Health Benefits of Virgin Coconut Oil: Gerard Dumancas Lakshmi C. Kasi Viswanath

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Health benefits of virgin coconut oil
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In: Vegetable Oil: Properties, Uses, and Benefits ISBN 978-1-63485-219-7
Editor: Brittany Holt © 2016 Nova Science Publishers, Inc.
Chapter 6
HEALTH BENEFITS OF VIRGIN COCONUT OIL
Gerard G. Dumancas1,*, Lakshmi C. Kasi Viswanath1,

Arnie R. de Leon2, Sindhura Ramasahayam3,
Randall Maples4, Rangika Hikkaduwa Koralege5,
Undugodage Don Nuwan Perera6, Joel Langford1, Aamina Shakir7
and Samuel Castles1
1
Department of Chemistry, Oklahoma Baptist University, Shawnee, OK, US 74804
2
Department of Chemistry, Vanderbilt University, Nashville, TN 37235
3
Department of Hematology and Genetics,
Children’s Hospital of Philadelphia, Philadelphia, PA, US, 19104
4
Science and Mathematics, Eastern Oklahoma State College, Wilburton, OK US 74578
5
School of Chemical Engineering, Oklahoma State University, Stillwater, OK US 74074
6
Department of Chemistry, Oklahoma State University, Stillwater, OK US 74074
7
College of Medicine, University of Oklahoma Health Sciences Center,
Oklahoma City US 73104
ABSTRACT
Virgin coconut oil (VCO) is a product that can be produced from fresh coconut meat,
milk, or residue. Over the years, it has become known as a popular functional food oil. It
is considered to be the newest, high-value coconut product, very much sought for its
human, nutraceutical benefits, as well as a functional food. Its increasing popularity can
be attributed to numerous studies showing its beneficial effects. Several studies have
investigated the pharmacological properties of VCO including anti-inflammatory,
analgesic, antipyretic, anti-oxidant, anti-stress, and antimicrobial properties. Furthermore,
other studies have also investigated the bone loss prevention as well as cardioprotective
*
Corresponding author: Email: gerard.dumancas@okstate.edu, Phone: +14057308752.
2 Gerard G. Dumancas, Lakshmi C. Kasi Viswanath, Arnie R. de Leon et al.
effects of VCO. For example, administration of VCO in animal studies (i.e., Sprague-
Dawley rats) showed significant antithrombotic effect compared to copra oil. The effects
were comparable with sunflower oil fed animals. This chapter will discuss the chemical
properties, sources, synthesis, preparation, uses, and worldwide production of VCO. A
particular focus will be on the health benefits of VCO including its most recent findings.
ABBREVIATIONS
AA Arachidonic acid
APCC Asian Pacific Coconut Community
APP Acute-phase protein
BAFPS Bureau of Agriculture and Fisheries Product Standards
BM Bawalan-Masa
COX-2 Cyclooxygenase-2
CMV Cytomegalovirus
DCN Desiccated Coconut
DME Direct Micro Expelling
EBV Epstein-Barr Virus
FA Fatty Acid
FFA Free fatty acid
GAE Gallic acid equivalents
GPX Glutathione peroxidase
GSH Glutathione
HDL High-density lipoprotein
ICS International Certification Services
IL-6 Interleukin-6
iNOS Inducible nitric oxide synthase
LDL Low-density lipoprotein
MCFA Medium chain fatty acid
MCT Medium chain triglyceride
MDA Malondialdehyde
MIC Minimum inhibitory concentration
NO Nitric oxide
NSAID Non-steroidal inflammatory drug
PG Prostaglandin
PNS Philippine National Standard
P. acnes Propionibacterium acnes
RA Rheumatoid arthritis
RBD Refined, bleached, deodorized
SFA Saturated fatty acid
SOD Superoxide dismutase
TNF-α tumor necrosis factors-α
VCO Virgin coconut oil
Health Benefits of Virgin Coconut Oil 3
1.0. INTRODUCTION
Coconut oil is one of the most important food oils in the world as a source of dietary fat.
It is extensively used as cooking oil, and also in food industries such as confectionary and
baking products [1]. There are two types of coconut oil based on how they are obtained from
the coconut meat: refined, bleached and deodorized coconut oil (RBD) and virgin coconut oil
(VCO). RBD oil is made from copra, which is the dried coconut kernel or meat, produced
through smoke drying, sun drying or a combination of both. Then the clean, ground and
steamed copra is pressed to obtain the coconut oil. Although coconut is one of the healthiest
foods known to mankind, the drying process and unhygienic storage and handling makes the
extracted oil unsafe for human consumption. Therefore the refining, bleaching, and
deodorizing process is necessary after the extraction. This process requires heating the oil at
high temperatures, between 204°C and 245°C, which destroys the essential amino acids,
tocopherols (i.e., Vitamin E) and other valuable compounds present in coconut oil [2-6].
Coconut oil can also be extracted from fresh coconut kernels, the process of which does
not involve high temperature treatments. The Philippine national standard defines VCO as the
oil obtained from the fresh, mature kernel (meat) of the coconut by mechanical or natural
means, with or without the use of heat, without undergoing chemical refining, bleaching or
deodorizing processes, which does not lead to the alteration of the nature of the oil [5]. This is
the purest form of coconut oil, which has the fresh coconut aroma and contains natural
Vitamin E and other valuable compounds present in the coconut meat. VCO has a clear water
appearance. RDB oil, in contrast, can appear yellow, pink or red-orange due to the
contaminants (microbial or other), or high temperature processing. VCO has low free fatty
acid content and peroxide value since it does not undergo the copra-making process, which
eliminates atmospheric and hydrolytic oxidation compared to the RBD process [5].
There is a growing demand for VCO in United Sates and other developed countries,
which can be attributed to the increasing number of books, journal articles and other scientific
literature published on the health benefits of VCO. The amount of VCO manufactured in
tropical countries has grown rapidly in the last two decades. For example, the number of
VCO producers increased from 20 in 2003 to 200-300 producers in 2005 in the Philippines
[7]. The exported VCO from the Philippines has increased from 19 metric tons to 177 metric
tons from 2002 to 2004 as reported [8]. It was reported in another document published by the
Philippine Coconut Authority that the export of VCO increased from 2737 metric tons to
6002 metric tons from 2010 to 2012 showing that the demand and the production of VCO is
rapidly increasing [9]. Worldwide production of VCO shall further be discussed in the
succeeding sections.
2.0. CHEMICAL PROPERTIES OF VCO

VCO, which is extracted directly from coconut milk by a wet process under controlled
temperature conditions, retains more of its beneficial components than copra oil. Particularly,
this extraction process avoids the loss of minor components such as pro-vitamin A, vitamin E
and polyphenols due to UV irradiation from sunlight during the drying of copra [4, 3, 10].
VCO has a rich content of medium chain fatty acids (MCFAs), predominantly lauric acid;
others include caproic acid, caprylic acid and capric acid [10]. A study conducted by Mansor
et al., [10] on VCO extracted by different processing methods reported that the lauric acid
contents ranged from 46.36%-48.42% and the total MCFA in the oil (caproic acid, caprylic
acid, capric acid and lauric acid) ranged from 59.02% to 62.27% of the total fatty acids.
According to his findings, the highest lauric acid content was reported from the samples
extracted using the fermentation process, followed by fresh-dry, chilling, and enzyme
methods.
Apart from the high concentration of MCFAs, VCO also contains saturated fatty acids
(SFAs) such as myristic acid, palmitic acid, and stearic acid, as well as unsaturated fatty
acids, both mono-and di-unsaturated fatty acids. As reported by Mansor et al., [10] the
concentrations of SFA and total unsaturated fatty acids ranged from 28% to 31% and 6.73%
to 8.13%, respectively. Table 1 presents the fatty acid compositions of VCO produced from
different methods and the Asian Pacific Coconut Community (APCC) standard compositions
for VCO [10]. Variations in fatty acid composition could result from different methods of
processing among VCO samples (Table 1) [3, 10, 11].
Iodine value, saponification value, and peroxide content are some of the most important
chemical properties that are vital in characterizing the quality of VCO. Other important
physicochemical properties in VCO include free fatty acid composition, moisture content, and
viscosity (Table 2).
Iodine value of VCO gives an indication of its saturation level. The low content of iodine
value as described by Mansor et al. (Table 2) [10] and Marina et al. [3] verified that VCO has
high degree of saturation. Consequently, VCO has high resistance to oxidative rancidity. Free
fatty acids (FFAs) are responsible for the undesirable flavor and aromas present in VCO and
are formed by the hydrolytic rancidity, due to ester hydrolysis either by lipases or moisture.
Measured FFA contents were varied from 0.29-0.46 (mg KOH/g oil) in a study conducted by
Mansor et al. [10]
Table 1. Fatty acid (FA) composition of VCO produced from different methods and
APCC standard compositions for VCO (% area)
Extraction Method APCC

