Health FAQs

  • Does palm oil contain vitamins?

    Palm oil is a rich source of fat-soluble vitamins, notably provitamin A (which is converted into vitamin A in the body) and vitamin E.

    Palm fruit oil, but not palm kernel oil, is one of the richest sources of fat-soluble vitamins. It contains very high concentrations of provitamin A (mainly beta- and alpha-carotenes) which is converted into vitamin A in the body. It is a rich source of vitamin E; its vitamin E activity is provided by alpha-tocopherol and tocotrienols, which are particularly high in palm fruit oil. It contains small amounts of vitamin K but no vitamin D. The carotenes are responsible for the red colour of crude palm oil. Red palm oil has been consumed in West Africa for thousands of years and is still popular in traditional dishes from the region. Refining removes the carotenes but not vitamin E. Carotenes are sometimes be added back to the refined palm oil to produce a refined red palm oil (e.g. CarotenoTM).

    Vitamin A deficiency disease is a major cause of blindness affecting children between the age of 1-6 particularly in India, South East Asia and Sub-Saharan Africa. Vitamin A deficiency also contributes to death from infectious diseases in children of this age group because vitamin A has an important role in supporting immune function. Incorporating red palm oil into foods such as biscuits has been shown in controlled clinical trials to help prevent vitamin A deficiency in children1.

    1 Dong S, Xia H, Wang F, Sun G. The Effect of Red Palm Oil on Vitamin A Deficiency: A Meta Analysis of Randomized Controlled Trials. Nutrients. 2017 Nov 24;9(12). pii: E1281.

  • Why is palm oil found in so many foods?

    Unlike palm oil, most vegetable oils are unsuitable for baking and margarine manufacture because of their very low melting points. Palm oil is also widely used commercially as a frying oil because of its stability to heat and longer life.

    Animal fats are favoured for baking because they melt in the range of 30-40°C providing the texture required. In the 1960s, butter, suet and lard were widely used in bakery products (e.g. bread, pastries, cakes and biscuits). In the 1970-80s, official dietary guidelines encouraged replacing animal fats with vegetable oil in order to decrease the intake of saturated fats. Most vegetable oils were unsuitable for baking and margarine manufacture because of their very low melting points. Consequently, liquid vegetable oils (typically soybean and rapeseed oil) were partially hydrogenated to produce fats with the desirable range of melting points containing less saturated fat but high amounts of trans fats. In the mid-1990s, these trans fats were found to increase the risk of heart disease. Nowadays, a technique called interesterification that does not produce trans fats is used to harden fats2. This process involves mixing blends of liquid and solid (“hard stock”) vegetable oils with enzymes that rearrange the molecular structure to give fats with melting points in the desirable range. It can be tailored to minimise the level of saturated fat in the product.

    Palm oil and palm kernel oil are widely used as “hard stock” to make trans-free fats. Palm oil mid-fraction has melting characteristics similar to cocoabutter and is widely used as a cocoabutter equivalent in the manufacture of chocolate. Palm oil is also widely used as commercial deep-frying oil because of its stability to heat and its longer life. Palm kernel oil is used in some specialised food applications to replace butter fat in products such as ice-cream, fillings in chocolate confectionery and non-dairy creamers. Food manufacturers and supermarkets have to reformulate the foods they produce and sell in order to accommodate the diverse needs of consumers which include those who wish to avoid animal fats for ethical or religious reasons. Consequently, the food industry prefers to use vegetable oils including palm oil.

    2 Mensink RP, Sanders TA, Baer DJ, Hayes KC, Howles PN, Marangoni A. The Increasing Use of Interesterified Lipids in the Food Supply and Their Effects on Health Parameters. Adv Nutr. 2016;7(4):719-29.

  • Does palm oil contain trans fats and why does this matter?

    Palm oil does not contain trans fats. The risk of dying from a heart attack is greater in people who consume high amounts of trans fats from industrial processing.

