Lauric acid increases total serum cholesterol more than many other fatty acids. But most of the increase is attributable to an increase in high-density lipoprotein (HDL) (the "good" blood cholesterol). As a result, lauric acid has been characterized as having "a more favorable effect on total HDL cholesterol than any other fatty acid [examined], either saturated or unsaturated".  In general, a lower total/HDL serum cholesterol ratio correlates with a decrease in atherosclerotic risk.  Nonetheless, an extensive meta-analysis on foods affecting the total LDL /serum cholesterol ratio found in 2003 that the net effects of lauric acid on coronary artery disease outcomes remained uncertain.  A 2016 review of coconut oil (which is nearly half lauric acid) was similarly inconclusive about the effects on cardiovascular disease risk.