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Randomised trial of coconut oil, olive oil or butter on blood lipids and other cardiovascular risk factors in healthy men and women
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    Response: Randomised trial of coconut oil, olive oil or butter on blood lipids and other cardiovascular risk factors in healthy men and women
    • Jessica Price, DPhil Student University of Oxford
    • Other Contributors:
      • Charlotte Albury, DPhil student
      • Kerstin Frie, DPhil student
      • Georgia Richards, DPhil student
      • Jack O’Sullivan, DPhil student

    We would like to congratulate the authors: the pragmatic trial design is novel and interesting, and may have provided a better estimate of the ‘real-life’ effectiveness of the intervention than a conventional RCT. Nevertheless, there are certain aspects of the paper that we wish to highlight. As the authors acknowledge, there are concerns about uncontrolled confounders. However, we would also like to raise the following 3 points of concern to consider:
    1. The study lacked a control group (where no additional lipid was added/replaced in the diet). This is problematic as the article’s conclusion suggests that the changes seen in LDL-C are an effect of extra virgin coconut oil, whereas it might instead be the impact of additional butter (and without a control group we are unable to assess the impact of coconut oil alone).
    2. The study is unclear about whether participants consumed the 50ml of coconut oil or olive oil as cold oils, or whether they cooked them before consumption. Multiple studies have suggested that hot (cooked) vegetable oil has a negative impact on blood lipids and metabolic profiles, increasing LDL-C levels, inflammatory markers and blood pressure (1). We would therefore welcome clarification of this point from the study authors.
    3. Longer follow up may be warranted to determine whether ongoing use of coconut oil would result in significant weight gain. This is of particular concern if coconut oil is added to the diet instead of replacing...

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    Conflict of Interest:
    None declared.