B Y T H E W A Y, D O C T O R

with Anthony L. Komaroff, M.D., Editor in Chief

Q A
Is coconut oil healthful?

Ive read recently that organic coconut oil has health benefits. Could coconut oil improve lipid profiles if consumed every day?

I doubt that coconut oil has health benefits, especially beneficial effects on lipids, and I wouldnt recommend that you consume it regularly. For years, fat was portrayed as unhealthful. Thats not true. Bad fats, such as saturated and trans fats, are bad for you, but good fatsmonounsaturated and polyunsaturated fatsactually have health benefits. The black-hat fats are a problem because they tend to increase LDL cholesterol levels, which in turn raises the risk of developing atherosclerosis and the heart disease and strokes that follow. True, they also tend to increase HDL (good) cholesterol, but not enough to compensate for the bad effects.

Dietary oilscanola, corn oil, and so onare all forms of fat. But unlike most other oils made from plants, coconut oil, as well as palm oil, are high in saturated fat. Saturated fat comes in several varieties; coconut oil is rich in one called lauric acid. Some groups and self-proclaimed experts are hawking lauric acid as a wonder food that will boost your immune system, help you lose weight, fight canceryou name it. Needless to say, the evidence is weak to nonexistent. A respected nutrition textbook on our shelves does refer to the possibility of it having modest cavity-fighting properties. By contrast, theres a great deal of evidence that, like other saturated fats, lauric acid increases LDL levels. As with most dietary donts, theres no need to be a prohibitionist. If you want to enjoy an occasional pia colada or a Thai curry dish, go ahead. I do. Coconut milk and oil are delicious. Just dont kid yourself that they are good for you.

Should I switch calcium supplements?

A recent test showed I have some hip osteopenia. Now every day I take two Tums Ultra (800 mg of calcium) plus a multivitamin (200 mg of calcium). I also get a total of 800 International Units (IU) of vitamin D daily. Ive been advised that Tums arent sufficient. Do I need to switch to a more expensive calcium supplement?

If youre older than 50, the current Recommended Dietary Allowance (RDA) for calcium is 1,200 mg. So even with the Tums and the multivitamin, youre still 200 mg short of the RDA. Calcium-rich foods such as fortified cereals and orange juice, tofu, or yogurt can help you bridge the gap. But in my view, the evidence that you need that much calcium isnt very strong. Indeed, 1,200 mg may be too much. Experts on our faculty advocate a daily intake of between 500 and 1,000 mg. Because you have thinning of the hip bone, you definitely want to protect your hip, but there are better ways to do that than taking lots of calcium. Id start with regular weight-bearing exercise, emphasizing some activity that strengthens your leg muscles.

Im glad youre taking vitamin D because, as we reported in the Health Letter last month, it not only strengthens bones and muscles but also has a surprising number of other health benefits. Most people (including doctors) arent aware that another vitaminvitamin Kalso promotes bone strength. A good source is dark green vegetables. Small doses of fluoride, like those in the drinking water of many communities, are also good for your bones, but dont take fluoride supplements unless your doctor recommends them. As for calcium supplements, they come in two basic forms, calcium carbonate and calcium citrate. Tums and its variations are made from calcium carbonate. The calcium carbonate supplements are usually less expensive and contain more elemental calcium than calcium citrate (40% by weight vs. 21%). But the calcium in calcium citrate is more readily absorbed, and you dont have to take calcium citrate supplements with meals. Some calcium supplementsboth carbonate and citrateinclude added vitamin D, a definite plus. Tums products weve seen dont have added vitamin D, a minus.

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8 | Harvard Health Letter

April 2006

www.health.harvard.edu