Coconut consumption and cardiovascular disease incidence, is there an association? a case control study in Sri Lankan population

Abstract

INTRODUCTION & OBJECTIVES: Consumption of coconut and its products is reported to be associated with an increased risk of cardiovascular disease (CVD). This study was conducted to determine if there is an association between coconut consumption (oil and coconuts) and CVD incidence among Sri Lankans who are known to consume a large amount of coconut-based products. METHODS: A hospital based case control study was conducted at the Colombo North Teaching Hospital, Ragama, Sri Lanka comprising 176 cases and 148 controls. Previously healthy patients admitted with a first incident Acute Coronary Syndrome (ACS) or a Cerebrovascular Event (stroke) were recruited as cases and patients with no previous history of CVD or diabetes mellitus were recruited from surgical wards as controls. There were 136 ACS and 40 Stroke patients as cases. An interviewer-administered questionnaire was used to estimate the average consumption of coconut (nuts and oil) and to obtain information on risk factors of CVD. Descriptive analysis and multiple logistic regression analysis were conducted using SPSS. RESULTS: The mean (+SD) age of cases and controls were 57.68 +8.91 and 56.05 +10.02, respectively (p=0.192). Mean (+SD) coconut nut consumption per person per week was 1.97 +0.81 in cases and 2.11 +1.01 nuts in controls (P=0.66). Coconut oil use for cooking was 88.44 +61.6 ml/person/week in cases and 81.4 +51.52 ml/person/week in controls (p=0.175). 91.5% cases and 98% controls used coconut oil for cooking. Coconut oil use was protective for cases (OR:0.197, 95% CI:0.052-0.744) while number of sedentary hours per day (OR:1.11, 95% CI: 1.044-1.188) and family history of IHD (OR:2.293, 95%CI:1.318-3.991) and stroke (OR:2.275, 95%CI:1.268-4.082) were significant risk factors after adjusting for each other and for the amount of oil used per person per week, number of coconuts used per person per week, family history of NCD, being current smokers and consumers of alcohol. CONCLUSION: There was no evidence of an association between coconut consumption and incidence of cardiovascular disease or stroke. Use of coconut oil had a protective effect on the incidence of cardiovascular disease.