3 Reasons Why You May Not Be Able to Tolerate Coconut Milk

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Reviewed by Laura Beth Schoenfeld, RD, MPH

iStock.com/Alexander_Tarassov

Coconut milk is often a staple fat source for those following a Paleo diet. From a nutritional perspective, it’s an excellent choice. It’s high in saturated fatty acids and medium-chain triglycerides (MCT), which are both easily burned as fuel by the body. MCTs are particularly beneficial in that they don’t require bile acids for digestion, and they’re directly shunted to the liver via the portal vein.

Coconut milk and fruit can be a great snack for Paleo folks, and coconut milk smoothies make a great Paleo breakfast choice – especially in the summer.

So what could be wrong with coconut milk? Here are three things to consider.

Bisphenol-A

Bisphenol-A (BPA) is a chemical that has been used in consumer goods since the 50s. It’s found in reusable drink containers, DVDs, cell phones, eyeglass lenses, automobile parts and sports equipment. While the research on BPA is still mixed (some studies indicating harm and others not), given the uncertainty I think it makes sense to avoid it whenever possible.

BPA is used in the lining of certain canned foods. BPA especially leaches into canned foods that are acidic, salty or fatty, such as coconut milk, tomatoes, soup, and vegetables.

So what’s the solution here? In short, if you want to be on the safe side and reduce your exposure to BPA, you have to reduce your consumption of canned foods (including coconut milk) as much as possible. I made this recommendation in 9 Steps for Perfect Health-#3: Eat Real Food. A study published in Environmental Health Perspectives found that families who ate fresh food for three days with no canned food, and using only glass storage containers, experienced a 60% reduction of BPA in their urine. The reductions were even higher (75%) for those with the highest BPA levels at the beginning of the study.

The good news, however, is that there are brands of coconut milk with BPA-free cans or carton packaging. One is Native Forest, which you can purchase on Amazon if it’s not available at your local store.

Coconut milk can also be made quite easily at home, with coconut flakes, a blender and cheesecloth. Here’s a video to show you how (get a load of the soundtrack). I find that blanching the coconut flakes prior to blending improves the results.

Guar gum

The other potential problem with canned coconut milk is guar gum. Guar gum is a galactomannan, which is a polysaccharide consisting of a mannose backbone with a galactose side group.

It’s primarily the endosperm of guar beans.

Beans and legumes have a variety of compounds in them that make them difficult to digest, especially for people with digestive problems (1 in 3 Americans, from the latest statistics). In my clinical experience, many patients with gut issues improve when they remove guar gum from their diet—including canned coconut milk.

There’s no evidence that guar gum may cause serious harm. So, if you’re able to tolerate guar gum, there’s no reason to avoid it. If it does give you digestive trouble, look for a brand that’s free from guar gum. The other option, of course, is making coconut milk at home.

Fructose malabsorption

Fructose malabsorption (FM) is a digestive disorder characterized by impaired transport of fructose across the small intestine. This results in increased levels of undigested fructose in the gut, which in turn causes overgrowth of bacteria in the small intestine. Undigested fructose also reduces the absorption of water into the intestine.

The clinical effects of FM include: intestinal dysbiosis, changes in motility, promotion of mucosal biofilm, and decreased levels of tryptophan, folates and zinc in the blood.

Symptoms produced include bloating, gas, pain, constipation or diarrhea, vomiting and fatigue (to name a few). Recent research has also tied fructose malabsorption to depression.

Lest you think this isn’t a common problem, studies have shown that up to 30% of people in Western countries suffer from fructose malabsorption.

Even in healthy people without fructose malabsorption, however, only about 20-25g of fructose can be properly absorbed at one sitting. Glucose assists in transport of fructose across the intestine, so in general foods with equal amounts of glucose and fructose will be better absorbed than foods with excess amounts of fructose (in relation to glucose).