FA
Chilling Enzyme Fermentation Fresh-dry Standard
C6 (caproic acid) 0.57 ± 0.00 0.52 ± 0.00 0.57 ± 0.01 0.55 ± 0.00 0.40-0.60
C8 7.39 ± 0.03 6.63 ± 0.01 7.21±0.13 7.23 ± 0.00 5.00-10.00
(caprylic acid)
C10 (capric acid) 6.15 ± 0.01 5.49±0.00 6.07±0.10 5.94 ± 0.01 4.50-8.00
C12 (lauric acid) 48.05 ± 46.36±0.00 48.42 ± 0.90 48.07 ± 0.02 43.00-53.00
0.11
C14 (myristic 18.45 ± 19.54±0.01 18.75 ± 0.34 19.23 ± 0.00 16.00-21.00
acid) 0.03
C16 (palmitic) 8.94 ± 0.05 9.94 ± 0.01 9.06 ± 0.16 8.91 ± 0.01 7.50-10.00
C18 (stearic acid) 2.96 ± 0.03 3.37 ± 0.00 3.15 ± 0.00 3.17 ± 0.09 2.00-4.00
C18: 1 (oleic 6.18 ± 0.03 6.50 ± 0.01 6.35 ± 0.01 5.79 ± 0.01 5.00-10.00
acid)
C18: 2 (linoleic 1.31 ± 0.01 1.63 ± 0.00 1.36 ± 0.00 1.12 ± 0.00 1.00-2.50
acid)
Table 2. Physicochemical analysis of VCO extracted using the different methods [10]
Extraction Method APCC

Analysis Standard,
Chilling Fermentation Fresh-dry Enzyme 2007
Iodine value (g 4.13 ± 0.02 4.30 ± 0.07 4.18 ± 0.04 4.26 ± 0.05 4.10
I2/100 g fats)
Free fatty acid (mg 0.31 ± 0.01 0.29 ± 0.02 0.46 ± 0.01 0.35 ± 0.01 0.5 max
KOH/g oil)
Saponification 258.23 ± 256.73 ± 0.85 258.42 ± 1.41 262.72 ± 0.32 250-260 min
value 3.09
(mg KOH/g oil)
Moisture content 0.11 ± 0.01 0.06 ± 0.00 0.04 ± 0.00 0.11 ± 0.01 0.1-0.5
(% wt)
Viscosity (Pa.s) 48.93 ± 0.31 48.73 ± 0.46 50.93 ± 0.31 48.93 ± 0.31 NA
The saponification value, another important chemical characteristic, measuresthe average

molecular weight of all the fatty acids present in VCO. One study found out that VCO has
very high saponification values compared to other vegetable oils (3). The higher the
saponification value, the shorter the fatty acids on the glycerol backbone, indicating that VCO
contains a higher amount of short-chain fatty acids. Mansor et al. reported the saponification
values from four different extraction methods (Table 2) [10].
VCO can also be characterized by the presence of antioxidants. Tocopherols, which are
natural lipophilic antioxidants, are known to be found in vegetable oils including VCO.
Mansor et al. [10] detected three types of tocopherols present in VCO including beta, gamma
and delta forms. Beta-tocopherol ranged from 0.04 – 0.05 mg/kg, gamma-tocopherol ranged
from 0.01–0.05 mg/kg, and delta-tocopherol was detected at a very low concentration levels
(1.30 x 10-5 to 1.10 x 10-3 mg/kg) in VCO.
VCO is also good source of phenolic compounds, which are potential natural antioxidants
found in foods. Total phenolic contents present in VCO will vary based on coconut varieties
and oil extraction processes [4, 3, 10]. VCO has been shown to have a high total phenolic
content (11.82–29.18 mg gallic acid equivalents [GAE]/100g oil), which is responsible for its
high antioxidant properties (antioxidant activity ranging from 52.54% to 79.87%) [12].
Another study conducted by Arlee et al. has reported total phenolic contents of VCO ranged
from 48.17–57.89 mg GAE/100 g oil [13].
Moisture content is another important quality characteristics for oils and fats. Low
moisture levels will increase the shelf life by preventing oxidation and rancidity processes,
whereas high moisture content will assist in hydrolysis. Mansor et al. reported the moisture
content (% wt) and viscosities for VCO extracted using four extraction methods (Table 2)
[10]. The highest recorded viscosity was from fresh-dry method while the lowest was from
fermentation method.
Besides the abovementioned properties, formation of peroxides and hydroperoxide in the
initial stage of lipid oxidation is also an important property of VCO that should be noted,
because it reflects the tendency of the oil to become rancid. As observed by Marina et al. [3]
peroxide values ranged from 0.21 to 0.63 mequiv oxygen/kg oil, which were far below the
maximum limits according to Codex standard [14].
3.0. SOURCES, SYNTHESIS, PREPARATION, AND USES OF VCO

3.1. Sources
Coconut oil extracted from the fruit of the coconut palm (Cocos nucifera L.) is of two
different types: (i) coconut or copra oil obtained from dry coconut flesh and (ii) VCO
acquired from fresh coconut flesh. VCO can either be obtained directly from the fresh
comminuted (grated, chopped, granulated) coconut meat or from coconut milk or from
coconut milk residue [5]. However, the choice of the technology to be implemented for VCO
processing depends on various parameters such as scale of operations, the degree of
mechanization desired, the amount of investment available and the demands of the
prospective buyer [5].
3.2. Processing of VCO
The Philippine National Standard (PNS) for VCO (PNS/The Bureau of Agriculture and
Fisheries Product Standards (BAFPS) 22:2004/International Certification Services (ICS)
67.2000.10) defines it as: “oil obtained from the fresh, mature kernel (meat) of the coconut by
mechanical or natural means, with or without the use of heat, without undergoing chemical
refining, bleaching or deodorizing, and which does not lead to the alteration of the nature of
the oil. VCO is essentially water-clear or colorless. It contains natural vitamin E and has not
undergone any hydrolytic and atmospheric oxidation as demonstrated by its very low free-
fatty acid content (even without refining) and low peroxide value [15].” VCO has a fresh
coconut aroma and its intensity depends on the extraction process. Hence, unlike refined
coconut oil, the production process of VCO does not go through the RBD procedures, which
are carried out at high temperature between 204°C and 245°C as mentioned earlier [16]. VCO
can be produced even at home without the need for any specialized equipment. As a means to
ensure the production of high quality oil, the VCO processor used at home or plant should
strictly comply with the good manufacturing practices and quality control procedures [17].
The production of VCO is divided into three stages, (i) pre-processing, (ii) processing
and (iii) post processing.
3.2.1. Pre-processing Stage

The pre-processing stage involves all the steps performed before the opening of the fresh
coconut such as on-farm activities (harvesting, collection and husking of nuts), transport from
the farm to the VCO processing site (factory or home), storage, and selection for daily
processing [18].
3.2.2. Processing Stage

The processing stage begins with the opening of the fresh kernel and is complete until the
final recovery of VCO. The VCO production process can be carried out in eight different
ways based on the desired final quality of oil [5, 4, 19-20]. The common method of
classification is based on whether a dry or wet process is employed. However, methods can
also be classified based on the precursor form of coconut used (Figure 1).
Figure 1. Methods of VCO processing.
A. Fresh Coconut Meat
(i) High Pressure Expelling Process

The high pressure expelling process is considered to be the most appropriate method to
process a capacity of 3000 or more coconuts a day [5]. The method demands the use of
mechanical dryers and high-pressure expellers that are equipped with water-cooled shafts.
VCO obtained from the high-pressure expeller process is highly viscous as it contains all of
the natural gums present in the parent fresh kernel. There are three different types of high-
pressure expeller method of VCO production based on the mode of preparation of kernels
prior to drying, the Wet Milling Route, the Desiccated Coconut Route, and the Grated
Coconut Route [5, 17].
• Wet Milling Route. In the wet milling route, the de-shelled meat is first washed with
copious amount of water and then milled. The particulated coconut meat is then dried
to 75°C and the oil is extracted using a screw-type press to produce VCO and
coconut flakes [8].
• Desiccated Coconut (DCN) Route. The DCN route involves washing, grinding,
blanching and drying of the coconut meat. The ground meat is dried to a moisture
content level of 2.5-3% using a conveyor type hot air dryer with three diminishing
temperature levels (100°C, 85°C, and 65°C) (17)°. Desiccated coconut products,
which do not pass the accepted quality standards in terms of color and microbial
content, can still be processed into high value VCO [8, 17].
• Grated Coconut Route. The grated coconut route is similar to the DCN route except
that it requires fewer processing steps and equipment [8].
(ii) Fresh-Dry Low-Pressure Extraction Technique

