Assessment of Knowledge About Effects of Coconut Oil on Human Health Among Students of Hail University

For several years, Consumers were made to believe that coconut oil is deleterious to health as it would block the arteries and cause heart disease. In recent years Coconut oil is receiving attention as a Functional food oil and its consumption has dramatically risen. Coconut oil has been claimed to have beneficial effects on health. There are rarely published studies from Saudi Arabia exploring the awareness about benefits or risks of coconut oil. The objective of the present work is to evaluate the knowledge of students of Hail University about the effects of coconut oil on health with a comparison between females (scientific and Literary College) and males (scientific and Literary College). Also, this report aims to review the available literature about benefits and risks of coconut oil consumption and highlight its positive effects on health. Results of the present study was concluded that students of University have a moderate knowledge about effect of coconut oil on human health but the knowledge of female students more than male students. Comparison between students of scientific College and Literary College in level of knowledge about healthy importance of coconut oil show a none significant difference in all questions. The present work concluded that coconut oil is the best oil for health and reported the need to increase the knowledge of students about beneficial of coconut oil by distributing booklets or by health education program to highlight its positive effects on health and correct their thinking that coconut oil is harmful.


Introduction
Coconut have used by tropical countries from the tree which known as Cocos Nucifera. This tree known as the "Tree of Life" In Philippines. It has many nutritional and medicinal properties and has gained new found interest in western medicine. In India and China Coconut oil used as food, as cosmetic and to cure illness as far back as 4,000 years ago. However, for several years, consumers were believed that coconut oil is bad to human health because it accumulates in arteries causing heart disease. Coconut oil is now receiving attention as a functional food oil and its consumption has dramatically risen in recent years especially, virgin coconut oil (VCO). [1][2][3][4]

Coconut Oil Properties
Coconut oil is the best oil in the world for food, medicine and cosmetic due to the following properties:

Saturated Fatty Acids (SFAs)
Recent research found that the highest percentage of SFAs present in Coconut oil is a good property and added advantage to it to be healthy. Due to this property coconut oil is not normally hydrogenated, stabilized and not replaced by oxygen atom which create bad free radicals for human health. [5][6][7]

Medium Chain Fatty Acids (MCFAs)
Coconut oil has 62% of MCFAs so that it broken down without pancreatic enzyme. It absorbed into the intestine and enters the liver where it is burned into energy. Consequently, all consumed food containing coconut oil are catabolized to release energy without conversion to fat. [5][6][7]

Antimicrobial Property
Lauric acid, capric acid, caprylic acid, and caproic acid are the Medium Chain Fatty Acids present in coconut oil. In the body, they transformed into monolaurin, monocaprin, monocaprylin, and monocaproin which are monoglycerides. These compounds kill pathogenic microorganisms and provide immunity especially during the first six months of life. [8][9][10]

Antioxidants Property
Vitamin E, phytosterols and phenolic compounds are antioxidants present in coconut oil and give it antioxidant property. These compounds prevent the formation of free radicals which are harmful to health. [11]

Heart Disease
Recent Studies found that taking coconut oil improve total, LDL and HDL cholesterol levels which are the risk factors of heart disease. Saturated fats of Coconut oil increase "good" HDL cholesterol and convert "bad" LDL cholesterol into a less harmful form. Addition of coconut oil to diets increases the high-density lipoprotein (HDL -good cholesterol) which protect against heart disease and improves cholesterol levels. [12][13][14][15][16][17]

Cancer
Coconut oil plays an important role in preventing cancer. It protects the body from harmful effect of free radicals due to its content of antioxidants. It protects from cancer-causing pathogens or their toxins due to its content of antimicrobial agents. It inhibits the growth of cancerous cells and increasing immunity of the body. [18][19][20]

Diabetes
Recent studies found that, Coconut oil has several roles in preventing diabetes. Coconut oil in the diet reduces glycemic index of the food, regulates the level of blood sugar and stimulates insulin action. [21][22][23]

Obesity
Coconut oil has high percentage of MCFAs so that it does not need breaking down by enzyme before absorption into the intestine. It utilized as fuel in metabolic reaction in the liver and stimulating metabolism to remove excess body fat. It helps in breaking down of fat stored in the body into energy through a process known as thermogenesis thus the saying, "Eat Fat -Look Thin". [24]

Coconut Oil and Oral Health
Recent studies found that, Coconut oil has strong effect in reducing plaque and decay which caused by Streptococcus mutans. Through massaging coconut oil on gums for 10 minutes a day, for at least three weeks. [25][26]

Coconut Oil and Healthy Skin
Coconut oil helps reduce the appearance of wrinkles and fine lines giving skin a healthier appearance. [27]

Coconut Oil and Alzheimer
Alzheimer is a neurological disorder in which memory loss and cognitive decline occurs because of death of brain cells. Recent study suggested that the saturated fat of coconut oil reduce symptoms in Alzheimer's disease patients. Because it provides the brain with ketones which are an alternate source of energy for malfunctioning brain cells. [28][29]

Coconut Oil and Thyroid Function
Coconut oil reduces inflammation leading to hypothyroidism and hyperthyroidism. It stimulates metabolism and increases the rate of food breakdown to release energy through regulation of thyroid gland. [25][26] The objective of the present work is to evaluate the knowledge of students of Hail University about the effects of coconut oil on health with a comparison between females and males. Also, this report aims to review the available literature about coconut oil and highlight its positive effects on health.