While fructose malabsorption can cause symptoms in anyone, those with Irritable Bowel Syndrome (IBS) or Inflammatory Bowel Disease (IBD) are particularly affected. While the prevalence of FM is the same in healthy populations and those with IBS & IBD, the experience of FM appears to be more intense in the latter group. This is probably due to the increased visceral sensitivity common in IBS and IBD patients.

In fact, one of the most promising clinical approaches to managing IBS & IBD right now is the low-FODMAP diet. FODMAP stands for Fermentable Oligo-, Di- and Mono-saccharides And Polyols. These include:

  • fructose (fruits, honey, HFCS)
  • fructans (wheat, onions)
  • lactose (milk sugar)
  • polyols (sugar alcohols like sorbitol, xylitol & mannitol, along with fruits like apples, pears and plums)
  • galactooligosaccharides (legumes & beans, brussel sprouts, onions)
  • other sweeteners like polydextrose and isomalt

Studies have found that restricting FODMAPs can significantly improve the symptoms associated with IBS, IBD and fructose malabsorption.

What does this have to do with coconut milk, you ask? According to Drs. Gibson & Barrett, experts in fructose malabsorption, coconut milk is a FODMAP and should be avoided by people with digestive conditions like IBS & IBD.

According to NutritionData.com, coconut milk has very little sugar of any kind – including fructose. Nevertheless, I do have patients that cannot even tolerate homemade coconut milk (which has no guar gum in it), even though they are fine with coconut oil. I assume that they are reacting to the fructose in the coconut milk – but I can’t be sure. According to Monash University, small quantities (up to 1/3 of a cup or 80g) of coconut milk may be tolerable for those who are sensitive to FODMAPs.

Recommendations

Let’s bring this together into recommendations for three different groups of people:

  • Women who are trying to get pregnant, pregnant or breastfeeding, children and other vulnerable populations (chronically ill): should avoid canned coconut milk products except for those that are BPA-free, like Native Forest and Arroy-D. Note: Native Forest is organic, but Arroy-D is not.
  • People with digestive problems (IBS, IBD, GERD, etc.): may want to avoid coconut products entirely, except for coconut oil
  • Healthy people: may be fine with canned coconut milk, provided they don’t react to the guar gum, and provided they’re willing to take the side of industry scientists that claim BPA doesn’t cause harm in humans

Want organic coconut milk – but without the BPA and guar gum?

There are available options to buy organic, guar-gum-free coconut milk in a BPA-free container. Or, with a little extra effort, you can easily make this at home yourself.

  • Purchase coconut cream (Let’s Do Organic and Artisana are good choices) and blend with water to make coconut milk.
  • Purchase shredded coconut (again, Let’s Do Organic is a good choice), and follow the instructions below for making homemade coconut milk.

Homemade coconut milk instructions

Ingredients

Instructions

  • Heat water until hot (but not boiling).
  • Add shredded coconut and water to blender (preferably a Vitamix!) If all of the water won’t fit, you can add it in two batches.
  • Blend on high for several minutes until thick and creamy.
  • Pour through a colander to filter out the coconut pulp, then squeeze through a cheese cloth or nut milk bag to filter the smaller pieces of coconut.
  • If you separated the water into two batches, put the strained coconut back into the blender with the second batch of water.
  • Drink immediately or store in the fridge. Fresh coconut milk should be used within 3-4 days of making it for the best flavor and texture.

1,043 Comments

Join the conversation

  1. I live in Thailand and use the aroy-D brand when I can’t get the fresh stuff. I trust the labeling to be correct that there are no preservatives but what you can’t see in the picture is that the box says that the coconut milk undergoes a UHT to increase the shelf life. What effect do you think UHT has on the coconut milk?

    • I rather late to this party, but I found this about uht: “Kevin – I researched the UHT process and found it involves heating the milk to 284 degrees for 10 seconds.” http://www.robbwolf.com/2011/08/24/coco-what/

      Perhaps Chris can give us his opionion of what the impact that would have on the sat fat in the coconut milk?