    Palm oil does not contain trans fats. The risk of dying from a heart attack is greater in people who consume high amounts of trans fats from industrially processed fats3,4.  Trans fats result from the hardening of vegetable oils using catalytic hydrogenation. The complete hydrogenation of vegetable oils, such as soybean and rapeseed oil, results in the formation of stearic acid (a saturated fatty acid) to form a very hard waxy fat, which lacks the melting characteristics desired for food preparation. Partial hydrogenation results in the formation of trans fatty acids which enables the production of fats with melting points in the desirable range (30-40 °C). The other major source of trans fatty acids is from the fat and milk of animals that chew the cud (e.g. cattle, sheep, goats) – these contain about 4% trans fatty acids. These animals have a specialised compartment in the digestive tract, called the rumen, where the oils present in grass and seeds are fermented by bacteria to form trans fats. These ruminant trans fats do not seem to be associated with an increased risk of heart disease3.

    In April 2019 the European Commission5 set a limit to the amount of trans fat content of vegetable oils to less than 2g/100g. Member states have until 2021 to comply with changes in the Regulation (EC) No 1925/2006.

    Much progress has been made in removing industrially produced trans fats from the food chain in Europe and this has been made possible by the increased use of palm oil as a source of higher melting point fats. In the UK, industrially produced trans fatty acids were effectively removed from the food chain by 2000. Thus, the use of palm oil has contributed to eliminating industrial trans fatty acids from the human food chain.

    3 Chowdhury R, Warnakula S, Kunutsor S, Crowe F, Ward Ha, Johnson L, Franco Oh, Butterworth AS, Forouhi NG, Thompson SG, Khaw KT, Mozaffarian D, Danesh J, Di Angelantonio E. Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Ann, Intern Med. 2014;160(6):398-406.

    4 De Souza RJ, Mente A, Maroleanu A, Cozma AI, Ha V, Kishibe T, Uleryk E, Budylowski P, Schünemann H, Beyene J, Anand SS. (2015) Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ. 351:h3978

    5 European Commission. Commission Regulation amending Annex III to Regulation (EC) No 1925/2006 of the European Parliament and of the Council as regards trans fat, other than trans fat naturally occurring in fat of animal origin.

  • Is palm oil liquid or solid?

    Crude palm oil has a melting point of around 36°C: close to body temperature.

    Crude palm oil has a melting point (36°C – range 33.8 -39.2°C) close to body temperature. In cool temperatures some of the fat crystallises to form a soft but not solid fat. However, refined, bleached and deodorised (RBD) palm oil is liquid at room temperature in countries such as Malaysia and Indonesia and can be poured from bottles.

    Palm oil is often fractionated into palm olein (80%) and palm stearin (20%). Palm olein has a melting point less than 24°C typically around 12-15°C and in temperate climates it remains in the liquid state in a bottle. Palm stearin has a higher melting point in excess of 44°C and is solid at room temperature and is typically sold wrapped in paper. Palm oil mid-fraction has a very sharp melting point between 35-36°C and is used as chocolate confectionery fat. Palm kernel oil is a soft fat with a melting point range of 28-30°C.

  • Does eating palm oil increase risk of heart attack?

    There are no studies showing that people who consume palm oil are more likely to have a heart attack.

    Most of the research on dietary fats in relation to risk of cardiovascular disease (including heart attacks and stroke) has been conducted in North America and Europe in the 1960-1980s. It was proposed that a diet high in saturated fat and low in polyunsaturated fat and high in cholesterol was linked to raised blood cholesterol levels and subsequently increased risk of a heart attack. The high intakes of saturated fat and cholesterol were derived mainly from meat, dairy foods and eggs not from palm oil. More recent analysis of long-term follow-up studies comparing usual intakes of saturated fat and subsequent risk of suffering a heart attack in many thousands of men and women finds no association between saturated fat intake and risk of cardiovascular disease3,4.

