The relationships between dietary C12:0 saturated

fatty acid (SFA) intake and circulating cholesterol

and waist circumference
Grace Flowers, Natalie Gavi, Antoinette Kruger, Jaime Ruisi
Dietetic Interns I Graduate Programs in Human Nutrition

Background

Heart disease is the leading cause of death in the United States

People with high circulating cholesterol concentrations
(>200mg/dl) are twice as likely to develop heart disease
Modifiable factors: saturated fat intake, exercise
Medium chain fatty acids (MCFA) are processed differently than
long chain fatty acids and may promote weight loss and reduce
adipose tissue deposition
As a result, products higher in MCFA, such as coconut oil, have
gained popularity due to purported health benefits

Background

Few studies have examined the relationship between coconut oil

consumption and cholesterol levels or body fat
Coconut oil is high in the MCFA SFA C12:0 (45%), which may
increase circulating LDL cholesterol concentrations
Due to the increase in popularity of coconut oil, it is important to
look at the effects SFA C12:0 has on cholesterol, body fat and
waist circumference

Specific Aims/Hypotheses

Research Question: Is increased dietary SFA C12:0 intake, a

marker of coconut oil intake, associated with increased circulating
non-HDL cholesterol concentration and waist circumference in
healthy adults aged 18-40 years old?
Specific Aim: To examine the relationship between SFA C12:0 and
circulating non-HDL cholesterol concentrations and waist
circumference using NHANES 2011-2012 data.
Hypothesis: Dietary intake of SFA C12:0 will be positively correlated
with non-HDL cholesterol concentrations, total cholesterol:HDL
cholesterol ratio, and waist circumference.

Methods
Cross-sectional study design using NHANES 2011-2012 data
Healthy adults age 18-40 years old
2, 24-hour dietary recalls used to analyze dietary SFA C12:0 intake
Total-, HDL- and LDL-cholesterol concentrations and anthropometric
measurements (height, weight, waist circumference) collected at MEC
Cholesterol calculations:
Total cholesterol - HDL cholesterol = Non-HDL cholesterol
Total cholesterol:HDL cholesterol ratio

Data Analysis
Participants divided into quartiles based on dietary SFA C12:0 intake
ANOVAs used to determine significant differences between quartiles:
Mean total cholesterol concentrations
Mean LDL cholesterol concentrations
Mean total cholesterol:HDL cholesterol ratio
Mean waist circumference
Correlation analysis & linear regression analysis in total sample between
SFA C12:0 and:
Non-HDL cholesterol
HDL-cholesterol
Total cholesterol
Total cholesterol:HDL cholesterol ratio
Waist circumference.

Figure 1. Data Exclusion

Starting data set
n=9756
Age 18-40
n=2367
No missing data
n=839
No cholesterol medication
n=824
No history of liver disease,
cancer, prediabetes
n=779

Removed participants >40

and <18 y
Removed participants with
missing dietary data
Removed participants taking
cholesterol-lowering meds
Removed participants with
liver disease, cancer, or
prediabetes

Removed pregnant women

Nonpregnant
n=767
Fair health or better
n=702

Removed participants with

health ranked less than fair

Table 1. Subject Characteristics

Gender
Characteristic

Male
(n=387)

Female
(n=315)

Mean Age (yr)

28.1 6.7

27.6 6.8

Mean Weight (kg)

84.5 20.6

72.2 20.3

Mean BMI (kg/m2)

27.3 5.8

27.1 7.1

Mean Waist
Circumference
(cm)

94.0 15.8

89.6 16.6

*Values represent mean SD

Table 2. Mean Energy, CHO, Protein, and Fat

Intake by Quartile
1st Quartile

2nd Quartile

3rd Quartile

4th Quartile

Mean Energy Intake (kcal)

1667 605

2083 670

2348 751

2772 1002

Mean CHO Intake (g)

216 91

257 91

288 99

339 127

Mean Protein Intake (g)

69 33

86 31

92 39

103 40

Mean SFA12:0 Intake (g)

0.15 0.08

0.38 0.06

0.68 0.12

1.72 1.34

Mean Total Fat Intake (g)

54.1 23.6

75.7 31.1

88.5 31.8

108.0 44.8

Mean Sat Fat Intake (g)

