have on their brains is unknown.

Copyright 2014 Carolyn Tielfan all rights reserved