    The strong positive association between blood cholesterol levels and the risk of a heart attack particularly under the age of 60 years has been confirmed by many studies. It is now recognised that genetics plays a much greater role in determining high blood cholesterol levels than saturated fat intake. Familial hypercholesterolemia affects about 1 in 250 people and if untreated they have a 25 times greater risk of developing CHD under the age of 60. In people with familial hypercholesterolaemia, reducing saturated fat intake has very little effect on their blood cholesterol levels and drug treatment is far more effective6.

    In the 1960-1980s several large trials were carried out to test whether reducing the intake of saturated fat in the diet cut the risk of dying from a heart attack. Most were conducted mainly in the USA but also in Europe and Australia and many were in men who had already suffered a heart attack. These studies failed to show that eating less saturated fat reduced the risk of dying from a heart attack. However, there was a trend for fewer non-fatal heart attacks when the intake of polyunsaturated fatty acid (soybean oil, corn oil and margarines made from these oils) replaced saturated fatty acids (provided by butter and lard). Reducing the intake of saturated fat and replacing it with carbohydrate did not reduce risk of a heart attack7,8. No further trials have been conducted since and are unlikely to be conducted in future in view of the enormous cost required to recruit many thousands of participants needed to demonstrate any effect as well as the difficulties controlling dietary intake over many years.

    In most economically developed countries, death rates from heart disease have fallen from the peak in 1960-70s for reasons that remain uncertain but smoking cessation and better treatment have played an important part. In North American, Western Europe and Australia the intakes of saturated fats, mainly of animal origin, fell from about 20% of the energy intake in the 1960’s to around 11-13% by the 1990s, with no further change in saturated fat intake in the last 25 years. Yet death rates from cardiovascular disease have continued to fall. This is well illustrated by the UK statistics collected by the British Heart Foundation9. Age standardised death rates for coronary heart disease fell from 469.1/100,000 in 1975 to 333.7/100,000 in 1994; over the same time period the intake of saturated fat fell from 53 g/d to 36 g/d. Coronary heart disease deaths fell even more steeply from 1994 to 106.9/100,000 in 2017 yet saturated fat intakes remained unchanged.

    The World Health Organisation10 as well as the UK government11 continues to recommend that total fat should provide no more than 30-35% of energy intake and that saturated fatty acids should account for no more than 10% of the energy intake, which is equivalent to an intake of 22 g/d for women and 28 g/d for men. The main sources of saturated fatty acids in Western diets are meat and dairy produce; vegetable oils only make a minor contribution.  However, despite its relatively high saturated fatty acid content compared to other vegetable oils, palm oil is a useful ingredient supplying high melting fats used to make healthier spreads free of trans fats with a reduced saturated fat content including those that actively lower blood cholesterol because of their contents of plant sterols (e.g. Flora Pro-ActivTM).

    In contrast to the falling rates of heart disease in developed economies, death rates from heart disease have been increasing in middle-income (e.g. Russia and former Eastern Bloc countries) and emerging economies (China, India). A large prospective cohort study called PURE 12 has been undertaken over the past two decades in middle-income and emerging economies, including Malaysia where palm oil is widely consumed. This study finds no relationship between saturated fat intake and risk of heart attack. These findings support the conclusion that the consumption of palm oil does not increase the risk of a heart attack.

    3 Chowdhury R, Warnakula S, Kunutsor S, Crowe F, Ward Ha, Johnson L, Franco Oh, Butterworth AS, Forouhi NG, Thompson SG, Khaw KT, Mozaffarian D, Danesh J, Di Angelantonio E. Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Ann, Intern Med. 2014;160(6):398-406.

    4 De Souza RJ, Mente A, Maroleanu A, Cozma AI, Ha V, Kishibe T, Uleryk E, Budylowski P, Schünemann H, Beyene J, Anand SS. (2015) Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ. 351:h3978

    6 Soran H, Adam S, Durrington PN. Optimising treatment of hyperlipidaemia:Quantitative evaluation of UK, USA and European guidelinestaking account of both LDL cholesterol levels and cardiovascular disease risk. Atherosclerosis. 2018;278:135-142.

