E-Mail Edition Volume 4 Number 3
Originally published Summer, 2007
Published by Piccadilly Books, Ltd., www.piccadillybooks.com.
Bruce Fife, N.D., Publisher, www.coconutresearchcenter.org
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Ask Dr. Coconut TM
Dr. Bruce Fife a.k.a. "Dr. Coconut" answers two of the most often asked questions about coconut oil.
I have purchased the same brand of coconut oil for many months. Normally the oil is very creamy and smooth. However, the last time I purchased some, the oil was grainy and contained many small hard chunks. Is the oil rancid or was this a bad batch?
This is a very common experience and has nothing to do with the quality of the oil. The development of coconut oil "grains" or crystals is determined by the melting point of the oil and the environment in which it is stored.
Fats and oils are composed of fat molecules known as fatty acids. There are a dozen or so fatty acids that are common in our foods. What makes corn oil different from soybean, olive, or coconut oils is the combination and types of fatty acids each contains. The fatty acids that make up the various dietary oils are in the form of triglycerides. Triglycerides are, simply, three fatty acids that are joined together. So, dietary fats, including coconut oil, consist of fatty acids that are in the form of triglycerides.
The melting point of coconut oil is generally quoted as being 76 degrees F (24 C). If the temperature is above 76 degrees, the oil will be liquid. If the temperature is below 76 degrees, it will become solid. This is really a generalization.
The melting point of coconut and other oils is determined by the fatty acid content.
The triglycerides in coconut oil consist of a mixture of 10 different fatty acids. Each fatty acid has its own melting point. Saturated fatty acids have a higher melting point than monounsaturated fatty acids, and monounsaturated fatty acids have a higher melting point than polyunsaturated fatty acids. This is why animal fat, which is highly saturated, is solid at room temperatures and why olive oil (monounsaturated fat) and corn oil (polyunsaturated fat) are liquid at the same temperature. When you put olive oil in the refrigerator, however, it will become solid, but corn oil will remain liquid.
In addition to degree of saturation, size of the fatty acid also influences the melting point. Fatty acids are composed predominately of a chain of carbon atoms. The longer the carbon chain, the larger the fatty acid and the higher the melting point. Consequently, long chain fatty acids have a higher melting point than medium or short chain fatty acids.
Therefore, each of the 10 fatty acids in coconut oil have their own unique melting points. To cloud the picture even more, triglycerides can be composed of any combination of three of the 10 fatty acids and each combination (or each triglyceride) will have a unique melting point.
Because of the various melting points of the different fatty acids and triglycerides, oils normally do not have a sharp or precise melting point. Unlike ice that melts at exactly 32 degrees F, oils change from a solid to a liquid over a range of temperatures. For this reason, the melting point is determined by the temperature at which only 3-5 percent of solids are present. Because coconut oil is composed predominately of medium chain fatty acids (60+%) which have similar melting points, the melting point of coconut oil is more precise than with other dietary oils. While 76 degrees F is given as the "official" melting point, in reality portions of the oil begin to melt (or freeze) a few degrees lower or higher than this.
Therefore, some of the oil may become solid or start to crystallize at 78 degrees and some at 72 degrees. If the change in temperature is rapid the melting point appears to be more precise. If the change in temperature is slow, you will have for a time an oil with both liquid and solid components.
Many homes maintain a constant temperature of around 72-76 degrees. This is precisely the range in which components of coconut oil begin to melt as well as freeze. When liquid coconut oil is stored in such an environment the transformation from liquid to solid is very slow. This allows portions of the oil that have the highest melting point to solidify first. If the change in temperature is very gradual it allows grains or crystals to develop. These are the grains or hard chunks you may find in the coconut oil.
There is nothing wrong with the oil. It is still as healthy as ever, although it does not have a smooth texture. If you prefer the smooth texture, there is an easy fix. Simply heat the oil until it is completely melted, then put it into the refrigerator to quickly harden. This will prevent crystals from forming. You can then store the oil in your cupboard. As long as the oil remains solid (temperatures below about 72 degrees) the oil will remain smooth.
If, however, you allow your kitchen, or wherever you store the oil, to get hot and the oil melts, when it recrystallizes it may develop lumps again. Simply repeat the melting-freezing process.
by Dr. Bruce Fife
is available from
Piccadilly Books, Ltd.
Animals and the
Healing Power of Coconut Oil
Coconut, and especially coconut oil, is gaining a reputation as a health food and natural healer. People are using it to improve digestion, clear up skin problems, boost energy levels, aid in weight loss, fight off infections, balance blood sugar, and bring improvement to numerous other conditions (see Coconut Cures: Preventing and Treating Common Health Problems with Coconut, www.piccadillybooks.com).
Having written seven books on the health aspects of coconut, I am often asked if it can be of benefit to animals as well. My answer is a most definite "Yes!" Virtually every health benefit associated with coconut oil in humans is applicable to animals. In fact, much of what we know about the health aspects of coconut oil was first observed in animals.
Like it or not, scientists often use animals in their research. For instance, we know of coconut oil's anticancer properties because when researchers feed it to lab animals or apply it on their skin in experimental conditions, they don't get cancer. We know that coconut oil neutralizes a variety of toxins because animals are protected from these poisons if given the oil. Animal studies also demonstrate how and why coconut oil digests more easily than other oils and how it is converted into energy rather than body fat, which increases energy and stimulates metabolism. The antiviral, antibacterial, and antifungal effects of coconut oil have been demonstrated in animals. These studies have also shown that coconut oil is well tolerated, causing the animals no harm, unlike many drugs and other treatments.
So it makes sense that coconut oil can be of great benefit to pet owners. Pets, like humans, suffer from a variety of health problems. Coconut oil offers a simple, inexpensive, and easy remedy to many of these problems. Over the years I've heard numerous testimonies from pet owners describing how coconut oil, as well as coconut meat, has been helpful. Coconut oil has shown to be of benefit to all types of animals including dogs and cats as well as horses, cows, and other farm animals. Some of the benefits owners have reported include reduced or elimination of body odor and bad breath; healthier skin and elimination of rashes, itchiness, etc.; coats becoming shiny and healthy looking; improved energy; better digestion; reduction of excess weight; relief from arthritic-like symptoms; cleared-up infections; expulsion of worms; and improved overall health. Applied topically it aids in the healing of cuts, bites, stings, and infections. There have also been some reports of healing from very serious conditions such as poisoning, cancer, and diabetes.
It sounds remarkable and maybe even unbelievable, but you don't need to take my word for it. You can read for yourself what pet owners are saying. Let me share with you a few of the testimonies. Here you can see for yourself what pet owners are experiencing with coconut oil.
Coconut oil has long been known for it healing effect on the skin when applied topically. Dry, rough, itchy skin becomes smooth and soft within a matter of days. Infections, warts, wounds, and such heal remarkably well with the daily application of coconut oil as the following describe. The most common type of coconut oil used by pet owners is virgin coconut oil (VCO), which is the type sold for human consumption at health food and grocery stores.