14.2 6.1

23.1 8.4

29.6 9.7

38.3 15.7

Mean MUFA Intake (g)

19.9 9.7

27.5 12.6

31.3 12.9

37.2 16.5

Mean PUFA Intake (g)

15.3 7.9

18.7 10.1

20.1 9.8

23.6 12.6

*Values represent mean SD

Table 2. Mean Serum Cholesterol and Waist

Circumference by Quartile
1st Quartile

2nd Quartile

3rd Quartile

4th Quartile

Mean LDL Cholesterol

(mg/dL)

106.8 33.4

106.4 31.6

110.0 32.0

109.9 31.9

Mean non-HDL
Cholesterol (mg/dL)

128.6 39

128.3 36.5

130.7 35.9

131.2 36.4

Mean Total Cholesterol

(mg/dL)

181.1 38.5

179.5 36.9

183.1 35.8

181.1 38.0

Mean Total
Cholesterol:HDL
Cholesterol Ratio

3.70 1.30

3.74 1.19

3.66 1.06

3.77 0.99

Waist Circumference (cm)

91.2 16.2

93.5 16.7

90.5 15.8

93.1 16.5

*Values represent mean SD

**No significant difference between quartiles found (p<0.05)

Results: Correlation Analysis & Linear

Regression Analysis
Average SFA C12:0 Intake vs. Total
Serum Cholesterol

Average SFA C12:0 Intake vs. Total

Cholesterol:HDL Cholesterol Ratio
18

Average SFA C12:0 Intake (g)

Average SFA C12:0 (g)

18

15

12

y = 0.0008x + 0.5785
R = 0.00102
R = 0.03194

15

12

y = -0.0151x + 84.334
R = 0.00021
R = 0.01449

0
0

100

200

300

400

Total Cholesterol (mg/dL)

500

10

Total Cholesterol:HDL Cholesterol Ratio

Results: Correlation Analysis & Linear

Regression Analysis
Average SFA C12:0 Intake vs. Serum
HDL Cholesterol

18

Average SFA C12:0 Intake (g)

Average SFA C12:0 Intake (g)

Average SFA C12:0 Intake vs. Serum

Non-HDL Cholesterol

15
12
9

y = 0.0012x + 0.5748
R = 0.00206
R = 0.04539

6
3
0

18
15
12
9

y = 0.0033x + 81.176
R = 9.7E-06
R = 0.00311

6
3
0

50

100

150

200

250

300

Serum non-HDL Cholesterol (mg/dL)

350

20

40

60

80

100

120

Serum HDL Cholesterol (mg/dL)

140

Results: Correlation Analysis & Linear

Regression Analysis
Average SFA C12:0 Intake vs. Waist
Circumference

Average SFA 12:0 Intake (g)

18

15

12

y = 0.0014x + 0.6062
R = 0.00051
R = 0.02258

0
0

40

80

120

Waist Circumference (cm)

160

200

Strengths and Limitations

Strengths
Large sample size
Analyzed multiple risk factors
Among one of first cross-sectional studies to examine
relationship between C12:0 intake and blood cholesterol
concentrations
Potential problems and limitations
Cannot determine cause and effect relationship between C12:0
and blood cholesterol levels and waist circumference
Unable to control select variables
Potentially inaccurate data from dietary recalls
Actual coconut oil consumption not measured

Conclusion

SFA C12:0 consumption is not associated with circulating non-HDL

concentrations or waist circumference
Increased interest and demand for coconut oil calls for additional
research studies to allow consumers to make informed decisions
This study adds to the literature review and may create interest for
additional research to be conducted regarding SFA C12:0,
specifically from coconut oil

Conclusion

Control specific variables such as SFA C12:0 intake from coconut

oil and other coconut products, total fat consumption, total energy
consumption, and total exercise
This study is a good foundation for stronger future research studies
to build upon to help dietitians confidently deliver evidence-based
responses to consumer questions

Acknowledgement

We would like to thank Dr. Stadler for her aid and direction
during the research process.

Contact
Grace Flowers
(334)797-3504
flowersg@ohsu.edu
Natalie Gavi
(847)687-3527
gavi@ohsu.edu
Antoinette Kruger
(310)529-7700
krugera@ohsu.edu
Jaime Ruisi
(516)476-8549
ruisi@ohsu.edu