    7 Hooper L, Martin N, Abdelhamid A, Davey Smith G. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev. 2015;(6):CD011737.4

    8 Thornley S, Schofield G, Zinn C, Henderson G. How reliable is the statistical evidence for limiting saturated fat intake? A fresh look at the influential Hooper meta-analysis. Intern Med J. 2019;49(11):1418-1424.

    9 British Heart Foundation. Heart Statistics. https://www.bhf.org.uk/what-we-do/our-research/heart-statistics accessed 6/12/2019.

    10 World Health Organisation. Healthy Diets. https://www.who.int/news-room/fact-sheets/detail/healthy-diet accessed 6/12/2019.

    11Scientific Advisory Committee on Nutrition. Saturated fats and health: SACN report. https://www.gov.uk/government/publications/saturated-fats-and-health-sacn-report accessed 6/12/2019.

    12 Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V, Iqbal R, Kumar R, Wentzel-Viljoen E, Rosengren A, Amma Li, Avezum A, Chifamba J, Diaz R, Khatib R, Lear S, Lopez-Jaramillo P, Liu X, Gupta R, Mohammadifard N, Gao N, Oguz A, Ramli As, Seron P, Sun Y, Szuba A, Tsolekile L, Wielgosz A, Yusuf R, Hussein Yusufali A, Teo Kk, Rangarajan S, Dagenais G, Bangdiwala Si, Islam S, Anand Ss, Yusuf S; Prospective Urban Rural Epidemiology (PURE) study investigators. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet. 2017;390(10107):2050-2062.

  • Can eating palm oil put you at risk of diabetes?

    No. There is no evidence that consuming palm oil directly or in the diet are involved in causing diabetes.

    There are two main types of diabetes. Type 1 diabetes results from a failure to produce insulin which controls blood sugar levels. Onset typically occurs in childhood but can also occur later in adult life. It is regarded as an autoimmune disease and is treated by insulin injections. There is no evidence that dietary intake or consuming palm oil are involved in the causation of type 1 diabetes.

    Type 2 diabetes which is much more common results from resistance to the action of insulin and typically has its onset in middle-age. It is strongly linked to obesity and low physical inactivity and can be reversed in the early stages by weight loss and regular physical activity. Neither total nor saturated fat intakes are related to risk of developing type 2 diabetes4. Diabetes can also develop among individuals of normal weight in later life because they produce insufficient amounts of insulin to control their blood sugar. In these individuals reducing the amount of carbohydrate consumed in the diet can improve blood sugar levels. Controlled experiments have tested whether palm oil or diets containing palm oil have adverse effects on risk of developing type 2 diabetes in both normal weight13 and obese14 individuals. These find no effect of palm oil on blood sugar levels, insulin secretion, or sensitivity to the action of insulin.

    4 De Souza RJ, Mente A, Maroleanu A, Cozma AI, Ha V, Kishibe T, Uleryk E, Budylowski P, Schünemann H, Beyene J, Anand SS. (2015) Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ. 351:h3978

    13 Filippou A, Teng KT, Berry SE, Sanders TA. Palmitic acid in the sn-2 position of dietary triacylglycerols does not affect insulin secretion or glucose homeostasis in healthy men and women. Eur J Clin Nutr. 2014;68(9):1036-41.

    14 Jebb SA, Lovegrove JA, Griffin BA, Frost GS, Moore CS, Chatfield MD, Bluck LJ, Williams CM, Sanders TA; RISCK Study Group. Effect of changing the amount and type of fat and carbohydrate on insulin sensitivity and cardiovascular risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) trial. Am J Clin Nutr. 2010;92(4):748-58.

  • How does palm oil affect gut health?