"I am very pleased with the great benefits of coconut oil. My horse had these ugly warts on her nose that would not go away. I decided to put some coconut oil on them and everyone thought that I was going nutty. Within 6 days they had all cleared up and I am so happy about it. She loves the smell and the taste of the oil too."
"I'm no expert, but I can tell you every skin condition I have used the virgin coconut oil for including my dog's very inflamed itchy skin, it has worked wonders on. It is very soothing to the skin. I think it would be beneficial since it has the antifungal, antiviral properties in it."
"Apply virgin coconut oil on the skin and rub gently on sores and flea bites. It works wonders and in a few days the sores and fleas are gone. The dog smells good too."
"A friend's cat got his tail caught in a door and she wasn't sure what to put on the wound (broken skin, bleeding, bruising) to keep it from getting infected. I had just read a description of coconut oil's topical use on serious cuts, and she happened to have some virgin coconut oil in her cupboard, so she applied it generously. The wound healed fast, even though the cat kept trying to lick the oil off."
"We have a hairless Chinese Crested dog that developed skin lesions. I have no idea if they are bacterial, viral, or fungal. My understanding is that VCO has abroad spectrum of activity. Here are pictures (below) of the result of topical application of virgin coconut oil, starting with day 1 and the second picture is of day seven. We continue to apply virgin oil on her skin and we expect that the pigmentation will return soon."
Hairless Chinese Crested dog before treatment (left), notice red, inflamed, and swollen sores. Seven days later (right) sores have healed, leaving pink, smooth, healthy skin.
"My dog had very infected ears complete with swelling and the smell of infection. I started putting the coconut oil right in his ears and within a few days they were greatly improved. His ears are completely healed now."
"My dog Katie had a tiny pink lump on her chin. It gradually grew larger so we brought her to the vet, who diagnosed it as folliculitis (a skin infection surrounding hair follicles). He said to wait until it got bigger and he would do surgery to remove it. It grew to the size of a pea and became a very angry reddish pink in color. It was really terrible to look at and right on her pretty face! I didn't want to put her through the surgery so I decided to try coconut oil after reading about other's success with skin problems.
"I applied coconut oil daily. Gradually the lump reduced in size and the color became normal. After about two weeks I noticed it had broken and become crusty. I kept applying the oil daily and now a month later it is very tiny and a normal skin color. I really had to look to find it! I'm really happy with the coconut oil."
Coconut oil is not limited to just topical applications; it can be added to the animal's food where it can work its healing magic throughout the body. In fact, for skin problems applying the oil on the skin as well as eating it enhances recovery time.
"I have a 14 year old Lhaso. For about two years now, she's had a scabby rash and all she did was lick it and itch 24-7. I was at my wits' end with her, as I tried everything and she still itched. Well, this time last week I thought, what the heck if it's good for people then it'll be good for my dog Candy. So I put it in her food daily and rubbed it on that spot. It is totally unbelievable but Candy isn't itching and the spot seems to be going away."
"I can't believe how quickly coconut oil heals skin problems caused by Valley Fever (fungus). Even dogs that are infected with this fungus respond well with this treatment"
Pet owners find the most dogs and cats relish the taste of coconut and coconut oil and readily eat it. Many dogs love to eat fresh coconut. A coconut shell with meat makes an enjoyable toy. They chew on the shell, scraping out the meat like chewing on a bone. Like bones, the shell is good for cleaning the dog's teeth and gives them something to chew.
"I was pleasantly surprised to notice the recreational value of a cut-in-half coconut for my dogs. It meant hours of happy gnawing until the last bit of meat was out of it and lots of fun thereafter as a toy."
"My little Maltese dog loves the VCO. Whenever I put it on he will run up and lick my leg, or if I am holding him he will lick my hands. Sometimes I put a little in the dog's food, and their food is gone in seconds!"
The most noticeable effects reported by pet owners is the improvement in skin, hair, and odor. Coats become silky and shiny. Body odor and kitty litter order dramatically diminish. Bad breath becomes sweet. Body odor and dull coat are signs of poor health. Coconut oil improves digestion, enhances nutrient absorption, aids in eliminating toxic waste, and kills bacteria that often contribute to foul smells. Here are a few examples of comments pet owners make after giving their animals coconut oil.
"Abby is our Labrador puppy. She smelled a bit "doggy" and had a few itches. She loves the coconut oil—I put a spoonful in my hand and she greedily laps it up, and I rub it on her coat. The doggy smell has disappeared, as have most of the itches. Her coat is glossy and beautiful."
"My dog and I both have a slice of whole grain bread smeared with coconut oil every morning. He can't wait for me to sit down and start eating, because he knows there's one waiting for him, too. I have to discourage him from wanting to give me a courtesy tongue bath when I use coconut oil as moisturizer. He also loves coconut water. He's a true coconut aficionado. It does keep his coat shiny, helps his dermatitis, keeps his energy level up even here in Central America where it's a bit warm for a long haired golden retriever. Helps his shedding, maybe because there is less scratching, but I still think there's less shedding too. I read sometimes animals shed due to deficient diets."
"My Labrador puppy has the most beautiful black coat and no puppy smell. She loves the oil. Each morning she takes her place in the kitchen waiting for me to give her a spoonful in my hand, which she eagerly laps up. Even her favorite treats don't tempt her away from the oil."
"Every night I rub some VCO on my dogs' teeth and they don't have bad breath anymore. Their coats are glistening."
"I have been feeding coconut oil to my husband's red tabby, Pumpkin. He was climbing into my lap at the table trying to steal it away, so I started putting half a teaspoon in his dinner. I have gradually increased the amount to 1 teaspoon. Almost immediately, we noticed a difference in odor—his cat box used to smell awful whenever he used it, and now there's no odor at all. His breath has improved as well."
"I have two German short hair pointers that are constantly shedding. If you pet them your hand ends up full of hair. My wife is constantly vacuuming hair everywhere. About 3 or 4 weeks ago I started feeding them a spoonful of coconut oil every day. Last night I was noticing how their coat shined and the shedding completely stopped."
"My dogs LOVE coconut oil! One is quite overweight even though they all eat the same diet—including treats. Since starting it, their coats are glossy, more energy, and Cinnamon (handsome collie/chow mix) is actually losing some weight!...I started them on about a teaspoon each. Five of them get 1-2 teaspoons a day—just as a supplement—no health issues."
Pet owners describe a variety of health problems that are alleviated with the use of coconut oil.
"I do know that coconut oil has done wonders for my golden retriever who has lots of allergies. His entire stomach area cleared up, he has lot more energy, and he has lost weight!"