This method is also known as the intermediate moisture content technique [17]. Utilizing
a low pressure of approximately 460 psi, oil can be extracted from most seeds and nuts
provided the moisture content is maintained between 10-13%. Likewise, oil can be extracted
from finely grated and dried coconut meat if moisture content levels are within the optimum
range. The grated kernels dried either by indirect hot air drying or solar drying is placed in
bags made of cheesecloth [17]. The oil extraction process is carried out in a bridge press,
which facilitates easy removal of the residue, and as the cheesecloth acts as a filter, the
resultant oil contains only a less amount of fine kernel particles. While the extraction process
performed with low moisture content meat results in reduced oil quantity, high moisture
content meat yields relatively turbid oil owing to a mixture of oil and coconut milk. The
acceptable level of moisture content in VCO should be 0.1% or less [17].
B. Milk Extraction
(i) Modified Kitchen Method

For many decades, people in coconut producing areas like the Philippines and India
produced coconut oil for hair and massage applications by boiling the extracted coconut milk
from freshly grated or comminuted coconut meat [17]. Nevertheless, the dark yellow oil, thus
produced possesses a very short shelf life and becomes sour within three to five days. A
slightly modified procedure known as the Modified Kitchen Method utilizes the same
principle with the exception that the heating systems are properly controlled so as to prevent
the recovered oil from turning yellow. Moreover, the recovered oil is further dried to maintain
moisture content less than 0.2%, in order to extend the shelf life. Although, the method
produces VCO with an intense coconut aroma, the final recovery of oil is relatively low when
compared to other methods due to the fact that a major portion of the oil gets trapped in the
protein residue [17].
The modified kitchen method includes two distinct parts, (i) Extraction of coconut milk,
and (ii) processing of VCO from the coconut milk. Extraction process can be done manually
or through the use of a hydraulic press. The grated kernel is mashed and placed in a cheese
bag (manual method) or a white net bag (hydraulic jack method), and tightly squeezed to
produce the coconut milk. Often times a second extraction is also performed to enhance the
oil quantity. The squeezed milk is then allowed to settle preferably for two hours so as to
distinguish the separation of coconut cream (oily phase) and skim milk (aqueous phase)
layers [21]. After scooping the coconut cream from the top, the cream is heated maintaining
an initial temperature of 90oC for the first hour and later reduced to 80oC to allow the
coagulation of protein. And as the oil separates, the temperature is further reduced, and
continuous stirring is done to facilitate uniform heat through the mixture. The oil produced is
scooped out from the wok carefully and filtered through a cotton-plugged funnel (small scale)
or a pressure filter can also be used for large scale processing [17].
(ii) Modified Natural Fermentation Method

The Modified Natural Fermentation Method requires much less investment, with
moderate labor and energy inputs compared to all the currently available VCO processing
technologies. Dayrit, et al. [22] suggested that the natural fermentation method is a familiar
process for the production of VCO which can be conveniently performed both at the
household level and at the industrial scale.
This method of VCO production is similar to that of the Modified Kitchen Method except
that the extracted coconut milk is diluted and allowed to stand for hours to undergo natural
fermentation. Fermentation can also be induced by the addition of foreign substances such as
Lactobacillus plantarum [23]. The maximum permissible level of FFA content in VCO is
0.1%. However, the FFA content of VCO produced by traditional natural fermentation
method ranges from 0.33–0.38%. The reason for such high FFA content in VCO obtained
through traditional method could be attributed to the long hours of settling time (36-48
hours). Hence, as a means to obtain water clear VCO with acceptable FFA levels, the
fermentation time is regulated to a maximum of 16 hours. The finely grated fresh kernel is
subject to a hydraulic press for the extraction of coconut milk. The extracted coconut milk is
mixed with one portion of water and left to settle at ~40°C for a maximum of 16 hours for
fermentation to occur [24]. The fermenting container displays five distinct layers comprising
of different components in ascending order: (i) gummy sediment at the bottom, (ii) fermented
skim milk, (iii) fermented curd layer, (iv) VCO layer and (v) a top layer of fermented curd.
The top layer of fermented curd is scooped out and the VCO layer is separated and filtered
through a filtering funnel plugged with cotton. The fermented skim milk obtained in this
process is unfit for human consumption and should be discarded. In certain cases, the coconut
milk emulsion can also be separated by adjusting the pH of the emulsion between 3 and 5.6
and inoculated with bacteria cultures [25].
(iii) Centrifuge Method

The best quality VCO can generally be achieved through the centrifuge process [26-27].
There are two different types of centrifuge processing of VCO: (i) the two-phase (liquid-
liquid) centrifuge process and (ii) the three phase (liquid-liquid-solid) centrifuge process.
Based on how the VCO is recovered from the coconut cream, the two-phase (liquid-liquid)
centrifuge process can have slight modifications. Three different routes have been reported.
(i) The cream is subjected to vacuum evaporation to remove water and coagulate the protein.
(ii) The cream is frozen and heated in a double boiler and is filtered to remove the coagulated
protein. (iii) The cream is heated in a controlled temperature to coagulate the protein and
remove water. In all the three cases the resultant oil is filtered through a filter press followed
by vacuum drying to remove traces of water [28-29].
Compared to the two-phase centrifuge process, the three-phase centrifuge process is
simpler: the filtered coconut milk is passed through a three-phase centrifuge system where the
individual components are separated by an applied centrifugal force [28]. The coconut milk
after its extraction is mixed with one portion of hot water and is fed into the centrifuge. The
cloudy oil that comes out of the centrifuge is again mixed with the second portion of hot
water and fed again into the centrifuge for a second pass. The final oil is filtered to remove
any solid particles and vacuum dried to afford water clear VCO. The scales of operation of
VCO are relatively large owing to the high investment cost [17].
C. Coconut Milk Residue
The Bawalan-Masa Process

The Bawalan-Masa Process (BM) is a hybrid of fresh-dry and the fresh-wet processes
[17]. The precursor for the VCO extraction in BM process is the coconut milk residue, which
represents approximately 25-50% of the weight of the freshly grated coconut meat. The
residue is blanched and dried in a mechanical dryer to reach specific moisture content. The
defatting of the dried residue under controlled conditions in a specially designed equipment
produce VCO and low fat, high fiber coconut flakes. The oil containing fine particles is
filtered through a mechanical filter to give a clear VCO. Coconut flakes obtained as a by-
product during the process can be re-dried and ground to produce coconut residue flour. The
VCO, thus, produced is very light in texture and is easily absorbed and has a very mild
coconut scent [17].
3.2.3. Post Processing Stage

The post processing stage includes all processes that are conducted to improve the quality
of the produced VCO. It includes oil drying (removal of moisture content), ageing (removal
of the sour smell), and fine filtration (removal of fine residue). Table 3 gives the comparison
data of the overall quantity and moisture content of the recovered oil of all the methods
discussed so far [5].
3.3. Uses of VCO
VCO has a wide array of uses and applications, which can be classified as either edible or
inedible categories. A comprehensive review of its health benefits is discussed in the
succeeding sections.
Edible Applications
• VCO serves as an important source of energy in diet [5].

• VCO is used as cooking and frying oil due to its exceptional resistance to rancidity
development, and it enhances the flavor of food [5].
• Due to its nature of unchanging palatability, VCO is used as a substitute for
buttermilk in filled milk, filled cheese and ice cream [5].
Inedible Applications
• It is used as a skin and hair conditioner [17].

• Aromatherapy and massage oils [30].
• Oil base for a variety of cosmetic and skin care products [31].
Synopsis of Health Benefits
• VCO is the only naturally available low-calorie fat [32].