      I have been consuming canned coconut milk this past week in a big pot of soup I made. Perhaps this is what is causing me some bowel issues this week??

      I pretty convinced to start making it myself.

  2. I have a history of IBS and GERD, both currently non-symptomatic, and I can’t tolerate any of the brands of commercial canned coconut milk I have tried. They trigger reflux symptoms for me.

    I have never made my own coconut milk (i.e., from dried coconut) but I am lucky to live in Hawaii where fresh coconuts are available year-round. I often make my own coconut cream, which is a thick puree of soft, fresh coconut meat, coconut water (the clear liquid inside the cavity of the coconut), and nothing else. This takes the place of canned coconut milk in most recipes, and has many unique uses of its own. Its texture and fat content depends on the maturity of the coconuts used, since younger coconuts yield a soft, fruity meat with little fat, and more mature coconuts yield a nutty meat with fat aplenty. There there are an infinitude of stages twixt fruit and nut. It’s wonderful to be able to enjoy all those different stages of the coco in different ways.

    Anyway, I have never had any problem with any preparation of fresh coconut. Canned coconut milk is made from dried, mature coconut. To me, it a processed, dead food, not a fresh, live one–but that is merely my own subjective appraisal, not a scientific analysis. Thanks, Chris, for this article–it adds to my understanding of the issue.

  3. For those wanting to purchase Native Forest coconut milk at a better price than amazon, Azure Standard (a distribution company out of Oregon) sells it. You’ll need to get an account, find an open drop site, etc. but might be worth your while for this and other items as well. The case price (12 – 13.5 oz cans) from Azure is $24.10.

    • Actually, as of 7/12 the price is $24.84 for 12 of the 13.5 oz cans…and that drops to $21.11 if you choose “Subscribe & Save”.

  4. For those following a GAPS diet to treat gut dysbiosis, do you recommend avoiding shreded coconut? Coconut manna/cream?

    • I recommend that people experiment to find out. There’s no other way of knowing.

  5. Thanks for the article. Do you have an opinion on “powdered” coconut milk / cream. I buy the “Chao Thai” brand and use it in my coffee and shakes. It come in a foil “wrapper”. I like using the powder much more than canned milk since the canned only lasts a couple days. Plus, the box of powder I buy runs around $3 and makes like 40 servings.

  6. Thanks for the insight, I’ve always love coconut milk. Am Asian and coconut is a must in our cooking but all canned ones including Arroy-D does not test like coconut, fortunately, I live in a town with lots of Asian grocery stores. I now buy shredded frozen coconut ( I used to buy the whole coconut, break it, and used a hand held grater but my hands get too tired) put in the blender with hot water then use cheese cloth to squeeze out the milk part.

  7. For someone dealing with a serious case of diverticulitis (where they soon might have to undergo surgery to remove part of their colon), would a FODMAP or GAPS protocol help? I’m sure Paleo would help on itself, but it seems like the person I’m referring will most likely need to consider other things. What about an autoimmune protocol? I’ve been following your blog and podcast for some time, but have yet to hear you touch on diverticulitis (I apologize if I missed it).

    Thanks

    Henry D

    • I realize this response may be late for you, Henry, but hopefully it will be helpful for you or other readers.

      I also experienced severe diverticulitis (as result of a parasite infestation). I was able to re-balance my intestinal ecology and heal my intestinal lining by following the Guts and Glory program by Jordan Rubin and Joseph Brasco, MD (Restoring your Digestive Health). The first phase calms the overgrowth of pathogens while also allowing your gut to rest and heal. Then, healing continues as you rebuild the tissues and introduce healthy bacteria. Onions are the only FODMAP restriction included in Phase 1, and Phase 2 does include 30-hour home-cultured goat milk (OR probiotics, for those sensitive to all dairy).