"I give all my animals virgin coconut oil on their food. The two most dramatic improvement to their health are:
"Casey is a Chihuahua mix given to me as a gift when she was young. Her hind knees are a bit knobby and the vet said we would have to watch them as she has a loose ligament in them and she may eventually need surgery. She was hesitant to jump up on the couch or bed and we often assisted her by picking her up. Even though she was a young dog she acted much older. I began putting virgin coconut oil on her food and it was no time that she began springing up onto everything! The vet was amazed.
"Belkie is a long haired Chihuahua mix and he was in very poor condition when we rescued him. You could feel every bone in his body, he had several bad teeth that needed pulling and his coat was very coarse. He cowered around and was very sad. After having him about a month and having some dental work done his health and attitude improved. However, I still could not get him to stop itching. He did not have one flea on him, but he still itched! I added virgin coconut oil to his food and in no time he stopped itching and his coat is shiny, soft, and bright. He is the happiest little guy you ever saw!"
"My large bulldog had severe hip problems. I gave him 2 glucosamine and one coconut capsules every day. He is so much better. I took him walking today for the first time in a long time. We have always had him on glucosamine but we have never had this kind of result."
"My nine year old Shar Pei senior dog, suffered from severe arthritis with bad hips and almost non-existent front elbows. The vets suggested I put him to sleep for he needed both front and rear wheels to stay mobile. Being an individual that doesn't take 'impossible' for an answer, I did my own research...After only two weeks of organic extra virgin coconut oil with one tablespoon per 50 pounds, Taz was up and running like a puppy on all four legs. After putting one tablespoon of organic virgin coconut oil in the dog's food daily, Taz was better. It has been over a year, and he's still truckin'."
"I had a goat who contracted what in our area is called 'udder pox,' which is a herpes simplex infection of the skin of the udder. It has to basically run its 3 to 6 week course, with chicken pox type lesions erupting on the udder. I used coconut oil on the worst case and it was the only thing that eased it...I began using straight chlorahexidine on the next 2 goats that showed symptoms. This product did not halt the progress of the disease at all, only the VCO helped."
Even very serious health problems are improved with the use of coconut oil, as the following three accounts show.
"My dogs are older; one, my black lab, has diabetes and cataracts. I give him insulin shots 2 times daily and drops to dissolve his cataracts. He was having trouble getting up and trembled when he walked. Since the coconut oil treatment—2 tablespoons daily on his food—he no longer trembles, walks more than he could before and has lost weight. I have cut back on his food as he doesn't seem to want his past amount."
My neighbor has a female Doberman that they adore. She became very ill and could not stand. Their vet said Dobermans often develop "wobblers" and there was not much they could do. It was degenerative and she may have about a month to live. They were, of course, crushed. I, of course, never gave up and told him to add virgin coconut oil to her food. I sent my neighbor home with a small jar of the precious oil. He was willing to try anything. They were having to force feed her a liquid diet at the time. In 24 hours the dog was up! Over the course of the week she continued to improve. He now puts it in her food daily. She no longer wobbles when she walks and all is right with the world! My neighbor was amazed."
"My dog Sadie had worms that I had been fighting off and on for two and a half years. I had spent lots of money on de-wormer between the vet and the pet store. That summer I was so sick of worms that I even tried horse de-wormer on my poor dog, and the worms just came back within two weeks! Then my sister said that coconut oil will kill worms, so I tried it on her, the coconut oil, shredded coconut, and cloves, mixed it up with hamburger, and gave it to all my three dogs. It worked better than any de-wormer I have ever used and Sadie's puppy, Poppy, who was at the time 7 or 8 months old, had the runs almost her whole life, and was constantly puking, was suddenly all better too!"
In some cases, coconut oil has the ability to restore health even when an animal appears to be a death's doorstep.
"About a week after we moved into our new home, our eight-year-old dog, Davis got deathly ill. We actually thought he may have broken his back on the stairs. He would not walk and had to be carried everywhere. The vet was certain that he had hurt his back as well, but on the second day, he started having blisters on his feet and on the back of his body. When he stood up on his feet, they would just bleed. (Just lovely in the new house!) After inconclusive tests, as well as even a spinal tap, they decided to call it an immune disease. Still not sure quite the diagnosis, but he was on death's bed. After $1500 in tests and medications the vet still was unsure of prognosis and suggested to put him out of his misery. Davis was still unable to walk, but now unable to open one eye and had large half-dollar size lesions all over his back and hind legs.
After making the appointment on Friday to put him to sleep on Monday, I decided to try one last thing over the weekend. I read on the net about coconut oil being good for dog's immune system. Desperately I tried it, and miraculously about four hours after his first dose, he got up and walked. Within a day, his feet stopped bleeding and he was once again walking over to the food bowl! I am convinced—and just amazed! Funny how after $1500 of tests and meds from the vet, a $15 jar of coconut oil healed him! It has now been two weeks and he is back to normal."
While some animals love the taste of coconut oil and will eat it "off the spoon," some don't take to it as easily. The best way to give it to your pet is to combine it with food. It can be added to food in either solid or liquid form. For cats and dogs about 1 teaspoon of oil for every 10 pounds of body weight daily has proven to be effective. If your pet has a serious health issue you may want to increase this amount until the problem is resolved. For other types of animals you may need to experiment a bit to get the amount that is most effective. Keep in mind that coconut oil is a food and not a drug. It is not harmful, so even if you overdue it, the worst thing that will happen may be runny stools. If this happens, simply back off on the amount given.
If your pet has never eaten coconut oil, start off slow, maybe half a teaspoon or less for every 10 pounds. If your pet is not accustomed to eating fat, too much may result in diarrhea or greasy stools. If there are no problems after a few days, gradually add more oil.
If your pet has a skin problem, apply coconut oil directly to the affected spot and put additional oil in its food. Skin problems respond more quickly when the oil attacks it from both inside the body and out. Apply the oil topically several times a day. Topical application seems to work with all types of animals.
Coconut oil isn't the only coconut product good for pets. Fresh coconut meat or shredded coconut is rich in dietary fiber and also contains some oil. Coconut milk and coconut water are other products that your pet may enjoy.
What's really interesting about all of the accounts reported in this article is that they substantiate the reported healing power of coconut oil that people have observed in themselves. In fact, there are far more accounts with people using coconut oil to improve their health then with animals (see Virgin Coconut Oil: Nature's Miracle Medicine, www.piccadillybooks.com).
Skeptics who don't want to believe that coconut oil can be as healthy as it appears claim that testimonies are unreliable. Personal experiences don't prove a thing, they say. People can overcome just about any health problem simply because they believe the treatment they are using will help them. It is the power of the mind that does the healing, not the treatment. While this is a valid argument, there is one major drawback. It doesn't work with animals. Animals don't know that coconut oil in their foods or applied on their skin is going to improve their health. Yet, it works. So obviously there is a power in coconut oil that does bring about improved health for both animals and humans.