• VCO boosts the immune system and protects humans from atherosclerosis and
cardiovascular disease [32].
• Digestion of VCO takes place easily without the need for bile.
• VCO stimulates metabolism and prevents obesity [33-34].
• It also inhibits cancer causing agents [35].
• It increases the absorption of vitamins, minerals and amino acids [32].
• VCO has the potential to prevent exercise and chronic cold restraint stress-induced
damage and restores the antioxidant balance [36].
• The presence of polyphenols and medium-chain fatty acids in VCO imparts anti-
stress activity [36].
• Wound-healing rate was increased in skin of rats treated with VCO [19].
• VCO was also used as an ‘ethnomedicine’ to treat gastrointestinal problems and
minor cuts, injuries and swelling [37].
• Effective and safe as mineral oil when used as a moisturizer for mild to moderate
xerosis [38].
• Dried-and fermented-processed VCO has hepatoprotective property [39].
• Has anti-oxidant activities and does not adversely affect serum lipid levels [40].
• Has anti-diabetic effects [41].
• VCO displayed inhibition of Candida sp. responsible for fungal infection [42].
• The fatty acid present in VCO acts as a potential immunostimulant, which increases
immunity through the increase of lymphocyte and Th-CD4 in chickens vaccinated
against Avian influenza virus [43].
Table 3. Comparative data of VCO obtained by different processes [5, 17]
Type of Process Quality of Oil Recovery

Fresh-Dry High- Wet Milling FFA–0.05-0.08% 60 kg per 100 kg of
Processes Pressure Route MC – 0.07-0.1% dried milled kernel
Expelling Desiccated FFA– 0.05-0.08% 58 kg per 100 kg of
Coconut Route MC – 0.0-0.1% desiccated coconut
Grated Coconut FFA– 0.05-0.08% 30 kg per 100 kg of
Route MC – 0.07-0.1% fresh grated kernel
Low- Low pressure FFA– 0.1-0.2% 25 kg per 100 kg of
Pressure Extraction MC – 0.17% & fresh grated coconut
below kernel
Fresh-Wet Coconut Modified Kitchen FFA– 0.1% 16.5 kg per 100 kg of
Processes Milk Method MC – 0.14% & fresh grated coconut
Extraction Modified Natural below kernel
Fermentation FFA– 0.1% 34 L per 100 L of
Method MC – 0.12% & coconut milk
Centrifuge below
Method FFA– 0.04-0.08% 28 L oil per 100 L of
(2-phase) MC – 0.1% & coconut milk
below
Coconut Bawalan-Masa FFA– 0.05-0.08% 17 kg per 100 kg of wet
Milk Process MC – 0.07-0.12% residue
Residue
4.0. WORLDWIDE PRODUCTION OF VCO

4.1. How Production of VCO Changed through Time
While it may be the common assumption that the production process of VCO has
changed through time, this may not actually be the case. The actual production processes and
the methodology behind them have not consistently changed. Fermentation and the unheated
and “cold pressed” procedures are the most typical methods used in the mass production of
VCO and have not been seen to drastically change over time. These methods are not to be
confused with RBD coconut oil (chemically refined, bleached, deodorized) methods [44-45].
However, what has been observed throughout time is an ongoing debate as to which method
is actually the best, which is the focus of multiple research groups around the world. For
example, a study conducted in 2005 at the University of the Philippines suggested that VCO
in general contained more antioxidants than that of RBDs [44]. Nonetheless, the real concern
was focused on the question as to which method, fermentation or unheated and “cold
pressed”, produced more antioxidants. The study concluded that the VCO prepared with heat
through the fermentation process contained on the average a significant amount more
antioxidants than other methods [44]. A few of these antioxidants included superoxide
dismutase, malondialdehyde, Vitamin E, phytosterols, and phenolic compounds, in which
were found to have a variety of different functions and benefits [46]. Further studies
conducted, which include a study done in 2005 in Malaysia and another in 2011 in Sri Lanka,
proved that all methods that involve heating the VCO produces more antioxidants [46-47].
4.2. Largest Producers of VCO
As previously mentioned, the studies conducted were located in a variety of different

countries including the Philippines, Malaysia, Sri Lanka, India, etc. The significance of
mentioning the location of these studies lies in the fact that these countries are all the major
producers of VCO. The leading coconut-producing country is the Philippines, followed by
Indonesia, India, Sri Lanka, Thailand, and Malaysia; most of which had universities that
conducted significant studies relating to debate between the methods behind producing VCO.
There are multiple factors to consider as to why these countries are the ideal location for the
production of VCO. Primarily, these countries are located in areas very favorable for coconut
palm growth, in which reasons include average rainfall per year, sunlight, sandy soil, and
humidity [48-49]. The Philippine coconut industry in and of itself accounts for 1.5% of gross
national product (GNP) and is the highest net foreign exchange earner in agricultural exports.
The Philippines coconut industry employs nearly 20 million people, which accounts for
around one-third of the country’s entire population. The industry earns approximately $510
million in U.S. currency on an annual basis. Across the globe, Indonesia and the Philippines
were the world’s two largest producers of coconuts with an estimated production of 16.3 mn
tonnes and 14.4 mn tonnes from 3.3 mn ha and 2.7 mn ha, respectively. India is the third
largest with an estimated world coconut production of 10 mn tonnes from 1.9 mn ha. The
major exporters were Philippines and Indonesia while India consumed most of its coconut
product. Across the Western Hemisphere, Central America, Jamaica, Brazil, and Mexico were
the major producers of coconut. The major coconut oil importing countries in the world
included EU-15 (15%), the USA (33%), Malaysia (5%), South Korea (4%), East Europe
(4%), and Singapore (4%) [50].
Coconut oil accounts for approximately 20% of all vegetable oils used worldwide [51].
Examination of the world coconut oil supply and distribution for over a decade (2002/03 to
2015/16) shows a steady decline in the total supply of the oil starting from 2013/14 (Figure
2). This total supply of the world coconut oil is the sum of the beginning stocks, production,
and imports. The decline can be attributed primarily to the decrease in the beginning stocks
available for the coconut oil supply. Worldwide exportation of the coconut oil has not
tremendously varied over the past five years. Industrial domestic consumption and food use
domestic consumption of the coconut oil have also started to increase slightly since 2014/15.
Overall, the worldwide ending stocks available for the coconut oil have steadily declined
since 2011/12 [52].
4.3. Economic Benefits and Analysis of VCO
VCO was flagged as an unhealthy food product and a possible contributor to heart
disease around 40 years ago. However, over the years this idea has been adjusted [53].
Saturated fatty acids in coconut oil gave the oil a bad reputation and resulted in its sparse
consumption [53]. However, an increasingly new wave of consumers have flocked to the oil
as new studies have proposed health effects including weight loss and analgesic, antipyretic,
cardio-protective and anti-carcinogenic effects. The economic boom, which has followed in
the wake of these new studies, has generated a very lucrative market in coconut producing
countries on a wide scale [54]. In general, VCO production has benefited the local economies,
but in other cases the opposite seems to be true.
Figure 2. World coconut oil supply and distribution [52].

One of the chief examples of the positive effects is the development of a VCO industry in
the Solomon Islands, which before the turn of the century primarily produced copra [55].
After the dried coconut kernel was harvested, it was then shipped off and processed away
from the site where it was harvested. The coconut oil demand has brought new prosperity to
the islands, which before were plagued with poverty. Dr. Etherington, a Stanford educated
economist developed a system called Direct Micro Expelling (DME), which presses the oil on
a small scale and obtains it in little under an hour. This allowed the people of the Solomon
Islands to expand their use of the coconuts, effectively utilizing more of the coconut at the
village level of the coconut oil production [55]. Dr. Etherington’s company, Kokonut Pacific,
has installed more than 40 DME systems in the Solomon Islands, and sees potential to put in
more than 300 in the coming years.
The world’s leading producer of coconut oil, the Philippines has shown how lucrative this
industry can be. About one third of the population in the Philippines is directly or indirectly
employed by the coconut industry in the Philippines [54]. The boom of the coconut oil has
generated a massive industry in the Philippines, but some argue that the influx of business has
not stimulated the economy at every level. Numerous farmers still live in poverty even though
their crop has grown in value. Evidence of this, is based in the facts that coconut farmers are
still some of the poorest farmers in the world. It is estimated that sixty percent of the farmers
living in the Philippines live in poverty [56].
5.0. BENEFICIAL EFFECTS OF VCO

5.1. Anti-Inflammatory Properties of VCO
Inflammation is a protective response of the immune system against pathogens, but can
also result to damaging consequences if not regulated [57]. The complex immune processes
and mediators involved in the inflammatory response can induce and aggravate many
diseases. Recent studies have found that inflammation plays a key role in various human
diseases that are not primarily disorders of the immune system, which includes cancer,
atherosclerosis, ischemic heart disease, and neurodegenerative diseases such as Alzheimer’s
disease [57]. However, current medications have adverse effects and there is a need for more
effective and safer anti-inflammatory therapeutics. Thus, VCO offers the potential for further
research and development of anti-inflammatory therapies. Different groups have shown great
interest in exploring the anti-inflammatory effects of VCO because of its high phenolic
contents. Some of the phenolic acids identified in VCO include caffeic acid, p-coumaric acid
and feulic acid [58]. Polyphenols control and reduce inflammation through a series of
pathways, therefore, preventing cancer and other diseases with an inflammatory pathogenesis.
Therefore, it is of interest of this section to summarize the anti-inflammatory action of VCO
that has been investigated [59].
5.1.1. Anti-Inflammatory and Anti-Oxidant Properties of VCO Inanimal Models of