      My understanding is that the fructose issue is separate from the diverticulitis but, as Chris mentions, the weakness of your intestines may exacerbate the fructose problem, if present. Here’s where you’ll have to know yourself and adjust the diet (or GAPS) to your own needs until healing has taken place.

      The combination of the Guts and Glory or GAPS plus the FODMAP diet would be considered a customized autoimmune protocol, as it would address your own particular causes for inflammation – poor gut integrity and gut ecology. Both the Guts and Glory and GAPS also emphasize low-carb (verses the SCD, which only emphasizes the type of carbs), to further reduce inflammation. Adding a high-quality Omega 3 supplement (and reducing Omega 6s), getting good sleep, and lowering stress also will help.

      The diets discussed already restrict most common allergens, but if you have any known personal allergens (food-related or otherwise), it would be wise to avoid these, too. Once healing has taken place (several months later), you could re-introduce certain items, one at a time, to discover whether an allergic response was related to your previous condition or whether it is something more permanent.

      IBD (Crohn’s and ulcerative colitis), of course, is an inflammatory/autoimmune disorder of the gut. Surprisingly, the Guts and Glory protocol still recommends certain probiotics as part of the recovery phase for IBD. Diverticulitis and fructose malabsorbtion in themselves are not auto-immune, so either way, probiotics should be beneficial, at least during gut restoration, in helping to heal the underlying problems contributing to systemic inflammation.

  8. The FODMAP diet is really very interesting. Chris, does this modify anything about your enthusiasm for the GAPS/SCD diets? These diets are all about reducing the amount of di- and polysaccharides, and thus they allow fruit, honey, etc. But according to the FODMAP diet, wouldn’t these things be off limits due to their fructose and honey content? Would the GAPS diet be more effective if it removed fruit and honey altogether and even limited certain vegetables like brussel sprouts and onions? I know some people on the GAPS diet who eat a lot of apples. This seems like it might not be such a good idea after all.

    • No. They’re different approaches. They could be combined, of course, and some find it necessary to do that. What I’ve found with FODMAP is that usually people are sensitive to some but not all of them. For example, some might be sensitive to onions (fructans) but not dairy (lactose), or vice versa.

  9. I dig the info, but a lot of it feels recycled from Wikipedia. Not to mention it’s more qualitative than quantitative (i.e. ‘BPA is bad, avoid it’ – well, how much are we exposed to, how much of that is absorbed and at what levels is it harmful?).

    I hope this doesn’t scare people into avoiding canned coconut milk, when in reality they more significant issue is previously mentioned and well known food toxins. However, thanks for the help and I do feel this may help a small few who may be having trouble with coconut products.

    • there is coconute milk in regular milk cartons now thats organic, so whats wrong with that.

      • Look at the labels – I think you’ll see Carageenon and Guar Gum amongst other things. Yes Turtle Creek So Delicious.

  10. Two things stand out- One, I really believe the article title should have had the word “Canned”, since
    much of the focus is on damage from can linings. Of course in general for all canned foods it is important to remind consumers there are dangers- given the make-up of the can.

    Second- we would be better off thinking about gut health in terms of balancing for healthy friendly bacteria in general. Of course I am aware that too much sugar/fructose could throw this balance off, but as a long term practitioner and teacher, I believe the focus should be on what “to do”, not solely on what “not to do”- in short, I do not think avoiding healthy brands of coconut milk, in judicious amounts within the diet, per-se is the solution, but rather rejuvenating the digestive system. And surely there will always be people who feel better avoiding one or another food- those who are paying attention, that is.

  11. Arroy-D coconut milk claims to be 100% coconut milk. On the box is written in large yellow script “กะทิ 100%”. กะทิ is the Thai word for coconut milk.

  12. Chris, always wanted to ask this. Can guar gum(or the fructans, or BPA) be altered/reduced/destroyed by fermentation? I always ferment my coconut milk(some along with chocolate too, it’s divine!) to get rid of the phytates. Thanks for all the great info.