Conrado S. Dayrit, MD
Coconut Oil Pioneer (1919-2007)
While doing research for my first book on coconut, The Coconut Oil Miracle, I came across some articles that were written by Conrado S. Dayrit, a medical doctor from the Philippines. Going against the politically correct dogma of the time, Dr. Dayrit challenged the prevailing idea that coconut oil was bad for the heart. At the time, few people and even fewer health care professionals openly spoke out in favor of coconut oil. It was Dr. Dayrit's groundbreaking research published in 1999 that provided the proof that coconut oil did possess antiviral effects in the human body and could be used in the treatment of HIV/AIDS and other diseases.
After the publication of my book in 2000, I was invited to the Philippines to lecture on the health benefits of coconut oil. My first trip to the Philippines was in 2004. This is when I had the privilege of meeting Dr. Dayrit and his wife Mila for the first time. It was a great honor for me. It just so happened that my visit corresponded with both of our birthdays. Mine is May 28, his was May 31, so we celebrated our birthdays together. Dr. Dayrit turned 85. Unlike many others his age, he was physically very active and mentally sharp. I was amazed at his apparent youthfulness and brilliant mind. He looked and acted as if he was 20 years younger. Age didn't seem to have an effect on him.
During my visit to the Philippines we were both featured speakers at several events. Over the next few years we would meet again several times in both the Philippines and the United States as co-speakers at various events expounding the merits of coconut oil.
We became good friends. He invited us to his home and we visited the sights of Manila, the capital city of the Philippines, where he lived. On one occasion he and his wife Mila took my wife and I to the old city of Manila, where he had grown up, gone to school, and attended church. We took a ride with a tour guide who was explaining the history of the area. The guide started telling us about the history of the buildings, making several errors. Dr. Dayrit kindly corrected him each time he made a mistake—after all, he grew up there and was personally familiar with the history. The tour guide wasn't offended; he was intrigued and asked for more details. Dr. Dayrit soon took over the narration and we, tour guide and all, were treated to a first-hand account of the history of the area.
Everyone who met Dr. Dayrit couldn't help but like him. He had a gentile demeanor and a kind heart. He gave freely to all good causes and was always willing to help those less fortunate than himself. It was no doubt his compassion for others that lead him into a career as a physician.
Conrado S. Dayrit was born in 1919. At this time the Philippines were a possession of the United States. Ruled by Spain for three hundred years, the Philippines were ceded to the United States in 1898 as part of the treaty at the end of the Spanish American War.
Conrado grew up in the city of Manila. He excelled in school and loved music. At the age of 9 he began taking violin lessons. In school he joined the band, but they didn't have a spot for a violin player so he ended up playing the drums. The violin remained a passion of his throughout his life and even in his 80s he was known to play for the audience before giving a lecture. If you were a close friend you might be lucky enough to get a personal concert at his home. Music was one of his passions.
In 1938 Conrado entered medical school at University of the Philippines (UP) in Manila. Hitler's invasion of Austria in 1938 affected his class, the class of 1943, in a pronounced way. Five distinguished professors of medicine fleeing occupied Austria joined the UP medical staff that year.
This was the most turbulent time in young Conrado's life. The Japanese invaded the Philippines in December 1941 just hours after the attack on Pearl Harbor. Some of the students were killed during bombings, others left to join the resistance, while others unable to cope with the stress dropped out. Of the 150 students who started in 1938, only 80 remained to graduate in 1943.
The Philippines was devastated under Japanese occupation. The war brought chaos to the economy. Agriculture was ruined. Most of the livestock were killed, eaten, or carried off. Farm equipment, roads, bridges, and communication facilities were destroyed. Schools were gutted, radio stations dismantled, and government buildings and factories were almost completely destroyed.
"Life during the occupation was difficult," recalls Conrado. "Food was scarce and so was transportation. Private cars had been commandeered by the Japanese and there was little gasoline available. Charcoal-fed buses were few and usually overloaded. So we just walked. Japanese sentries were stationed on every street corner. Pedestrians passing by had to bow low at the risk of being shouted at, beaten, or jailed."
The Japanese occupiers closed most of the school down, allowing only engineering, nursing, and medical students to continue their studies, with the hope of utilizing their skills in the future. Life was difficult under the occupation, but Conrado completed his medical training and worked as an intern in the hospital until the end of the war in 1945.
Playing his violin in the intern's dormitory did a lot to ease fear and tension, not only for himself but for the medical staff and patients as well. Years later patients would thank him for the beautiful music that lifted their spirits during these trying times. Eighteen-year-old Edith Dizon recalls the birth of her first child during these trying times. "All the beds were occupied and there was no room in the ward, so they put a cot for me at the porch and told my husband to go home. This was about eleven o'clock at night. I was afraid that the soldiers patrolling the streets would kill him, and my birth pains were getting much closer and very painful. I was afraid for my husband and I cried—being alone, hungry, very discouraged, afraid, wondering what to do with the baby that was to be born. My feelings were at its lowest ebb. Suddenly I heard violin music being played by one of the doctors at the intern's quarters next to the maternity ward. The music was God's answer to prayer for comfort. It took away my fear, I could stand the pain of childbirth and just before midnight, I had my first born, a perfect baby boy."
Dr. Dayrit was both an accomplished musician and skilled physician caring for the physical and emotional needs of others. It was with selfless service that he devoted his life to helping others.
After the war, some American intuitions and foundations offered a limited number of fellowships for interns to continue their studies in the US. The young doctor was among the handful chosen. He did postgraduate work at the University of Michigan Medical School from 1946-1947 and Cornell University from 1947-1948. In the United States he studied pharmacology and cardiology and learned how to use the latest heart diagnostic equipment such as the ECG.
He returned to the Philippines to continue his medical career. In 1952 he was honored with the Outstanding Young Man of Science award. Throughout his career he received many other awards and honors for research, teaching, and lifetime achievement.
Over his 58-year professional career he served in many capacities. He was very active in professional organizations throughout his life and distinguished himself as a leader. He was one of the six founders of the Philippine Heart Association (1952) and later served as one of its presidents. He was a charter member of the Asian Pacific Society of Cardiology (1956). He served as the editor-in-chief of the Philippine Journal of Internal Medicine and was a board member of the Philippine Institute of Pure and Applied Chemistry at Ateneo de Manila University. He was the director of the Polymedic General Hospital and a Professor of Pharmacology at the University of the Philippines (UP), which is the most distinguished university in the country. He was the first president of the Society of Clinical and Experimental Pharmacology; president, National Academy of Science and Technology; president, Federation of Asian Scientific Academies and Societies; president, Philippine College of Physicians; and served as the vice-president, Medical Affairs Division of United Laboratories until his retirement at the age of 80. Unable to slow down even in his later years, he continued to serve as the Medical Director of the Victor R. Potenciano Medical Center until his death.