    Palm oil has no adverse effect on gut health and there is no evidence that its consumption is associated with cancer or other diseases of the bowel.

    Palm oil is well digested15. It has no adverse effects on gut health. There is no evidence to suggest that the consumption of palm oil is associated with risk of developing colorectal cancer or pancreatic cancer or inflammatory diseases of the digestive tract such as Crohn’s disease, ulcerative colitis and irritable bowel disease.

    15 Sanders TA, Filippou A, Berry SE, Baumgartner S, Mensink RP. Palmitic acid in the sn-2 position of triacylglycerols acutely influences postprandial lipid metabolism. Am J Clin Nutr. 2011;94(6):1433-41.

  • Does eating palm oil lead to weight gain?

    Palm oil is no more fattening than other vegetable oils such as soybean, sunflower and rapeseed oil.

    Palm oil in common with other vegetable oil provides 9 kcal/g. Palm kernel oil provides slightly fewer calories per gram because of its high content of medium chain fatty acids. Palm oil is no more fattening than other vegetable oils such as soybean, sunflower and rapeseed oil.

    Weight gain results when energy intake exceeds energy needs. Dietary fats contain more than twice as much energy per gram as carbohydrates or protein. This means that the addition of fat to a food has a disproportionate effect on the number calories/g. For example, dipping a slice of bread in oil will double the number of calories consumed. When energy needs are high this can be advantageous. Energy intakes are low in parts of Asia and Sub-Saharan Africa and this is one reason why the growth of children is stunted. In those countries, palm oil can play an important role in meeting energy intakes, facilitating the absorption of fat-soluble vitamins and supporting normal growth in children.  Palm oil is also ideally suited for these countries because it is heat stable and can also be stored for long periods at ambient temperature. However, fats and oils need to be consumed in moderation in well-nourished populations in order to avoid unhealthy weight gain.

  • Is it unhealthy to use palm oil for frying food?

    Palm oil has a neutral taste and is the most heat-stable vegetable oil: it can be re-used for several days without deterioration in quality.

    Deep fat frying is a very effective means of cooking food and leads to minimal losses of nutrients. Palm oil is the most heat-stable vegetable oil and can be re-used for several days without deterioration in quality. Palm oil has a neutral taste and does not develop off-flavours which happens with oils with a high polyunsaturated fatty acid content such as soybean, maize and sunflower oils, particularly if they are used more than once.

    Deep fried foods will have a high calorie content if they take up a lot of oil. This is particularly a problem for vegetables and starchy foods which can soak up oil rather than for meat or fish.  The uptake of oil by food can be reduced by frying at 180°C and not cooking vegetables from frozen because this cools the frying medium down and allows oil to soak in. Reducing relative surface area of the food being cooked also helps. Large potato chips cooked at the correct temperature only take up 4-5% fat whereas French fries will take up 15% fat.

  • What is the effect of palm oil on blood cholesterol?

    There is no reduction in risk of cardiovascular disease, based on measured cholesterol, from replacing dietary saturated fatty acids, such as palm oil, with carbohydrates.

    Cholesterol is carried in blood mainly by low density lipoprotein (LDL) but about a quarter is carried by high density lipoprotein (HDL). Increasing levels of LDL cholesterol are associated with increased risk of cardiovascular disease but higher levels of HDL cholesterol confer a lower risk. The ratio of LDL/HDL cholesterol or the ratio of total/HDL cholesterol is often used as an index of risk of cardiovascular disease. Blood total and LDL cholesterol levels increase in middle-age. Well controlled longer term dietary feeding studies in large numbers of middle-aged and older adults (Jebb et al. 2014; Reidlinger et al. 2015) show that replacing saturated fatty acids with carbohydrates modestly lowers both low density lipoprotein (LDL) fraction as well as the beneficial high density lipoprotein (HDL) fraction but has no effect on the ratio of LDL/HDL or total/HDL cholesterol ratio i.e. no benefit would be expected.  Only saturated fatty acids that are 12-16 carbon atoms long have any effect on blood cholesterol. The most common ones found in food and also palm fruit oil are palmitic acid (16 carbon atoms long) long and stearic acid (18 carbon atoms long).