Rheumatoid Arthritis
Arthritis is caused by joint inflammation that can ultimately lead to disability.
Rheumatoid Arthritis (RA) in particular is a chronic inflammation that affects synovial joints
and progressively results to destruction of articular cartilage. Current medications used to

treat RA have side effects; the need for effective therapeutics that also permit greater
compliance is what drive the investigation into products such as VCO. Vysakh et al. explored
the anti-inflammatory effect of the polyphenolic fraction extracted from VCO on
experimental arthritis [60]. Their results demonstrated the potential health benefit of VCO on
adjuvant induced arthritis in rats, and determined that mechanism behind this action is due to
its antioxidant and anti-inflammatory effects. Their findings on how VCO inhibits arthritis
can be summarized as follows:
• Downregulated (inducible nitric oxide (NO) synthase) iNOS expression. Nitrite

production in VCO treated animals was reduced significantly compared to adjuvant
treated rat. This suggests that reduction of chronic inflammation in arthritic animals
might be due to the downregulation of iNOS expression followed by decreased
cellular production of NO. Therefore, the anti-inflammatory activity of VCO may be
due to their ability to counteract NO induced oxidative damage, which eventually
helps in the remodeling of cells.
• Decreased cyclooxygenase-2 (COX-2) expressions. During inflammation, COX-2
enhances the synthesis of prostaglandins (PGs) that are associated with
inflammation. The activity of total COX and COX-2 expressions was decreased in
VCO treated rats. Reduction of paw swelling and decreased expression of COX-2
indicate the immunological protection provided by VCO.
• Inhibited tumor necrosis factors-α (TNF-α) activity. TNF-α may play a role in the
pathology of RA. Blocking of TNF-α followed by inactivation of T cells,
macrophages, and fibroblasts interrupts the inflammatory process. This anti-TNF-α
activity supports further pharmacological research on VCO, in hopes of improving
anti-inflammatory medications.
• Downregulated Interleukin-6 (IL-6) expression. IL-6 plays a devastating role in
cartilage and bone degradation during arthritis. VCO supplementation significantly
downregulated the expression of IL-6 in paw tissue of arthritic rats. VCO
supplementation also restored the levels of acute-phase proteins (APPs) to near
normal values in arthritic rats. Thus, decreased IL-6 production correlated with
decreased APP production, thereby reducing disease severity.
• Enhanced Glutathione (GSH) and superoxide dismutase (SOD) activity.
Polyphenols from VCO enhanced the activity of GSH and SOD, which help preserve
the integrity of cellular membranes. VCO administration produced a significant
increase in free radical scavenging activity of antioxidant enzymes like glutathione
peroxidase (GPX) and catalase.
• Decreased lipid peroxidation. The elevated levels of lipid peroxidation were
significantly decreased after VCO treatment. VCO reduces free radicals formation as
well as inflammation. These results imply that adjuvant induced arthritis may be
associated with lipid peroxidation and demonstrates the anti-arthritic effect of VCO.
VCO reduced lipid peroxidation causing a modulation in cellular antioxidant defense
system.
Intahphuak et al. also explored the inhibitory activity of VCO against acute and chronic
inflammation. They found that VCO exhibited moderate anti-inflammation on carageenin-
and arachidonic acid (AA)-induced hind paw edema in rats as well as on ethyl
phenylpropiolate-induced ear edema, which are all models of acute inflammation [59].
Consistent with the findings by Vysakh et al., they also demonstrated that the consumption of
VCO aided in inhibiting the expected immune factor responses to endotoxin, and diminished
the production of pro-inflammatory cytokines in vivo. They also found that the mode of
action of VCO to inhibit inflammation may also involve the lipoxygenase pathway because it
is effective in AA-induced rat paw edema model. AA-induced edema animal model has been
reported to be resistant to selective COX inhibitors but sensitive for detecting the in vivo anti-
inflammatory activity of lipoxygenase inhibitors [61].
The group also investigated the effects of VCO on cotton pellet-induced granuloma
formation in rats and compared it to the effects of the known anti-inflammatory drugs
indomethacin, and prednisolone. Granulomatous inflammation is a distinctive pattern of
chronic inflammatory reaction. Indomethacin and prednisolone inhibited granuloma
formation by interfering with the proliferative phase of inflammation. However, both drugs
also caused weight gain. They have shown that VCO also inhibited granuloma formation but
did not result in weight gain. VCO exhibited an inhibitory effect on chronic inflammation by
reducing the transudative weight, granuloma formation, and serumalkaline phosphatase
activity. The results obtained suggest that VCO probably inhibits the proliferative phase of
chronic inflammation but avoids the steroidal-like effect, as it had no effect on body weight
gain and dry thymus weight. The activity of VCO on the alkaline phosphatase level in serum
may be due to its inhibitory effect on inflammatory cell activity and/or stabilization of the
lysosomal membrane.
Similar to the paper of Intahphuak et al. [59], Zakaria et al. [85] investigated the anti-
inflammatory effects of VCO using in vivo models. The group utilized two types of VCO,
produced by standard drying (VCOA) and fermentation (VCOB) on animal models
(mice/rats) of both acute and chronic inflammation. The VCOs exhibited anti-inflammatory
activity in an acute model (carrageenan-induced paw edema test), consistent with the findings
of Intahphuak et al. with the same animal model. Comparing the two, VCOB showed a
greater anti-inflammatory effect than VCOA. However, in contrast to the findings of
Intahpuak et al. [59], the VCOs did not show ant-inflammatory effects on chronic (cotton-
pellet-induced granuloma test) model of inflammation.
5.1.2. Anti-Inflammatory Effect of VCO against E.Coli Endotoxin

Dietary fat influences many aspects of immune function. Escherichia coli endotoxin is a
potent stimulator of interleukin 1 production from macrophages. The present study examines
how feeding rats high-fat diets either rich (corn oil) or poor (coconut oil) in linoleate at high
and low concentrations affect responses to endotoxin. Spleen phosphatidylcholine linoleate
contents were higher in the corn oil than in the coconut oil group and arachidonate
concentrations were highest in the group fed a high concentration of corn oil. Coconut oil
completely abolished the responses to endotoxin. The inhibitory effects of coconut oil against
the endotoxin largely be due to reduced prostaglandin and leukotriene synthesis [62].
Similar to the aforementioned study, Sadeghi et al. (1999) carried out an investigation on
the effect of dietary oils such as coconut oil, corn oil, olive oil, safflower oil and fish oil on in
vivo cytokine response to bacterial lipopolysaccharide [63]. These dietary oils were fed to
mice for 5 weeks and the mice were then injected with a non-lethal dose of Escherichia coli.
The mice were sacrificed after 90 or 180 minutes post E. Coli injection to measure plasma
cytikine concntrations. The results showed lower peak plasma concentrations of TNF-alpha,
IL-1beta and IL-6 in mice fed with coconut oil and fish oil compared to other dietary oils.
Moreover, peak plasma IL-10 concentrations were higher in mice fed with coconut oil than in
mice fed with other oils. These results suggest that coconut oil diminishes production of pro-
inflammatory cytokines in vivo and diminishes enhanced production of IL-10. This appears to
be an additional anti-inflammatory effect of this oil, which could give added benefit in
various clinical conditions.
5.1.3. Therapeutic Effect of VCO on Inflammatory Acne Vulgaris

VCO contains a large amount of lauric acid, which has been shown to have antibacterial
property on Propionibacterium acnes (P. acnes). This served as the motivation to investigate
the anti-inflammatory property of lauric acid on acnes vulgaris. The anti-inflammatory
activity of VCO has also been explored on Acne vulgaris. Acne vulgaris or simply acne, is the
most common human skin infection and its prevalence is about 80% in the majority of the
countries worldwide [64]. Inflammatory lesions of acne may lead to acne scarring and may
have an impact on psychosocial health [65]. Acne is caused by P. acnes, a Gram-positive
anaerobic bacterium that dwells in the pilosebaceous follicles of the skin. Although P. acnes
is part of the normal skin bacterial flora, it plays a key role in the development of
inflammatory acne when it proliferates and colonizes the pilosebaceous unit. Previous studies
have found that P. acnes triggers the production of proinflammatory cytokines that are
mediated by Toll-like receptors [66]. In another study, Nakatsuji et al. demonstrated the
potential of lauric acid as an alternative option for antibacterial therapy in acne treatment.
Lauric acid showed stronger antimicrobial activity as compared with benzoyl peroxide
against skin bacteria, including P. acnes, in vitro. It also showed therapeutic potential against
P. acnes-induced inflammation in vivo. This study evaluated the antimicrobial property of
lauric acid against P. acnes both in vitro and in vivo. Both intradermal injection and
epicutaneous application of lauric acid effectively decreased the number of P. acnes
colonized with mouse ears, thereby relieving P. acnes-induced ear swelling and
granulomatous inflammation. This promising result showed the potential of using lauric acid
as an alternative treatment for antibiotic therapy of acne vulgaris [67].
5.2. Analgesic and Antipyretic Potential of VCO
Intahphuak et al. found that VCO demonstrated a moderate analgesic effect on acetic
acid-induced writhing response in mice [59]. VCO at high doses (1000-4000 mg/kg)
decreased the number of writhes induced by acetic acid significantly (~30-60%). This effect
is modest compared to the known non-steroidal anti-inflammatory drug (NSAID) drug,
Indomethacin, which only requires 10 mg/kg dose to markedly decrease the writhing response
by ~80%. The mechanism of acetic acid-induced algesia involves the release of endogenous
substances such as H+, K+, serotonin, histamine, bradykinin, PGs, and substance that excite
pain-nerve endings. The analgesic effect of VCO could be due to its ability to block both the
synthesis and release of these endogenous substances responsible for pain.
The analgesic effect of VCO was also assessed by Zakaria et al. [85] using several tests.
The group utilized acetic-acid induced abdominal constrictions, hot plate test and formalin-
induced paw licking test on mice or rats. The VCOs (VCOA and VCOB) exhibited analgesic
effect in both the abdominal constriction test and hot plate test indicating their activity in
blocking both peripherally and centrally mediated pain induced by chemical and thermal
stimuli. The peripheral and central effects of VCOs were further confirmed by their
effectiveness in reducing pain in the formalin test. Compared to the analgesics, acetyl acetic
acid and morphine, VCOs were less effective even at higher concentration.
5.2.1. Antipyretic Effect Effects of VCO on Yeast-Induced Hyperthermia in Rats