In 1953 he was part of the team who performed the first open heart surgery in the Philippines. In 1955, he was honored for his work on digitalis for heart patients. As a pharmacologist he spent much of his career at United Laboratories, producing low-cost medicines for the poor.
When criticism was first cast on coconut and coconut oil in the 1960s Dayrit listened to the arguments with caution. To him it didn't make any sense. People had been eating coconuts and coconut oil for generations without experiencing any trouble with heart disease. The facts just didn't fit the accusations. The attacks on coconut oil intensified in the mid 1980s. But still the evidence against it was based on conjecture without any real scientific proof.
As a cardiologist and pharmacologist he knew that coconut oil did not promote heart disease. The people in the Philippines, including himself, had been using coconut oil extensively all their lives. Yet, heart disease was significantly lower there than it was in the United States or Europe, where so-called "heart healthy" polyunsaturated vegetable oils were more commonly used. If anything, he believed that coconut oil helped protect against heart disease. His careful study of published research on the topic only confirmed this belief. The attack on coconut oil was really just a marketing ploy sponsored by the soybean industry in an attempt to take over the tropical oils market.
The soybean industry in the U.S. had been fighting the importation of coconut oil for years, lobbying congress to levy taxes on coconut oil to dissuade customers from buying it. Now they were attacking it as being unhealthy and promoting their own product as a better alternative. With the aid of misguided special interest groups such as the Center for Science in the Public Interest (CSPI) and the National Heart Savers Association, coconut was demonized. The medical profession and the public alike were brainwashed into believing the hype and shunned it as an artery-clogging saturated fat.
Dr. Dayrit, convinced that coconut oil was harmless and even beneficial, questioned the accusations. Despite the opposition and pressure from the medical community, he openly expressed his concern. He wrote several articles refuting the criticism. It was only because of his stature as one of the country's leading physicians that his editorials and articles were published in Philippine medical journals. Opposition to coconut oil was so intense that American and European journals wouldn't dare publish them. Consequently, his voice had a limited audience, but he never gave up.
"With all the opprobrium cast against it," says Dayrit "it bears repeating again and again that no evidence has ever been presented to prove that coconut oil causes coronary heart disease...On the contrary, the human epidemiologic evidence proves that coconut oil is safe. Coconut eating peoples like the Polynesians and Filipinos have low cholesterol, on the average, and very low incidence of heart disease."
Although there were many studies that confirmed Dayrit's position, they were not well publicized and few people were aware of coconut oil's many benefits. One of the more well researched and remarkable characteristics of coconut oil is its antimicrobial effects—its ability to destroy disease-causing virus, bacteria, and fungi. Although described in the medical literature as effective in laboratory studies, there were few clinical trials to substantiate these "test tube" experiments. Antidotal and epidemiologic evidence, however, did corroborate these studies. Yet, there was still a lack of carefully controlled clinical studies on human subjects.
Dr. Dayrit was impressed by the low incidence of deadly viruses like HIV, SARS, and avian flu among the Filipino population. Some of these diseases were rampant in neighboring counties but virtually nonexistent in the Philippines. Could it be because of all the coconut and coconut oil they consume? he wondered. He put the theory to the test in the late 1990s. With the assistance of Jon Kabara, Ph.D., a professor of pharmacology from Michigan State University and long time coconut researcher, they began the first clinical study of coconut oil on HIV/AIDS patients. Fifteen HIV-infected patients were recruited for the study. They would have used more subjects if they could, but there were simply too few HIV cases available in the country to work with.
The study lasted for six months. In that period of time 60 percent of the patients showed signs of improvement. Since HIV is a condition that progressively gets worse with time, this was a significant achievement. The study did not continue longer because of a lack of funding. Nonetheless, this landmark study demonstrated the effectiveness of coconut oil in treating infectious disease. Dayrit states, "This initial trial confirmed the anecdotal reports that coconut oil does have an antiviral effect and can beneficially reduce the viral load of HIV patients."
Dr. Dayrit remained vibrant and active throughout his life. He was a much sought-after speaker even after his retirement. Actually, he didn't have time to retire; he was too busy, still active with many organizations, lecturing, writing, and lobbying for acceptance of coconut oil as a nutritious food. Whenever he had the opportunity he would expound on the wonders of the coconut and especially coconut oil. Many an acquaintance had their health myths shattered after spending time with him and became coconut advocates themselves.
Retiring from United Laboratories allowed him a little more time to pursue things he enjoyed, such as historical research and writing. His first book, The History of Philippine Medicine, was published in 2004. Various other small booklets and articles on history and science followed. And finally, The Truth About Coconut Oil was published in 2005. I asked him to write a foreword to my new coconut book Coconut Cures which was also published in 2005. "I'll write a foreword to your book," he said with a smile "if you write a foreword to mine." I agreed, so we each have forewords written by the other. I think I got the better end of the deal. Having his contribution in my book is a great honor.
In addition to his lectures on medicine, heart disease, and coconut oil, he also lectured on the archeology and history of the Holy Land replete with slides and maps from his many travels.
Conrado Dayrit, MD
Conrado was deservingly proud of his eight children and 23 grandchildren—all achievers in their own right. His oldest and youngest sons are also physicians. The elder, Dr. Manuel Dayrit, served as the Health Secretary of the Philippines and is now one of the directors of the World Health Organization. The younger works as a pulmonologist in South Carolina. Two other sons are bankers. Another son, Jun-Jun, is a businessman who runs various STI companies. Another son, Toby, a graduate of Princeton University is currently the Dean of Science at Ateneo de Manila University. His only daughter, Gina, is a successful exporter of Christmas and home décor.
A proficient violinist, Dr. Dayrit passed on his love of music to the younger generation, and one granddaughter is now a music scholar in the United States.
In September of 2007, Dr. Dayrit came down with a high fever. He was admitted to the Victor R. Potenciano Medical Center where he was still actively serving as medical director. At first, doctors didn't know what was wrong. All tests were negative. After almost two weeks the cause of the fever was finally determined: the presence of tuberculosis was found in his bone marrow. Years earlier he was infected with tuberculosis and treated successfully, but apparently some of the infection managed to survive in his bone marrow. Advancing age, an unending work load, and excessive stress wore him down to the point that the infection spread to vital organs. By the time the diagnosis was made, it was too late. Dr. Conrado Dayrit died October 6. He lived 88 healthy, productive years, a testimony to the benefits of coconut oil. Up until the very end Dr. Dayrit remained physically active and mentally alert. We will all miss him.
Note to Readers: Dr. Dayrit knew about the health benefits of coconut oil and frequently ate it in his food. He did not take dietary supplements, including coconut oil, on a regular basis. He would eat coconut oil with his foods but took it only occasionally by the spoon as a supplement. He was in excellent health and did not see the need to take it like a medicine for himself. Consequently, there were times he would go for weeks without getting any appreciable coconut oil in his diet. His heavy work load combined with his advancing age lowered his resistance and contributed to the activation of the TB hiding in his bone marrow. Ironically, coconut oil could have been helpful in fighting off this infection, had he been using it regularly or had been given it when he became ill.
