Lead Author’s Financial Disclosures None

Study Funding None

Background/Synopsis Replacing saturated fatty acids (FAs) in the diet with poly- and monounsaturated-FAs may reduce the risk of cardiovascular disease. Recent U.S. Department of Health and Human Services and the U.S. Department of Agriculture dietary guidelines recommend consumption of diets that are low in saturated fat. Dietary trends such as the “Paleo diet” and “bulletproof coffee” promote the consumption of high amounts of saturated FAs. “Bulletproof coffee” is a blend of black coffee and grass-fed butter with brain octane oil (caprylic acid). Advertised as a “healthy” beverage that leads to sustained energy, concentration and weight loss, its ingredients include 2 tbsp of unsalted grass-fed butter, 1 tbsp of brain octane oil mixed with 1 to 2 cups of branded “Bulletproof Upgraded Coffee.” Grass-fed butter and brain octane oil include predominantly saturated fats. The effects of “bulletproof coffee” on the lipid profile have not been described in detail. One report describes elevated levels of LDL cholesterol and apolipoprotein B after “bulletproof coffee” consumption. Some suggest “bulletproof coffee” with butter should replace statins.

Objective/Purpose To describe the effects of “bulletproof coffee” on the lipid profile.

Methods A 59-year-old male with dyslipidemia who was referred for an acute increase in serum lipids after incorporating “bulletproof coffee” into his diet. The patient has dyslipidemia and his father had coronary artery disease. He was previously on rosuvastatin but had self-discontinued this.

Results The patient’s lipid levels almost doubled after discontinuation of rosuvastatin (Table). He then incorporated 1 to 2 cups of “bulletproof coffee” every day into his diet as an alternative to rosuvastatin therapy. After several months of daily consumption, with stable exercise level, his lipid profile worsened and was advised to stop. Table below depicts this patient’s lipid profile while on and off of rosuvastatin therapy and after he started consuming “bulletproof coffee.”

Conclusions Tabled 1 Table. Total Cholesterol LDL-C HDL-C Triglycerides Non-HDL On rosuvastatin 138 84 43 53 95 Off of rosuvastatin 215 156 44 75 171 On “bulletproof coffee” 285 (+ 33%) 232 (+ 49%) 48 (+ 9%) 63 (- 16%) 237 (+ 39%) We believe that the rise in cholesterol levels of this patient was due to a diet enriched in saturated FAs, mainly resulting from the incorporation of “bulletproof coffee” into the diet. Despite potential changes in dietary recommendations limiting the consumption of saturated FAs, some patients may show worsening lipid profiles, and this may represent a cardiovascular risk factor.