Intahphuak et al. also studied the antipyretic potential of VCO. Fever is a clinical sign of
inflammation; elevation in body temperature occurs when the concentration of PGE2 in
certain parts of the brain increase. The group demonstrated that VCO exhibited antipyretic
activity on yeast-induced hyperthermia. The antipyretic activity of VCO most probably is due
to the inhibition of cyclooxygenase, therefore blocking the synthesis or release of PGs in the
thermoregulatory center. This mode of action is similar to that of Ibuprofen, a non-steroidal
anti-inflammatory agent that possesses antipyretic activity [59].
5.3. Antioxidant, Anti-Stress, and Anticancer Benefits
Mainstream popularity of VCO has led to misinformation regarding potential benefits

and how it is beneficial. For example, many companies touted the Vitamin E content of VCO
and interchange the benefits of the two. Vitamin E comes in several forms and refers to a
group of compounds that include tocopherols and tocotrienols. Coconuts have been shown to
have modest tocopherol and tocotrienol concentrations of 0.07, 0.79, 0.18, and 1.04 mg/100 g
edible weight of γ-T, α-T3, γ-T3, and total, respectively [68]. Regarding potential anticancer
properties, Jordan, et al developed tocopherol-rich nanoemulsions which were shown to
possess anticancer activity [69]. This finding shows that VCO may possess some anticancer
activity due to the presence of tocopherols and tocotrienols. Also, in a separate study, VCO
enriched with zinc was shown to increase the number of helper Tcd4 and cytotoxic Tc cells
[70]. Tc cells release cytokines, which are capable of activating macrophages, thereby
eliminating virus-infected cells and destroying cancer cells. Thus, VCO appears to have some
anticancer value. However there are a couple of things to bear in mind. One is that VCO only
has a small amount of vitamin E and many other fruits and vegetables have more of these
tocopherols and tocotrienols. Another thing to note is that to the author’s knowledge there
appears limited evidence as of yet to support VCO having significant anticancer properties.
The greater body of working comparison, instead supports VCO having antioxidant, anti-
inflammatory, and immunomodulatory effects [71].
In the body, lipoproteins carry cholesterol through the body, to or away from cells. Low-
density lipoprotein (LDL) carries cholesterol through the body and into cells. High-density
lipoprotein (HDL) carries cholesterol away from cells. When LDL is carrying cholesterol into
the cells of arteries, it can become trapped within artery walls. If there are free radicals within
the body or other oxidizing substances, plaque can form and restrict blood vessels [72].
The lipid peroxides are typically unstable, decomposing to form a complex series of
compounds [69, 71, 73-74]. These newly formed compounds often include reactive carbonyl
compounds comprised of reactive carbon-oxygen double bonds. Malondialdehyde (MDA) is