If you want to take advantage of all the health benefits offered by coconut oil you need to consume it on a regular basis, either in your foods or as a dietary supplement. When you become sick, you should consider increasing your intake to aid in your recovery. Although coconut oil is not a cure-all, it is not harmful either and may do you a lot of good.
The following article by Dr. Conrado Dayrit was originally published in the Philippine Journal of Cardiology, July-September 2003, Volume 31, Number 3:97-104.
COCONUT OIL: Atherogenic or Not?
(What therefore causes Atherosclerosis?)
By Conrado S. Dayrit, MD, FPCC, FPCP, FACC
According to the universally accepted Lipid-Heart Theory, high saturated fats cause hypercholesterolemia and coronary heart disease. Coronary morbidity and mortality are said to be highest in the countries and peoples consuming the highest amounts of saturated fats. Coconut oil, with its saturated medium chain fats, has been especially condemned for this reason. The true facts are just the opposite. The countries consuming the highest amounts of coconut oil — the Polynesians, Indonesians, Sri Lankans, Indians, Filipinos — have not only low serum cholesterol but also low coronary heart disease rates — morbidity and mortality.
The reason why coconut oil cannot be atherogenic is basic. Coco oil consists predominantly of 65% medium chain fatty acids (MCFA) and MCFAs are metabolized rapidly in the liver to energy and do not participate in the biosynthesis and transport of cholesterol. Coconut oil, in fact, tends to raise the HDL and lower the LDL:HDL ratio. Coco oil is not deposited in adipose tissues and therefore does not lead to obesity. It is primarily an energy supplier and as fast a supplier of energy as sugar. MCFAs therefore differ in their metabolism from all the long chain fatty acids, whether saturated or unsaturated.
The pathogenesis of atherosclerosis has recently taken a complete paradigm shift — from a simple deposition of cholesterol and cholesterol esters to an inflammatory condition where numerous genetically dependent factors — dyslipoproteinemias, dysfunctions of endothelial and other cells leading to invasions of the subendothelial region by macrophages, smooth muscle cells, leukocytes and T cells — all interplay in a scenario still not fully understood. This will be discussed at length and whatever role fat deposition plays appears late in atherogenesis and secondary to oxidation process and the overriding role of the dysfunctional endothelium. Coconut oil has no role at all to play in this highly complex and still ill understood process.
It is an honor, privilege and pleasure for me to be this year's H.B. Calleja lecturer. I am honored because H.B. Calleja is one of the top names in Cardiology in ASEAN and Asian-Pacific regions. I am privileged and pleased because H.B. or Bono is a good friend of close to half a century — even when vector-cardiography was still in bloom and H.B. was among its prime exponents upon his return from his training abroad. Since then, he has continued doing research and publishing extensively — even provocatively. I recall the topic of his paper last year — Diabetes is Coronary Heart Disease, which I see he is reemphasizing this year.
The topic assigned to me this morning is equally or even more provocative: Coconut Oil: Atherogenic or Not? Why this topic? Because coconut oil has been a "No No" as a dietary fat. Every cardiologist, internist, even housewives are saying that coconut oil is "bad for the heart"; that it causes heart disease. Consequently, our coconut oil manufacturers now hide behind the label "vegetable oil." Whenever I propose the use of coconut oil for, say SARS (Severe Acute Respiratory Syndrome) or other infections, because it is antibacterial, antiviral, antifungal for all lipid coated organisms, I am asked — "but where can we get coconut oil?" Apparently, our own people do not know that the oils they use — Baguio Oil, Minola — are 100% coconut oil. The move away from coconut oil has convinced many housewives to use other oils like Mazola (a corn oil) or Canola or even olive oil. Years, nay, decades, of being taught that "coconut oil causes heart disease" has created this bad image of our national product. I am here to show you that coconut oil does not cause heart disease — that it is not atherogenic — that it cannot even be atherogenic because of its unique metabolism.
THE LITERATURE ON COCONUT OIL
Kintanar1 reviewed 119 articles of original studies, review papers, and citations on whether or not coconut oil raises cholesterol or is atherogenic. Three fourths (73%) of the papers showed coconut oil to be neither cholesterogenic nor atherogenic. One fourth (27%) showed coconut oil to raise cholesterol. The animal experiments (on rabbits, mice, rats, gerbils, dogs, monkeys) were flawed because of their use of hydrogenated coconut oil and lack of linoleic acid (l8:2 n16) supplementation, leading to essential fatty acid deficiency1,2. The human clinical studies were done on few subjects and were poorly designed. Only a very few large human studies (epidemiologic studies) were done on Polynesians and Bicolanos — and all these show that people who take coconut oil as part of their daily diet have low cholesterol and heart disease. (see below)
THE LIPID-HEART THEORY
The Lipid-Heart theory says that high intake of saturated fats and cholesterol causes high serum cholesterol and the latter causes coronary heart disease. This theory was proposed by Ancel Keys3,4 and subsequently supported by his Seven Country study5, the Lipid Research Clinics (LRC) and the Multiple Risk Factor Intervention Trials (MRFIT)6,7. Despite the many serious flaws and blatantly contradictory data in these and many other studies, saturated fats (animal fats and coconut oil) as well as dietary cholesterol have become the prime villains (together with smoking, diabetes and hypertension) and the lowering of serum cholesterol as one of the most important therapeutic targets.
Coconut oil became involved in the indictment against saturated fats because it is the most saturated of all fats and in spite of the fact that it is not at all used by any of the countries having high coronary mortalities(Figure 1). These are no epidemiologic studies that show coconut oil to be cholesterogenic or atherogenic. The animal experiments, as already mentioned, were mostly flawed by the use of hydrogenated coconut oil resulting in essential fatty acid deficiency1,2,9. Deuel and his coworkers already demonstrated this as early as 195510.
EPIDEMIOLOGIC STUDIES ON COCONUT OIL DAILY CONSUMERS
The countries that use coconut oil in their daily diets are only the Asian countries of India, Sri Lanka, Indonesia, Philippines and the islands of the South Pacific11. (US consumption of coconut oil is a mere 0-2% of dietary calories). In all these high coconut oil consumers, their serum cholesterol level and coronary heart disease morbidity and mortality rates are low.
Citing the 1978 Demographic Yearbook of the United Nations, Kaunitz12 noted that among the countries which submitted complete reports, Sri Lanka, where coconut oil is the predominant dietary fat, reported a rate of one death from ischemic heart disease per 100,000 population, while the rate in countries with little coconut oil consumption varied from 16 to 187.