    Oleic acid, a monounsaturated fatty acid, and palmitic acid are the two major fatty acids in palm oil. Both these fatty acids are physiologically essential components of all cell membranes in the human body, are key intermediates in fatty acid metabolism, and are present in all fats and oils. The relative proportions of these two fatty acids differs between varieties of oil palm. The American oil palm Elaeis oleifera has relatively more oleic acid and less palmitic acid than the African oil palm Elaeis guineensis. High oleic palm oil is produced from a cross between Elaeis guineensis and Elaeis oleifera  and contains as much as 60% oleic acid and only 23% palmitic acid as opposed to roughly equal proportions in Elaeis guineensis. Palm olein also contains more oleic acid and less palmitic acid than crude palm oil whereas palm stearin contains more palmitic acid and less oleic acid.

    Controlled human feeding studies (Fillipou et al. 2014; Fattore et al. 2014) found that palmitic acid provided as palm oil resulted in a small increase (0.044 mmol/L) in plasma low-density lipoprotein (LDL) cholesterol concentrations compared with oleic acid for each 1% energy exchanged. Palm kernel oil contains more medium chain fatty acids (8-14 carbon atoms long) and is similar in composition to coconut oil and only a few studies have examined its effects on blood cholesterol. However, a recent UK study found that coconut oil did not differ from olive oil with regard to its effects on blood cholesterol (Khaw et al. 2018). The impact on blood cholesterol level of exchanging palm olein with olive oil at a relatively highly level of intake (30-40g/d) has recently been evaluated in a large study in Chinese factory workers (Sun et al. 2018). This study found no differences in blood cholesterol or its fractions compared with olive oil.

  • References

    1 Dong S, Xia H, Wang F, Sun G. The Effect of Red Palm Oil on Vitamin A Deficiency: A Meta Analysis of Randomized Controlled Trials. Nutrients. 2017 Nov 24;9(12). pii: E1281.

    2 Mensink RP, Sanders TA, Baer DJ, Hayes KC, Howles PN, Marangoni A. The Increasing Use of Interesterified Lipids in the Food Supply and Their Effects on Health Parameters. Adv Nutr. 2016;7(4):719-29.

    3 Chowdhury R, Warnakula S, Kunutsor S, Crowe F, Ward Ha, Johnson L, Franco Oh, Butterworth AS, Forouhi NG, Thompson SG, Khaw KT, Mozaffarian D, Danesh J, Di Angelantonio E. Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Ann, Intern Med. 2014;160(6):398-406.

    4 De Souza RJ, Mente A, Maroleanu A, Cozma AI, Ha V, Kishibe T, Uleryk E, Budylowski P, Schünemann H, Beyene J, Anand SS. (2015) Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ. 351:h3978

    5 European Commission. Commission Regulation amending Annex III to Regulation (EC) No 1925/2006 of the European Parliament and of the Council as regards trans fat, other than trans fat naturally occurring in fat of animal origin.

    6 Soran H, Adam S, Durrington PN. Optimising treatment of hyperlipidaemia:Quantitative evaluation of UK, USA and European guidelinestaking account of both LDL cholesterol levels and cardiovascular disease risk. Atherosclerosis. 2018;278:135-142.

    7 Hooper L, Martin N, Abdelhamid A, Davey Smith G. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev. 2015;(6):CD011737.4

    8 Thornley S, Schofield G, Zinn C, Henderson G. How reliable is the statistical evidence for limiting saturated fat intake? A fresh look at the influential Hooper meta-analysis. Intern Med J. 2019;49(11):1418-1424.

    9 British Heart Foundation. Heart Statistics. https://www.bhf.org.uk/what-we-do/our-research/heart-statistics accessed 6/12/2019.