    • I would assume that fermentation may affect the fructans and guar gum (perhaps they are metabolized at least in part by the bacteria, since that is what happens in the gut), but I don’t think fermentation would affect the BPA. But I don’t have any data on this.

    • How do you ferment coconut milk? I suppose I could make coconut milk kefir out of it, is that what you do?

      • Thanks for the reply, Chris.

        Yes, you either ferment by leaving it covered with a cloth for about 5 days(adding sugar/dextrose or honey for the bacteria to thrive on) or use a culture starter, like Body Ecology. I prefer their regular starter over the Kefir one because it has the L. Plantarum, which eats up the phytate and is dairy free: “may contain trace amounts”. But once you have made it once it’s easy to save a small part to add to the next batch and so on.

        • I use live kefir grains which you have to get from someone who has live grains, and I keep a small batch of milk kefer going for hubby who does well on it. That also keeps me in multiplying kefir grains. Then, for the the last two years I’ve used his leftover grains, rinsed well, to make non-diary kefir for me. I’ve tried several recipes, but my fall back is to dissolve refined sugar in water and then keep in it a jar in the frig to use as my kefir sugar liquid. I do set in on the shelf when I pour some over the kefir grains to ferment. I use sugar water because it’s lower in fructose than some other methods that I’ve tried and it is inexpensive. The bacteria eat up all the sugar, so I don’t think it matters that it’s refined. I spend my dollars on high quality meat, fermented cod liver oil and chlorella, so this is one area I try to save money. 🙂

          I rarely use coconut milk and have not noticed it bothering me as long as I make it fresh (from frozen coconut). If that ever bothers me, I’ll try the ferment if I need it for a recipe. Thanks! 🙂

          • By the way, if anyone tries the sugar water kefir, it doesn’t ferment well even if you make it very sugary unless you throw in a few raisins. I’m not sure why, but that does the trick. I guess that adds more fructose, but I think theoretically, if you ferment it long enough the sugars are eaten up by the bacteria anyway. I dissolve 2/3 cup sugar in 7 cups of water. I only make a small amount of kefir everyday, so I probably use 2/3 cup of sugar water and five raisins.

  13. Emilee….your comments are coming across as arrogant. There was no wrong information presented here.

    My daughter has Fructose Malabsorption. She cannot tolerate coconut milk at all. She cannot tolerate strawberries either. Some things cause instant symptoms with her and sometimes it takes a couple hours. The limit of fructose for most people is 25g-50g per sitting. My daughter reacts to one strawberry which contains about 239 mg of fructose. Coconut milk contains approximately 6 grams of carbohydrate per cup. There is more fructose than glucose for carbohydrate in these 6 grams of carbs. Therefore in the fructose sensitive individual…this equates to gas, bloating, diarrhea and Steatorrhea.

  14. Hi Chris

    Re guar gum, does this mean that gluten free products could be a problem? How about Xanthum gum?

    • Sure does. A lot of gluten-free packaged products are full of junk. That’s why I’m always telling people to “eat real food”.

  15. In response to Emilee’s comment above. That is exactly why Chris removed reader comments……
    Thanks again for the great article!

  16. Going paleo almost 2 years ago fixed 90% of the relatively mild but unpleasant chronic GI issues I’ve had my entire life, especially when I was vegetarian. However, I was still baffled by occasional flareups. My recent discovery of the FODMAP concept has been helping me nail down the remaining 10%. I had already figured out I had issues with soy, legumes, wheat, xylitol, and inulin, but FODMAP helped tie everything together. Sure enough, coconut milk and especially coconut water are problematic for me. Coconut ice cream (sweetened with high-fructose agave, no less) is one of the worst things I have ever found for my digestion, with the exception of textured soy protein. I’ll never make that mistake again! Sadly, I love all things coconut. 🙁

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