A few years later, Mendis, Wissler and coworkers13 reported their study where they replaced the customary dietary coconut oil with corn oil in the diets of 16 free-living healthy young adult Sri Lankan males. The observation periods for the two diets was 6 weeks each. In Phase I, the regular diet with coconut oil was used; in Phase II, cow's milk powder and corn oil was substituted for the coconut oil. The blood lipid values taken at the end of each phase (Table 1) showed that: (a) on Sri Lankan regular diet with coconut oil, the blood cholesterol was low 179 ± 9 mg/dl and the HDL-C a goodly 43 ± 5 mg/dl, (both well within recommended values) and a normal LDL:HDL ration of 3:1 (b) on the corn oil-cow's milk diet, the serum cholesterol fell to 146 ± 13 mg/dl and the HDL-C to a relatively even lower 25 ± 4 mg/dl and an unfavorable LDL-C-HDL-C ratio of almost 4:1. Significantly, Sri Lankans are coconut oil consumers and have low rates of coronary heart disease.
The peoples of Polynesia are also high coconut consumers. Prior et al's 1981 paper14 reported the Pukapukan fat consumption to be 32 and 39 percent of total calories for males and females, respectively, three-fourth of which was saturated fats mostly from coconut. The Tokelauans were heavier fat consumers (56% of total calories from fat by males and females), 90% of which came from coconuts. (Table 2). They also ate fish, the omega 3-polyunsaturates which provided the essential fatty acid requirement. The serum cholesterol of the Tokelauans was below 220 mg/dl, while the Pukapukans, who ate as much fat as most Caucasians but from coconut, had a mean cholesterol level below 180 mg/dl. Polynesians also have low coronary heart disease incidence according to Prior15.
Biolanos of the Philippines
The Filipinos of the Bicol region of Luzon are famous for their coconut-flavored dishes. Every Bicolano food, it seems, has some "gata" in it so that their fat consumption from coconut oil is the highest in the Philippines — 26 g daily vs. Manilans' intake of only 16 g daily of coconut oil. It is obvious from the dietary data of Florentino and Aguinaldo (Table 3)16 obtained from their nutritional survey of 9 of the 12 regions of the Philippines, that while Filipinos do eat less than Americans, they take a lot more coconut oil. Camara-Besa et al17 who joined the survey to study and specifically determine cholesterol levels, found that although Bicolanos had the highest cholesterol among Filipinos, it was below 200 mg/dl. Significantly again, Bicolanos have the lowest mortality from heart disease and strokes among all Filipinos.
PHILIPPINES HEART MORTALITY
Heart disease is reported to be the No. 1 cause of death in the Philippines. Deaths from infectious diseases have shown a progressive descent since the 1940s, and deaths from heart disease and cancer a progressive increase (Figure 2). In the early 1990s Diseases of the Heart and of the Vascular System assumed Nos 1 and 2 in the national mortality statistics. Unfortunately Philippine statistics do not classify the diseases of the heart.
Does coconut oil have protective action against atherosclerosis?
The figure is total for all heart diseases: hypertensive, rheumatic, coronary, congenital and cardiomyopathies, because of (a) inability of public health physicians, who report on most of these cases, to make definitive diagnoses; and (b) even more important is that, as admitted by the Department of Health, 60 per cent of deaths in the Philippines are not attended by any doctor but perhaps only by herbolarios or barrio health workers. Hence, the heart disease mortality figure is most likely exaggerated.
How frequent is coronary heart disease compared to other heart diseases? Yason et al's survey of rural Pangasinan in 198618 showed hypertension to be the most prevalent, and rheumatic heart disease to be twice as prevalent as coronary heart disease (Table 4). No figure was given for hypertensive heart disease. Pangasinan is in Central Luzon. While Central Luzon's coconut oil intake is about the same as Manila's, its heart disease mortality is two thirds (65%) that of Manila's but its stroke rate significantly higher (Table 3). The reason for the high stroke and hypertension rate may have to do with the salty bagoong diet.
How does the Philippine's total heart disease compare with other countries? In Key's 1957 paper, he cited Hilleboes 1950-52 data on total heart disease mortality in males of 12 countries and each country's calories from fat (Figure 3). To determine where the Philippines would be in this heart disease "map," I used the Philippine 1987 sum of total heart disease mortality plus cerebrovascular mortality per 100,000 males (when our increasing CVD rates were leveling off). Figure 3 shows that the Philippines has the lowest mortality among these countries, lower even than Japan's. And the Philippines is the only coconut oil consumer among these countries. If coconut oil were atherogenic as universally proclaimed, the Philippines should have been among those in the upper right corner of the map. Again, rather than being pro-atherogenic, coconut oil appears to be even anti-atherogenic.
METABOLISM: WHY COCONUT OIL CANNOT BE ATHEROGENIC?
Coconut oil and palm kernel oil are the only two oils in creation that are made up predominantly of medium chain triglycerides (MCT). The medium chain fatty acids (MCFA) are six to twelve carbon chains in length and are saturated (6:0, 8:0, 10:0, 12:0); they comprise two thirds of coconut oil's fatty acids; the saturated long chain fatty acids or LCTs (14:0, 16:0, 18:0) are less than a third (28-30%) and the unsaturates (18:1, 18:2) less than a tenth of coconut's fatty acids. Coconut oil is therefore more than 90% saturated, more saturated than other oils or fats. MCTs differ from saturated animal and dairy fats (LCTs) in their metabolism and fat in the body (Figure 4). MCTs are rapidly absorbed in the intestines, even without pancreatic lipase; they are carried by portal vein to the liver where they are rapidly oxidized to energy19,20,21. This process is as fast as the metabolism of sugars. MCTs, unlike LCTs, do not enter the cholesterol cycle, are not deposited in fat depots, and do not cause obesity. LCTs, on the other hand, need pancreatic lipase for absorption; they are carried by lymph to the systemic circulation in chylomicrons and eventually reach the liver where they either undergo beta oxidation, biosynthesis to cholesterol, or are repackaged as triglycerides. Triglycerides and cholesterol enter the systemic circulation in large, very low density lipoproteins (VLDLs) and on the way to peripheral tissues, the triglycerides are slowly used up, acted upon by endothelial lipases. The VLDLs become IDLs and finally LDLs, as the triglycerides are broken down by endothelial lipases till only the cholesterol remains in the LDLs. The latter are endocytosed by body cells and the cholesterol is used for synthesis of various steroid hormones (adrenal and sex hormones) and to reinforce the plasma membranes of all cells and their organelles. The surplus cholesterol is carried by reverse transport by HDLs for elimination in bile.
The LCTs of coconut oil which may participate in the cholesterol cycle are a small part (30%) of its fatty acids. What coconut oil lacks is linoleic acid (18:2 n6), an essential factor needed at 3-5% of calories to prevent deficiency states. Coconut oil has less than 2% of this essential ingredient which, however, can easily be supplied by other dietary items like fish or seafoods. This explains why the hydrogenated coconut oil used in most animal experiments was cholesterogenic; hydrogenation saturates the small amount of particularly the linoleic acid and without linoleic acid supplementation, the animals suffered from essential fatty acid deficiency.