a product formed from the decomposition of polyunsaturated fatty acid peroxides.
Measurement of the MDA is an indicator of lipid peroxidation. The assays often used include
chromogenic reagent, which reacts with MDA to form a stable chromophore whose
absorbance maximum can then be measured by UV-VIS spectrophotometry. Antioxidant
activity is assessed by measuring lipid peroxidation/oxidative stress and antioxidant capacity
through the evaluation of the MDA concentration and other antioxidant enzyme levels, which
often increase in response [69, 71, 73-74]. These enzymes may include catalase, glutathione
peroxidase (GPX), glutathione reductase, and superoxide dismutase (SOD). The presence of
polyphenols and the medium chain fatty acids are said to contribute to the antioxidant
activity/antioxidant capacity of VCO.
Lipid peroxidation from free radicals and oxidants is a well-established injury mechanism
in both plants and animals and is used to indicate oxidative stress in cells as well as tissues
[69, 71, 73-74]. Oxidative stress can occur due to this free radical generation in the body
leading to bone stress as well as organ damage, including the heart. Antioxidants generally do
not reduce cholesterol levels, but rather they prevent plaque from building up by binding to
and removing free radical scavengers and other oxidants, thus preventing LDL oxidation. The
polyphenol groups present in VCO were found to be capable of preventing in vitro LDL
oxidation, thus, VCO does provide antioxidant benefits and numerous studies have shown
these benefits when VCO has been added to the rat diet [69, 73-77]. In one of these studies,
VCO had a greater inhibitory effect on microsomal lipid peroxidation compared to copra and
groundnut oil and so is a better antioxidant [73]. The VCO increased the level of antioxidant
enzymes and, thus, was able to prevent lipid peroxidation. Findings in this study showed that
VCO also reduced LDL and increased HDL cholesterol and total cholesterol levels [73].
The antioxidant properties of coconut oil obtained through the various methods have
often been examined. The antioxidant properties of coconut oil obtained from different
extraction methods are different in scale. For example, Seneviratne, et al. concluded that a hot
method of extraction of coconut oil can produce an oil that contains more phenolic
compounds than a coconut oil extracted under cold conditions [78]. As a result of this,
coconut oil extracted under hot conditions showed higher antioxidant potential than coconut
oil extracted under cold conditions since the phenolic compounds are the free radical
scavengers. Therefore, consumption of VCO that have undergone different methods of
processing may result in VCO with different antioxidant content and, thus, slightly different
potential health benefits. Other extraction methods for coconut oil have been examined as
well with a goal of using only as little processing as can be to keep the properties of the virgin
material. An extraction using supercritical carbon dioxide resulted in 99% extraction
efficiency [79]. Use of this method would result in minimal alteration of virgin material and
maximum recovery of oil, however it would have a high extraction cost.
The properties of coconut oil may vary in look, taste and composition depending on
methods used to obtain the oil from the nut, regardless of whether the method involves
processing (non-VCO) or not (VCO) (3-4, 46). For example, in one study, VCO was obtained
through two separate methods: through chilling and also through fermentation, and both were
compared to each other as well as coconut oil obtained through the RBD process [80]. The
VCO obtained through fermentation showed a stronger scavenging effect and higher
antioxidant activity than the VCO obtained from the chilling method. The VCO from use of
the chilling method showed a higher reducing power than fermentation obtained VCO and the
RBD oil. The VCO obtained via either method showed a greater antioxidant capacity and
higher phenolic acid content than the RBD processed oil.
The loss/change in hormone such as estrogen through naturally growing older or other
means leads to a progressive accumulation of oxidative damage in tissue and bone [81]. In
2012, Abujazia, et al., showed that addition of 8% VCO (8 g VCO to 100 g chow) to the rat
diet caused a significant decrease in stress-induced MDA levels in bone [81]. In these studies,
female rats were subjected to ovariectomy or sham manipulation in order to simulate
postmenopausal osteoporosis. The removal or manipulation of the ovaries and subsequent
change in hormones leads to progressive loss of bone matrix in the rat, and, thus, a useful
model for the occurrence in postmenopausal women. Osteoporosis is bone inflammation
associated with oxidative stress and in this study the stress due to lipid peroxidation was
estimated by an MDA assay kit using tibia bone sample. Rats subjected to ovariectomy also
had higher GPX and SOD concentrations compared to control groups which seems to indicate
that VCO prevents the lipid peroxidation and increases the concentrations of antioxidant
enzymes in the rat model used. Although the SOD concentration was increased, the increase
was not statistically significant unlike the MDA and GPX concentrations, which were
statistically significant and the results of these studies indicate alignment with other studies
showing the effectiveness of VCO in maintaining bone structure. VCO prevented loss of bone
density by preserving bone mass in the rat model.
A similar study from the same group and also using the postmenopausal osteoporosis rat
model was performed by Hayatullina, et al. using an 8% (8 g VCO to 100 g chow) VCO
supplemented diet [82]. A diet supplemented with VCO led to rats with significantly greater
bone volume in rats that had ovariectomy or sham manipulation than those without VCO in
the diet. These findings support the evidence for reduction of bone loss density through lipid
peroxidation in the estrogen deficient ovariectomized rat by inclusion of a VCO enhanced
diet.
VCO then, clearly is effective as an antioxidant when included in the diet. How might
VCO compare as an antioxidant to several other oils deemed healthy enough to be included as
part of a balanced diet? Findings by Arunima, et al. revealed that a diet supplemented with
VCO was more effective at reducing oxidative stress in rats than olive, sunflower and copra
oil [36, 83]. In these studies, VCO functioned to help increase several enzyme activities
including those of catalase, glutathione peroxidase, and glutathione reductase and superoxide
dismutase. Enzymatic activity in the rat model used in this work supports findings indicating
the antioxidant ability of VCO as part of a balanced diet. VCO also decreased tissue lipid
levels in this study as it did in those previously mentioned.
Studies in similar animal models regarding the antioxidant capacity of VCO have
continued to reinforce findings from previous rat studies. Yeap examined in vivo antioxidant
and anti-stress properties of VCO in mice [36]. The studies showed that stress induced lipid
peroxidation from mice administered the forced swim test and cold restraint stress test at 4°C
was reduced in mice serum through the use of VCO at doses of 10 ml/kg animal weight. VCO
also caused an increase in the liver superoxide dismutase enzyme level and administration led
to restoration of balance in brain monoamine neurotransmitter levels, particularly serotonin.
Since administration of VCO blocked the increase of serotonin seen in untreated, stressed
animals, the depletion of this neurotransmitter was not observed in the VCO-treated animals.
This study demonstrated the potential for VCO in blocking stress-induced inflammation and
lipid peroxidation.
Thus, VCO consumption as part of a balanced diet is beneficial due to the known
antioxidant/antistress properties. It turns out that antioxidant properties are also seen in the
topical application of VCO in addition to dietary intake of VCO. Nevin, et al., 2010, showed
that rats treated topically with VCO to excision wounds healed faster. 0.5 ml and 1.0 ml of
VCO was applied to wounded Sprague-Dawley rats [19]. Lipid peroxide levels were lower in
the VCO treated wounds versus control. Antioxidant activity was also proven based on the
alteration of enzyme levels of glutathione and MDA. Thus topical application of VCO is
beneficial in addition to dietary intake.
Clearly, we have seen how VCO can reduce lipid peroxidation and alter enzyme levels
associated with oxidative stress. VCO can eliminate or reduce the loss in bone density due to
accumulation of oxidative damage. VCO can also reduce or eliminate oxidative damage in
body organs as well. For example, oxidative stress can lead to hepatic toxicity [84].
Treatment with VCO was shown to help protect liver function, reduce liver damage
associated with lipid peroxidation and lead to an improvement in hepatic antioxidant
enzymes, enzyme activity and liver fatty acid level [39, 85-86]. Treatment with VCO was
shown to help protect liver function, reduce liver damage associated with lipid peroxidation
and lead to an improvement in hepatic antioxidant enzymes, enzyme activity and liver fatty
acid level
5.4. Cardioprotective Effects
VCO has a rich content of MCFAs consisting of caproic acid, caprylic acid, capric acid,
and lauric acid [10]. It contains high amount (65%) of medium chain triglycerides (MCTs).
These MCTs are directly absorbed from the intestinal tract and sent directly to the liver and
doesn’t participate in the biosynthesis and transport of cholesterol [87] and, thereby provides
a quick source of energy. As a result, VCO was found to be effective against cholesterol
levels. VCO was found to reduce the total cholesterol, triglyceride, phospholipid, and LDL,
and increase the HDL in the serum and tissues [73]. In addition, the polyphenolic component
found in VCO was capable of reducing lipid levels and LDL significantly [74].
VCO was also reported to prevent hypertension and improves endothelial functions in
rats fed with repeatedly heated palm oil [88]. In another similar study, it was reported that
VCO supplementation demonstrated a cardioprotective effect by preventing an elevated blood
pressure when rats were fed with repeatedly heated palm oil [89]. VCO at a dose of 1.43
ml/kg reported protective effects on the vascular and cardiac tissue remodeling when rats
were fed with repeatedly heated palm oil [90].
The higher reaction polyphenols in VCO are responsible for its anti-inflammatory and
anti-oxidant effects and therefore helps in the prevention of cardiovascular disease and
atherosclerosis [60]. Animals fed with VCO were found to have better coagulation studies
with lower fibrin levels and better prothrombin time when compared with copra oil and
sunflower oil [12]. VCO administration to rats increased anti-oxidant activity and lowered
lipids and thrombotic factors compared to normal coconut oil [76].
In a prospective open label trial in humans, it was found that a 4-week supplementation
of VCO significantly reduced waist circumference and improved lipid profile and it is safe for
use in humans [91]. In another study, it was found that coconut oil consumption did not
elevate serum total cholesterol or serum triglycerides in a cohort of 1,839 Filipino women
[92].
As described in this section, the existing literature reports the cardiovascular health
benefits of VCO. However, evidence pertaining to VCO use is limited and more research in
this area is needed to definitively recommend dietary VCO to improve cardiovascular disease
risk.
5.5. Bone Loss Prevention
Oxidative stress and free radicals are implicated in the pathogenesis of osteoporosis.
Therefore, antioxidants are likely to prevent the disease. In one study, it was shown that VCO
effectively improved bone structure and prevented bone loss in osteoporosis rats and this
effect can be attributed to the polyphenols present in VCO [82]. Further, VCO
supplementation showed a significant improvement in the bone antioxidant status by
preventing lipid peroxidation and increasing levels of glutathione peroxidase and superoxide
dismutase enzymes in the osteoporotic rat model [81].
5.6. Antimicrobial Effects
VCO has a long history of use as an antibacterial agent. A history of safe topical use and
no known or reported cases of adverse effects opens up more possibilities of the use of VCO
against infections. VCO contains high quantities of MCFA like lauric acid, caproic acid, and
caprylic acid; studies have shown that these MCFA are responsible for its antibacterial,
antifungal, antiviral, and properties [93].
• Antibacterial activity. MCFAs and their derivatives are effective in destroying lipid-
coated bacteria by disintegrating their lipid membrane. The antimicrobial activity of
VCO might be due to an active compound monolaurin, which is a product of lauric
acid metabolization [94]. Lauric acid is the predominant fatty acid in the coconut oil
[95]. It is also present in breast milk and was found to helpsupport healthy growth in
breastfed infants and was shown to possess antimicrobial properties [96].
VCO and monolaurin have shown antibacterial effects on Staphylococcus aureus,
and can be useful in the proactive treatment of atopic dermatitis colonization [97].
Similarly, in pediatric patients with mild to moderate atopic dermatitis, a topical
application of VCO for 8 weeks was superior to that of mineral oil based on clinical
and instrumental assessments [98]. In contrast, VCO did not inhibit the growth of
Staphylococcus aureus and the morphology of Staphylococcus aureus cells exposed
to the oil was not different from that of the untreated cells. This effect might be
attributed to the low concentration of lauric acid (0.47 mg/ml) in VCO, which is
below the minimum inhibitory concentration (MIC) of lauric acid (1.6 mg/ml) [99].
Another study demonstrated the inhibition of growth of antibiotic resistant
Clostridium difficile mediated by MCFAs, which are derived from VCO [100].
Hydrolyzed VCO was more effective against Pseudomonas aeruginosa, while
unhydrolyzed VCO did not inhibit the bacterial growth [101]. In another study,
enzymatic hydrolysis of VCO inhibited growth of Salmonella species in in vitro and