Materials and Methods
The study design was a cross-sectional survey and was conducted during first semester 2018-2019 at Hail University. The questionnaires were distributed to 200 students (100 students from female campus and 100 from male campus) for answering. The questionnaire was designed as shown in Table  1 which included questions related to the objectives of study.
Answered questionnaires were later downloaded for statistical analysis to compare degree of knowledge between female and male. Also, comparison between scientific and human colleges.
Statistical analyses were performed using the Statistical Package for Social Sciences (SPSS) software and Mstat-c Program. Descriptive statistics and ANOVA (One Way analysis) for the parametric variables and non-parametric variables were tested by Chi-square tests. [30][31]  This gives Cronbach's alpha coefficient. If the score is over 0.7 for high internal consistency means the Reliability of output. In this case, N of Items= 20 and α = 0.768, which shows the questionnaire is reliable.  Table 2 show that mean of age was 21.56 ± 1.643 year, mean weight was 69.35± 17.008 kg and height was 165.06±10.165 cm.  In table 3, difference between answer levels for all questions from question 1 to question 21 is high significant but for questions (3, 4, 6, 9, 10, 11, 15 and 20) there is a none significant difference. Results showed that; 88.9% of students think that coconut oil is useful for health. [32]. 66.7% of students care when buying oil to be a virgin free of chemicals; 60.2% prefer to use it in Cosmetic and 81.5% of students know that coconut oil treat dry skin and promote skin health. This knowledge supported by a study which reported that Coconut oil can reduce the appearance of wrinkles giving skin a healthier appearance. [26] The study represents that 86.1% of students are aware about good role of coconut oil for healthy hair; 18.5% of students have knowledge about its therapeutic effect in treatment of epilepsy. This knowledge supported by a study which concluded that Coconut oil is effective in treatment of epilepsy and Alzheimer's disease due to its contents of medium-chain triglycerides. [29] The results show that 34.3% know its effect in the treatment of psoriasis and eczema symptoms and 36.1% of students have a background about useful role of coconut oil in controlling blood glucose level in diabetic patient. This knowledge supported by a study which reported that coconut oil in the diet reduces glycemic index of the food, regulates the level of blood sugar and stimulates insulin action [14]. In present report, 42.6% of students know that it has a therapeutic role in arthritis; 68.5% know that excessive intake of coconut oil leads to an opposite reaction and 27.8% of students know antimicrobial property of coconut oil and its ability in killing pathogenic microorganisms. [33,34] Table 4 show none significant difference in answer levels between male and female students in all questions but questions number (2, 6, 7, 14, 16, 17 and 19) there is a significant difference.

Results and Discussion
In current study, 43% of male students know that coconut oil is useful for health while for female the percentage was 53%. Results showed that 20% of male students use coconut oil while only 40% of female use coconut oil. 44% of female use coconut oil in cosmetic while only 21% of male students use coconut oil in cosmetic. Results showed that 20% of male students use coconut oil while 40% of female know use coconut oil. 50% of female know that coconut oil treats dry skin and promote skin health while only 38% of male knows this knowledge. Results also found that 52% of female students have a background about useful role of coconut oil for healthy hair while only 41% of male know this knowledge. The present study represents that 17% of male students know that it has an effective therapeutic role in the treatment of epilepsy while only 3% of female knows this knowledge. Results of the current study found that 22% of male students know that it is useful for infection control and viral resistance while only 8% of female knows this knowledge. Published studies from Kingdom of Saudi Arabia about benefits of coconut oil are rarely. Results of the current report found that students of University have a moderate knowledge about positive effect of coconut oil on health but the knowledge of female students more than male students.  In table 5, difference between answer levels for all questions about beneficial of coconut oil is none significant.

Conclusion
Coconut oil, especially virgin coconut oil (VCO), has been claimed to have beneficial effects on health while Partially hydrogenated coconut oil is not healthy and any manufactured foods contain it should be avoided. Benefits of coconut oil related to high content of medium-chain triglycerides (MCTs). These are easier to the body to burn off and harder to convert into stored fat. Results of the present study was concluded that students of University have a moderate knowledge about effect of coconut oil on human health but the knowledge of female students more than male students. Comparison between students of scientific College and Literary College in level of knowledge about healthy importance of coconut oil show a none significant difference in all questions.

Recommendation
The present work reported the need to increase the knowledge of students about beneficial effect of coconut oil by distributing booklets or by health education program to highlight its positive effects on health with recommendation to use it for food, medicine and cosmetic and correct their thinking that coconut oil is harmful. The highest percentage of SFAs present in Coconut oil is a good property and added advantage to it to be healthy. All consumed food containing coconut oil are catabolized to release energy. It provide immunity and prevent the formation of free radicals which are harmful to health. Finally, coconut oil is the best oil in the world for health.