THE US EPIDEMIOLOGIC EXPERIENCE — A "NATURAL" EXPERIMENT
The Lipid (or Diet)-Heart Theory of Keys found 99% acceptance especially in the U.S. Since the 70s and 80s, cardiologists have preached that animal fats and coconut oil are bad and should be avoided. In 1992, the US Department of Agriculture (DA) incorporated this advice into its Food Guide Pyramid program and convinced Americans to a diet of carbohydrates and vegetable oils (soybean oil and corn oil, both rich in linoleic acid). The program of course also advised more vegetables, fruits, exercise, etc. After 10 years on this diet, Americans are now described to be suffering from "obscene rates" of obesity, hypertension, diabetes and heart disease. The pyramid has been called a "disaster"22.
Why, what has gone wrong? The culprits in the USDA Food Guide Pyramid are not the saturated fats after all — but carbohydrates and omega 6 (n6) poly unsaturates. On hindsight and a good knowledge of the biochemistry of carbohydrates and linolenic acid, such an outcome can be predicted. Carbohydrates, especially sugars, are rapidly metabolized and, in excess, cause obesity. At present about 60-70% of Americans are said to be overweight and more than 50% obese. With such a diet, the requirement for insulin is acute and excessive; insulin resistance and hyperinsulism are bound to follow and development of what is now labeled "metabolic syndrome" which ends in hypertension, dyslipidemia and atherosclerosis.
The other probable cause for this "disaster" is overdose of linoleic acid. Linoleic acid (18:2 n 16) is elongated and desaturated in the body to arachidonic acid (20:4 n 6) and the latter forms part of the phospholids of plasma membranes. Phospholipase A2 releases the arachidonic acid and from it are derived platelet thromboxane A2, endothelial prostacyclin, inflammatory prostaglandins-2 of various tissues, and allergenic and asthmagenic leucotrienes-4 of the respiratory system, skin and connective tissues. In large doses (25% or more of calories) linoleic acid can lead to excess production of its inflammatory, allergenic, and platelet aggregating derivatives. Hence, the combination of excess carbohydrates, and linoleic acid (soy bean oil, corn oil) could explain the American Pyramid disaster.
Obviously, the Lipid-Heart Theory is in need of drastic revision if not complete rejection. Ravnskov, in a very straightforward and hard-hitting book8 where he called a spade a spade, called the Lipid-Heart theory a collection of "Myths!" That the claim that saturated fats in the diet cause coronary heart disease is a myth; that the saturated fats causing hypercholesterolemia claim is myth; that hypercholesterolemia causing coronary heart disease claim is also a myth. But what is devastating in his revelations is his analysis of the supporting studies: their faulty design and execution, their selection of favorable data and rejection of non-supporting data, in short the dishonesties, scientific, and otherwise, of many investigators. His arguments are, to say the least, difficult to refute or ignore.
WHAT THEREFORE CAUSES ATHEROSCLEROSIS?
For all that has been learned about atherogenesis (and it is a lot — Tables 5-6)23-27 we still do not fully understand how it comes about. More and more the answer appears to lie in our genes; for it is our genes that regulate all body synthesis, enzyme systems, receptors and structures, normal or abnormal. Table 7 lists some gene-dependent factors that play a role in atherogenesis. Almost everything in the process is under the control of a gene. And we do not know how these genes operate, or why they operate at all.
As regards lipid, exactly what role do they play in this complex genetic-inflammatory process? The fatty streaks may start in childhood or even infancy23. These are said to be macrophage-derived foam cells and the interesting question is why they occur so early. Do these occur in breast-fed infants (mother's milk is rich in lauric acid) or only in the bottle-fed? Bottle-feeding with powdered cow's milks has been very prevalent in the US where these findings were reported.
Fatty streaks may stay as is or develop into fibrotic plaques which still produce no symptoms and cause no trouble. In just relatively few and late in life do they start accumulating fatty foam cells, become soft and large, rupture and induce platelet aggregation and thrombotic clots that lead to vessel occlusion. Of which vessel? It varies and why, we do not know; sometimes the cerebral arteries, sometimes the coronaries, the peripheral arteries or the aorta, thoracic or abdominal — "lesion prone or resistant." (The old term for this was "locus minoris resistentiae", the part most vulnerable or least resistant). Do lipids play an active role in this process or are they just passengers? The LDLs bearing the cholesterol that somehow enter the subendothelial space are the ones oxidized to become the toxic LDLox, and be engulfed by macrophages. These macrophages become the foam cells that make the plaques soft and large. Are foam cells the culprit? The atherosclerotic thoracic aorta has more foam cells than the sclerotic abdominal aorta and the thoracic aorta is less liable to rupture; here foam cells appear to be protective. Are the foam cells responsible for the weakening and rupture of the plaque or is it the thinning of the fibrotic cap or perhaps lack of calcification?
And what about hypercholesterolemia: how bad is it? Kannel of Framingham reported in 1979 that 80% of individuals who develop coronary artery disease (CAD) have total plasma cholesterol values within the same range as those who do not develop CAD28. A more recent finding is that elderly women with high cholesterol live longer and healthier than other women. Therefore should hypercholesterolemia be vigorously and assiduously lowered? Should cholesterol be lowered to levels presently being recommended.
It must be remembered that cholesterol and other lipids are structural elements of cells, particularly of the neurons and the brain. Alzheimer's disease is on the increase; could this be partly due to too much cholesterol control?
Lastly, besides smoking and free oxygen radicals, homocysteine, a biogenic derivative of methionine, has recently been shown to be toxic to the endothelium. Hyperhomocystenemia, which can result from deficiencies in vitamins B6 and B12 and particularly folic acid, may be an important etiologic agent among peoples who eat much meat and are deficient in these vitamins29. Is it not therefore likely that the high coronary mortality rates of the countries that ate more saturated fats were due instead to the meat they ate, and not the fat?
Whatever the answers to these questions, it should be evident that coconut oil is not a player in the atherogenic process and therefore that it cannot be atherogenic. In fact, it might even be anti-atherogenic and made part of every diet, like fruits and vegetables — all in moderation.
It is unfortunate that man oftentimes is too simplistic; he thinks in terms of black and white, good or bad. Like a pendulum, he swings from extreme right to extreme left. Fad diets are good examples and the USDA Food Pyramid, if not in intent, was executed in such a manner. Saturated animal fats were treated like "poisons" to be rejected, while the essential vegetable oils were thought as good in any amount and allowed ad libitum. Just as drugs have their therapeutic (good) and toxic (bad) dose levels, foods also have their "proper" amounts. Taken in adequate amounts to prevent deficiencies and not in excess to avoid "toxicities," all foods should be good for health and nutrition.
As to our inherited gene-dependent tendencies, there really is little that can be done except avoid all the known risk factors — if we can.
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