#dissertation critique

In fairness, the study was only in phase I and was largely epidemiological. One of the most important things this lifestyle change have thought me when looking at journals and studies is that correlation does not always imply causation. The proponents of different studies may be looking at the wrong data and therefore could misinterpret their findings. The diet of the volunteers on this study was never change. Like the Standard American Diet RDA, the Philippine Recommended Energy Nutrition Intake (RENI) follows the high carb source for main energy (~55-70%), with daily calories coming largely from breads, grains, rice, etc. 

They received standard dietary instruction from a clinical dietitian from the Dietary Department of the University of the Philippines – Philippine General Hospital (UP-PGH) based on the Recommended Energy Nutrition Intake (RENI) seen on Appendix B. Compliance to the dietary advice throughout the study period was emphasized by the primary author after consultation with the clinical dietitian.  

The study lasted for six weeks and boy were the results scary.

Number one: VCO significantly increases the fasting blood sugar (FBS). I was hoping the authors would elucidate on this curious result but then the only discussion they wrote was

The elevated FBS may be due to added calories from intake of VCO.  One tbsp coconut oil (14 g) contains 116 calories, so 1 tbsp three times a day would mean additional 348 calories daily.

From what I have learned from my Biochemistry class, lipid is lipid and carb is carb. Both can be sources of fuel but lipids can never be carb, ergo they are not sugar. Well they can be, but it is a long, winding process which will only be activated if there is a shortage of quick source of fuel that is the glucose. More on it later. Anyway, fats are broken down into fatty acids, cells extract ATP from it and use it as fuel and that's it. In addition, short- and medium chain-triglycerides are directly absorbed by the body to be used as fuel, unlike long chain fatty acids which VCO is exactly not. On the other hand, carbs are broken down into glucose, which in turn are the "sugar" of the blood. Cells can also extract ATP from glucose.

So why then, an increase in dietary fat have an effect on fasting blood sugar? Energy from lipids are utilized as such, except when there are excess, which like any excess glucose molecules, are stored by the hormone insulin as fat. Therefore, if in the whole study, the majority of the volunteers consumed more calories than they can expend (this is what I think the study largely implies), we should see an increase in weight or in size, and not an increase on blood glucose chemistry. But we do not. Instead,

Eight subjects had weight loss of more than 1 kg 

Oh wow! Curious and curiouser. Sad thing though:

but there was no significant effect on mean weight and BMI. This is in contrast to some data that medium chain triglycerides may have a potential role in treatment of obesity [...]

You bet. MCT oils do help in losing weight and lower the body fat, but it won't have any significant result if the volunteers of the study follows a high-carb way of eating. High-carb means a surge in insulin, and both glucose and lipids are stored if it can't be properly utilized by the body.

The only rationale I can think why the result came out like this is there are some variable in VCO that directly affects the fasting blood sugar. It cannot be about the calories. I won't accept it. But hey, who am I do challenge these doctors?

Number two: Another curious result is the effect on the HDL of the volunteers

Virgin coconut oil significantly decreased the mean HDL (47.58 ± 7.54 to 44.09 ± 7.10 mg/dl, p = 0.024). Six subjects had post-treatment HDL levels below 40 mg/dL.  There was no significant effect on total cholesterol, triglyceride, and LDL

HDL is the good cholesterol. Thousands upon thousands of anecdotal evidence from HFLC dieters have shown an excellent lipid panel while on this lifestyle. The authors even referenced one study that showed an increased in HDL and decrease in triglycerides, LDL, and cholesterol, which somehow refutes their data

These results are in contrast to the study done by Nevin and Rajomohan on VCO-fed rats that showed VCO decreases TC, LDL and TG and increases HDL.

Actually they stated two other VCO studies that goes against their results

It is also contradictory to reviews by Drs. Dayrit[1] and Enig[9] that coconut oil increases HDL. 

I think they know their data were off so to compensate they ended their discussion stating that their paper should not be taken as final

However, it must be noted that this conclusion was drawn from epidemiological and diet studies in the general population, rather than from clinical trials of VCO.

I should cut them some slack. Heh.

I could further elaborate some of their results but since they are either not significant, or have nothing of significance to low-carb, I'd rather not.

So, in conclusion, what have we learned?

This study shows that short-term use of virgin coconut oil appears to significantly increase FBS and decrease HDL but there is no significant effect on the rest of the lipid profile. VCO also appears to increase serum creatinine and platelet count and decreases WBC count. There were no significant effect on liver function and the rest of the hematologic parameters. Gastrointestinal complaints were the most commonly reported adverse events, but they were generally mild and tolerated.

But this study only lasted for 4 weeks, compared to their 6 weeks study, and VCO helped in lowering the volunteers' waist circumference.

One last thing though:

These guys are the blokes behind the best-selling drug of all time: statin, aka the cholesterol-lowering drug. I may be looking way too much and this could just be a coincidence, but an off result with a grant from them is way too much coincidence to ignore. Not to demonize the authors or anything. I mean, there are quite a few local studies on coco oil or VCO, from Dayrit [1][2] to Lym-Silianco to prove them otherwise.

I somehow want to see the continuation of their study, and if any of their data here holds any truth or this is just an isolated case. I am all for discussion and clarification.

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