    10 World Health Organisation. Healthy Diets. https://www.who.int/news-room/fact-sheets/detail/healthy-diet accessed 6/12/2019.

    11Scientific Advisory Committee on Nutrition. Saturated fats and health: SACN report. https://www.gov.uk/government/publications/saturated-fats-and-health-sacn-report accessed 6/12/2019.

    12 Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V, Iqbal R, Kumar R, Wentzel-Viljoen E, Rosengren A, Amma Li, Avezum A, Chifamba J, Diaz R, Khatib R, Lear S, Lopez-Jaramillo P, Liu X, Gupta R, Mohammadifard N, Gao N, Oguz A, Ramli As, Seron P, Sun Y, Szuba A, Tsolekile L, Wielgosz A, Yusuf R, Hussein Yusufali A, Teo Kk, Rangarajan S, Dagenais G, Bangdiwala Si, Islam S, Anand Ss, Yusuf S; Prospective Urban Rural Epidemiology (PURE) study investigators. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet. 2017;390(10107):2050-2062.

    13 Filippou A, Teng KT, Berry SE, Sanders TA. Palmitic acid in the sn-2 position of dietary triacylglycerols does not affect insulin secretion or glucose homeostasis in healthy men and women. Eur J Clin Nutr. 2014;68(9):1036-41.

    14 Jebb SA, Lovegrove JA, Griffin BA, Frost GS, Moore CS, Chatfield MD, Bluck LJ, Williams CM, Sanders TA; RISCK Study Group. Effect of changing the amount and type of fat and carbohydrate on insulin sensitivity and cardiovascular risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) trial. Am J Clin Nutr. 2010;92(4):748-58.

    15 Sanders TA, Filippou A, Berry SE, Baumgartner S, Mensink RP. Palmitic acid in the sn-2 position of triacylglycerols acutely influences postprandial lipid metabolism. Am J Clin Nutr. 2011;94(6):1433-41.

     

    Jebb SA, Lovegrove JA, Griffin BA, Frost GS, Moore CS, Chatfield MD, Bluck LJ, Williams CM, Sanders TA; RISCK Study Group. Effect of changing the amount and type of fat and carbohydrate on insulin sensitivity and cardiovascular risk: the  RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) trial. Am J Clin Nutr. 2010;92(4):748-58.

    Fattore E, Bosetti C, Brighenti F, Agostoni C, Fattore G. Palm oil and blood lipid-related markers of cardiovascular disease: a systematic review and meta-analysis of dietary intervention trials. Am J Clin Nutr. 2014 ;99(6):1331-50.

    Filippou A, Teng KT, Berry SE, Sanders TA. Palmitic acid in the sn-2 position of dietary triacylglycerols does not affect insulin secretion or glucose homeostasis in healthy men and women. Eur J Clin Nutr. 2014;68(9):1036-41.

    Khaw KT, Sharp SJ, Finikarides L, Afzal I, Lentjes M, Luben R, Forouhi NG. Randomised trial of coconut oil, olive oil or butter on blood lipids and other cardiovascular risk factors in healthy men and women. BMJ Open. 2018;8(3):e020167.

    Reidlinger DP, Darzi J, Hall WL, Seed PT, Chowienczyk PJ, Sanders TA; Cardiovascular disease risk reduction study (CRESSIDA) investigators. How effective are current dietary guidelines for cardiovascular disease prevention in healthy middle-aged and older men and women? A randomized controlled trial. Am J Clin Nutr. 2015 May;101(5):922-30.

    Sun G, Xia H, Yang Y, Ma S, Zhou H, Shu G, Wang S, Yang X, Tang H, Wang F, He Y, Ding R, Yin H, Wang Y, Yang Y, Zhu H, Yang L. Effects of palm olein and olive oil on serum lipids in a Chinese population: a randomized, double-blind, cross-over trial. Asia Pac J Clin Nutr. 2018;27(3):572-580.