in vivo studies [102].
• Antifungal activity. Since VCO is a rich source of MCFA, which possesses
antifungal activity, a study in Nigeria reported its effectiveness as an antifungal
agent, and compared its action to fluconazole, a first line of treatment against drug
resistant Candidaalbicans. The study concluded the oil to be very potent against
Candida species at 100% concentration when compared to fluconazole and therefore,
can be used in the treatment of fungal infections caused by Candidaspecies [42].
Capric acid was more effective against Candidaalbicans, while lauric acid was the
most active at lower concentrations.
• Antiviral activity. VCO was found to be effective against lipid-coated viruses, such
as Epstein-Barr Virus (EBV), influenza virus, leukemia virus, hepatitis C virus, and
Cytomegalovirus (CMV); it acts by disrupting viral membranes, assembly, and
maturation. Lauric acid has greater antiviral activity than caprylic acid, capric acid,
or myristic acid [103]. Monolaurin acts by solubilizing the lipids and phospholipids
in the envelope of the virus and, thereby causes disintegration of the envelope [53].
6.0. CONCLUSION
VCO is becoming popular as a functional food oil due to increasing public awareness
about its health benefits. VCO is obtained from the fresh, mature kernel (meat) of the coconut
by mechanical or natural means, with or without the use of heat, without undergoing chemical
refining, bleaching or de-odorizing process, which does not lead to the alteration of the nature
of the oil and preserves the essential amino acids, tocopherols (vitamin E) and other valuable
compounds present in coconut oil. Recently published literature about the health benefits of
VCO has been a boost for the growing demand of VCO.
VCO has a rich content of MCFAs, predominantly lauric acid and some SFAs with a
higher amount of myristic acid compared to other SFAs. The properties such as higher levels
of saponification, phenolic compounds and tocopherols and low iodine numbers and peroxide
values make VCO a potential healthy addition to the normal diet.
As discussed before, there are several methods by which one can produce VCO.
Accordingly, the quality and quantity of the final oil produced vary with the different
processing techniques employed for extraction. Also, the produced VCO possess varied
organoleptic characteristics. The high-pressure expelling method and Bawalan-Masa method
generally produce VCO with a longer shelf life of one year or more. The modified kitchen
method incurs a very low investment cost and is prone to rancidity development after five
days if moisture is not properly removed after extraction. A two-stage centrifuge process can
produce best quality VCO with coconut aroma. However, the best oil recovery is achieved
with a high pressure expelling method. Hence, in order to ensure that only high quality VCO
is produced, it is highly recommended adhering to the principles of good manufacturing
practices.
Different groups in animal models have evaluated the anti-inflammatory, analgesic and
antipyretic properties of VCO. VCO inhibits both acute and chronic inflammation in RA
induced animal models when used in high dose. In other studies, VCO also exhibited
moderate analgesic and antipyretic effect on acetic acid-induced pain and yeast-induced
hyperthermia, respectively. There are very few studies on the analgesic and antipyretic
activity of VCO and, thus, needs further investigation. These preliminary studies give
encouraging results to further exploit the therapeutic potential of VCO.
On the other hand, other studies proved that there are indeed beneficial antioxidant
properties in VCO. A diet enhanced with VCO may have potential health benefits as long as
the fatty acid content in the diet is moderated. Unadulterated VCO may also be richer in
antioxidants providing greater health benefits than RBD or other means of obtaining the
coconut oil. Of course, maintaining a proper balance of saturated fatty acids in the diet is
important and this should be kept in mind when VCO is included in dietary intake.
VCO with limited pharmacotherapeutic properties is gaining popularity in the modern
society. From the existing literature, there are many health benefits including cardioprotective
effects, bone loss prevention, antibacterial, antifungal, and antiviral effects. However, more
research is needed to provide conclusive evidence against clinical applications.
7.0. FUTURE DIRECTIONS

VCO is currently enjoying a great deal of positive press thanks to increased publicity
about its potential health benefits. Although it is being touted as the latest “superfood,” with
ascribed qualities that run the gamut from causing weight loss to fighting cancer, it is likely
that future research on VCO will focus on its anti-inflammatory properties. This is because
inflammation is now attracting attention from scientists as a potential unifying factor among
multiple diseases. Recent studies have shown that tissue degeneration due to chronic
inflammation plays a role in the pathogenesis of such different diseases as type 2 diabetes,
Alzheimer’s, and age-related macular degeneration [105]. While inflammatory mediators are
usually produced in response to cellular injury, they are also released from fat cells, which
explains the increased risk that overweight people face for a variety of conditions.
A 2016 study published in the neurology journal Brain showed that brain inflammation is
likely a driving factor behind Alzheimer’s disease, rather than simply an immune reaction
after brain pathology has already set in [106] Treatment of inflammation in Alzheimer’s mice
stalled their loss of neuronal connections, and improved their memory loss and behavioral
problems. However, treatment did not stop the progression of amyloid plaque buildup in the
mice’s brains. Interestingly, the results of this study dovetail with those of a 2015 study
published by the University of Valencia, which found that administration of 40 mL/day of
VCO to Alzheimer’s patients produced a statistically significant improvement in cognitive
status [107]. It is important to note, however, that this study ascribed the beneficial affects of
VCO to the cellular energy source, namely ketones, provided by its medium-chain
triglycerides. Other studies with similar results also prefer the ketogenic hypothesis to the
anti-inflammatory hypothesis [108]. Nevertheless, considering the novelty of the association
between Alzheimer’s disease and inflammation, it is likely that more light will be shed on
how much of a role VCO’s anti-inflammatory properties play in its therapeutic effects on
Alzheimer’s patients.
The ketogenic and oxidizing properties of VCO have also attracted attention in recent
years, particularly in the context of weight loss. The most recent example is the craze for so-
called “bulletproof coffee,” which was claimed to heighten alertness, suppress appetite, and
increase fat burning via ketosis, due to the addition of butter and medium-chain triglycerides
(often in the form of VCO). The current scientific standpoint towards bulletproof coffee is
one of skepticism, considering the variability of results and lack of formal research. However,
the potential association between weight loss/ketogenesis and VCO alone is a current hot
topic in research. A study due out in 2016 correlates a high-VCO diet with improvement in
hyperglycemia and dyslipidemia in high fructose-fed rats [109]. A 2014 study reported that
VCO significantly increased hepatic lipid metabolism and fatty acid oxidation compared to
copra oil [110]. Research in this area is ongoing.
In summary, the future directions of VCO research seem to focus most on its anti-
inflammatory and ketogenic/lipid oxidizing properties. Furthermore, both these areas of
research appear most popular in the context of treating Alzheimer’s disease and promoting
weight loss. While results for these topics of investigation remain preliminary, they are the
focus of nearly all the most recent papers published on the health effects of VCO. We may,
thus, anticipate that research into the correlation of VCO administration with inflammation,
lipid levels, weight loss, and Alzheimer’s is ongoing, and that more complete information is
forthcoming.
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Health beneﬁts of virgin coconut oil

Chapter · March 2016

Gerard Dumancas Lakshmi C. Kasi Viswanath

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HEALTH BENEFITS OF VIRGIN COCONUT OIL

Gerard G. Dumancas1,*, Lakshmi C. Kasi Viswanath1,

2.0. CHEMICAL PROPERTIES OF VCO

Extraction Method APCC

Extraction Method APCC

The saponification value, another important chemical characteristic, measuresthe average

3.0. SOURCES, SYNTHESIS, PREPARATION, AND USES OF VCO

3.2. Processing of VCO

3.2.1. Pre-processing Stage

3.2.2. Processing Stage

Figure 1. Methods of VCO processing.

A. Fresh Coconut Meat

(i) High Pressure Expelling Process

(ii) Fresh-Dry Low-Pressure Extraction Technique

(i) Modified Kitchen Method

(ii) Modified Natural Fermentation Method

(iii) Centrifuge Method

C. Coconut Milk Residue

The Bawalan-Masa Process

3.2.3. Post Processing Stage

3.3. Uses of VCO

• VCO serves as an important source of energy in diet [5].

• It is used as a skin and hair conditioner [17].

Synopsis of Health Benefits

• VCO is the only naturally available low-calorie fat [32].

Table 3. Comparative data of VCO obtained by different processes [5, 17]

Type of Process Quality of Oil Recovery

4.0. WORLDWIDE PRODUCTION OF VCO

4.2. Largest Producers of VCO

As previously mentioned, the studies conducted were located in a variety of different

4.3. Economic Benefits and Analysis of VCO

Figure 2. World coconut oil supply and distribution [52].

5.0. BENEFICIAL EFFECTS OF VCO

5.1.1. Anti-Inflammatory and Anti-Oxidant Properties of VCO Inanimal Models of

and progressively results to destruction of articular cartilage. Current medications used to

• Downregulated (inducible nitric oxide (NO) synthase) iNOS expression. Nitrite

5.1.2. Anti-Inflammatory Effect of VCO against E.Coli Endotoxin

5.1.3. Therapeutic Effect of VCO on Inflammatory Acne Vulgaris

5.2. Analgesic and Antipyretic Potential of VCO

5.2.1. Antipyretic Effect Effects of VCO on Yeast-Induced Hyperthermia in Rats

5.3. Antioxidant, Anti-Stress, and Anticancer Benefits

Mainstream popularity of VCO has led to misinformation regarding potential benefits

compounds comprised of reactive carbon-oxygen double bonds. Malondialdehyde (MDA) is

5.4. Cardioprotective Effects

5.5. Bone Loss Prevention

5.6. Antimicrobial Effects

enzymatic hydrolysis of VCO inhibited growth of Salmonella species in in vitro and

7.0. FUTURE DIRECTIONS

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