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Carefully balancing your food intake eliminates the problems of getting sick, the trick is to not rely totally on coconuts.
Cosmo and Fred
https://www.bustle.com/p/7-little-known-risks-of-using-coconut-oil-13236729
https://www.quora.com/Does-coconut-milk-give-you-diarrhea
https://www.click2houston.com/health/2017/10/26/pros-and-painful-cons-of-drinking-coconut-water/
you might want to tell all those doctors, nutritionists, and pacific island dwellers they are wrong.
Good luck
Second link is using coconut oil in which using a copious amount of it and using it all day every day can cause diarrhea.
third link tells you that drinking too much coconut milk or eating too much flesh can give you diarrhea but it's not a constant and is more common in people with IBS or lactose intolerances.
fourth link goes over the health implications of using it as a medicinal treatment and drinking too much of it again can, not will, cause an upset stomach.
Drinking 2 coconuts worth of milk will not immediately make you defecate and give you diarrhea, apart from the fact it takes 4+ hours for your body to even react to it.
But yes they need to have it in the game to balance it out, because god forbid if there are more than 3 crabs on an island then that's just too easy. and no you cant live off 2 inch long fish. But as cosmo said it's a game. a survival game that is more about exploring and fighting monsters than survival.
the quantity in game that gives you diarrhoea should not in the real world unless you have a bad case of IBS or lactose intolerance. i'm lactose intolerant and can still drink and eat coconuts and many foods with multiple cans of coconut cream in them without feeling anything. but yes it is a balancing aspect, although only being able to drink 2 coconuts without immediately getting punished is a bit overboard.
TL:DR you'd have to eat a lot of coconuts to even have a chance of getting diarrhoea, the ingame character is the type of person that thinks ketchup is spicy
same goes for any food really. I can eat apples every day without a problem. eat two apples in one day and nothing else and it wrecks havok on my intestines XD found that out the hard way last week :P
And of course I keep that box of oreos for those times when my sugars drop just too low heh