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Medium Chain Triglycerides

  • Vitamins & Supplements
  • Updated March 5, 2024

Medium-chain triglycerides (MCTs) are a naturally occurring source of dietary fats that are abundant in coconut oil. Our bodies rapidly convert MCTs into ketones, which can be used as an energy source by the brain. No studies have yet found that MCTs can prevent dementia, but some evidence suggests that there may be short-term cognitive benefits from taking MCTs, including for patients with dementia. While they are generally considered safe, some gastrointestinal side effects are common.

Evidence

More than a dozen trials have investigated the cognitive impacts of MCTs in different populations, and four systematic reviews and/or meta-analyses have assessed these clinical trials. The analysis is hampered by several methodological issues, including suboptimal study design, small study size, and widely varying doses and kinds of MCTs. Our search identified:

  • 1 systematic review of MCT use in individuals without dementia 
  • 3 systematic reviews and meta-analyses of MCT use in patients with AD-related cognitive impairment or dementia
  • 0 observational studies
  • Multiple preclinical studies

Potential Benefit

In healthy individuals, glucose supplies almost all of the brain’s energy. However, in certain patient populations (e.g. those with or developing Alzheimer’s disease, type 2 diabetics) the ability of the brain to use glucose is impaired. Ketones are an alternative energy source for the brain and might be able to compensate for this impairment [1; 2].

Several clinical trials have tested MCTs in patients with and without dementia and reported benefits. Some meta-analyses and systematic reviews of these studies overall suggest potential cognitive benefits of MCT usage [3; 4; 5], though not all do [6]. However, many of the studies had design issues. For instance, some studies were small, or did not compare MCT to a placebo, or were not blinded – that is, the participants knew they were receiving MCTs – which means results could be biased. Studies also used very different kinds and doses of MCTs. Some of the studies found no benefit of MCTs, including one Phase 3 study [7]. Overall, the evidence suggests that MCTs might have benefits, but larger and better controlled studies are needed to determine whether these benefits are real. It is also not known what the effects are of taking MCTs long term, as no identified trial lasted longer than six months [8]. No human studies have examined whether MCTs can prevent or delay dementia.

Although some laboratory studies provide a biological rationale of how MCTs might benefit brain health such as improving brain cell function, preventing Alzheimer's-like pathology, and enhancing learning in older animals [9; 10; 11], there exists no clinical data that MCTs promote long-term brain health.

APOE4 CARRIERS:

Studies suggest that MCT supplementation might improve cognitive function only in, or to a greater extent in, patients who do not have an APOE4 allele [5].

For more information on what the APOE4 gene allele means for your health, read our APOE4 information page.

For Dementia Patients

Potential cognitive benefits for patients with dementia have been reported, though larger and longer studies looking specifically at individuals with dementia are needed [3; 5]. Some preclinical laboratory studies suggest that MCTs may improve some measures of cognition and prevent amyloid plaque formation in animals, but these results have not been confirmed in humans [10; 11; 12].

Safety

Strong evidence suggests that MCTs are low risk when used by healthy adults. Foods high in MCTs such as coconut oil are used widely with few adverse events reported. However, for some people MCTs can increase plasma triglyceride levels, which might be harmful for cardiovascular health [8; 13; 14]. Gastrointestinal side effects are common in individuals taking MCTs. The side effects may be reduced by taking MCTs with food and by slowly incorporating them into the diet.

NOTE: This is not a comprehensive safety evaluation or complete list of potentially harmful drug interactions. It is important to discuss safety issues with your physician before taking any new supplement or medication.

How to Use

MCTs can be found in certain foods, as supplements, and as medical foods. Coconut oil has the highest naturally occurring percentage of MCTs, which make up nearly 60 percent of its total fat content. Coconut oil has other fats as well as MCTs, so some individuals opt for refined versions of coconut oil or MCT oil that have higher proportions of MCTs. Palm oil and butter also contain significant amounts of MCTs. In most studies, individuals have taken 6-56 g of MCTs per day.

Learn More

Full scientific report (PDF) on Cognitive Vitality Reports

Check for drug-drug and drug-supplement interactions on Drugs.com

References

  1. Cunnane SC, Courchesne-Loyer A, St-Pierre V et al. (2016) Can ketones compensate for deteriorating brain glucose uptake during aging? Implications for the risk and treatment of Alzheimer's disease. Ann N Y Acad Sci 1367, 12-20.
  2. Castellano CA, Nugent S, Paquet N et al. (2015) Lower brain 18F-fluorodeoxyglucose uptake but normal 11C-acetoacetate metabolism in mild Alzheimer's disease dementia. J Alzheimers Dis 43, 1343-1353.
  3. Avgerinos KI, Egan JM, Mattson MP et al. (2020) Medium Chain Triglycerides induce mild ketosis and may improve cognition in Alzheimer's disease. A systematic review and meta-analysis of human studies. Ageing Res Rev 58, 101001.
  4. Giannos P, Prokopidis K, Lidoriki I et al. (2022) Medium-chain triglycerides may improve memory in non-demented older adults: a systematic review of randomized controlled trials. BMC Geriatr 22, 817.
  5. Sun L, Ye KX, Wong HLK et al. (2023) The Effects of Medium Chain Triglyceride for Alzheimer's Disease Related Cognitive Impairment: A Systematic Review and Meta-Analysis. J Alzheimers Dis 94, 441-456.
  6. Castro CB, Dias CB, Hillebrandt H et al. (2023) Medium-chain fatty acids for the prevention or treatment of Alzheimer's disease: a systematic review and meta-analysis. Nutr Rev 81, 1144-1162.
  7. Henderson ST, Morimoto BH, Cummings JL et al. (2020) A Placebo-Controlled, Parallel-Group, Randomized Clinical Trial of AC-1204 in Mild-to-Moderate Alzheimer's Disease. J Alzheimers Dis 75, 547-557.
  8. Page KA, Williamson A, Yu N et al. (2009) Medium-chain fatty acids improve cognitive function in intensively treated type 1 diabetic patients and support in vitro synaptic transmission during acute hypoglycemia. Diabetes 58, 1237-1244.
  9. Pan Y, Larson B, Araujo JA et al. (2010) Dietary supplementation with medium-chain TAG has long-lasting cognition-enhancing effects in aged dogs. Br J Nutr 103, 1746-1754.
  10. Kashiwaya Y, Bergman C, Lee JH et al. (2013) A ketone ester diet exhibits anxiolytic and cognition-sparing properties, and lessens amyloid and tau pathologies in a mouse model of Alzheimer's disease. Neurobiol Aging 34, 1530-1539.
  11. Dunn E, Zhang B, Sahota VK et al. (2023) Potential benefits of medium chain fatty acids in aging and neurodegenerative disease. Front Aging Neurosci 15, 1230467.
  12. Yin JX, Maalouf M, Han P et al. (2016) Ketones block amyloid entry and improve cognition in an Alzheimer's model. Neurobiol Aging 39, 25-37.
  13. Nosaka N, Kasai M, Nakamura M et al. (2002) Effects of dietary medium-chain triacylglycerols on serum lipoproteins and biochemical parameters in healthy men. Biosci Biotechnol Biochem 66, 1713-1718.
  14. McKenzie KM, Lee CM, Mijatovic J et al. (2021) Medium-Chain Triglyceride Oil and Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Trials. J Nutr 151, 2949-2956.