Medium chain triglycerides (MCTs) are absorbed directly from the gut and transported to the liver where they can be converted easily to ‘ketones’. These ketones are brain- and body-friendly fuels that can:

• Provide a non-sugar fuel source to the brain and nervous system
• Supply non-sugar fuel to working muscles
• Reduce inflammation
• Improve relative relaxation vs over-stimulation of brain and nervous system cells (neurons)

MCTs themselves also help to feed beneficial bacteria in the gut and reduce levels of unwanted bacteria and fungi (like Candida).

Cliff’s Notes

What are MCTs?

‘Triglycerides’ is the fancy name we use for dietary fats. These fats consist of a sweet-tasting compound called glycerol and three fatty acids made up of chains of carbon. Hence, tri (three fatty acids) and glyceride (the glycerol backbone). Because they are shorter than most of the fats we consume from our diet (which are mostly ‘long-chain’ fats greater than 12 carbons in length), MCTs aren’t digested in the way longer fats are, and instead are absorbed into the hepatic portal vein and transported directly to the liver where they can be converted into ketones easily for use as fuel. MCTs are also directly used by beneficial bacteria in the gut and cells of the intestinal wall, thereby improving gut health. 

How to take MCTs?

MCTs are available as oils and in powders. They can be used to make salad dressings or added to smoothies or hot or cold beverages. The powders, in particular, are easily added to hot drinks and act as a ‘coffee creamer’.

How much to take?

Everyone’s tolerance for MCTs is different. Usually, people take around 1 tsp up to a maximum of 2 Tbsp in a drink or with food, 1-3 times per day. Try increasing your dose by 1 tsp per serve until you feel improvements in mental energy or mood. If you feel any uncomfortable feelings in your gut or urgency to go to the bathroom, reduce by 2 tsp.

Note: In a study on ketone levels, lipids, and oxidative stress resulting from the ingestion of MCTs in coffee, it was found that 28g of MCT added to coffee increased blood ketones (BOHB), and HDL-c (‘good’ cholesterol) while reducing triglycerides, insulin, and markers of oxidative stress. However, 42 g resulted in increases in markers of oxidative stress; advanced oxidation protein products and malondialdehyde.¹ So, it might be prudent to limit intake to <30 g per serve, which is typically the maximum tolerable dose anyway.²

MCT – In Depth

Medium-chain triglycerides are dietary fats in which at least two fatty acid chains consist of 6-12 carbon atoms. They are found in the highest quantities in palm kernel and coconut oils and are also found in the milk of ruminants and the common name of the C6 to C10 fatty acids refer to this link, with the root word ‘Capra’ referring to goats.

The medium-chain fatty acids

Lipid number	Name	Salt/ester name	Formula	Chemical structure
Common	Systematic	Common	Systematic	Molecular	Structural
C6:0	Caproic acid	Hexanoic acid	Caproate	Hexanoate	C6H12O2	CH3(CH2)4COOH
C8:0	Caprylic acid	Octanoic acid	Caprylate	Octanoate	C8H16O2	CH3(CH2)6COOH
C10:0	Capric acid	Decanoic acid	Caprate	Decanoate	C10H20O2	CH3(CH2)8COOH
C12:0	Lauric acid	Dodecanoic acid	Laurate	Dodecanoate	C12H24O2	CH3(CH2)10COOH

MCTs have become popular supplements to provide non-carbohydrate fuel for low-carbohydrate and ketogenic diets but they are also being increasingly used by those following more moderate and even higher carbohydrate diets.

Increased ketogenesis

The main function of MCTs is to increase ketogenesis. Ketogenesis is the process, in the body, of producing ‘ketone bodies’ to use as fuel.^3-6 These ‘ketone bodies’ (usually just called ‘ketones’) can be used as a fuel by most tissue in the body, including cells of the brain and nervous system which typically rely almost exclusively on glucose (sugar).

Helping you get into and stay in ketosis

Ketogenic diets were originally used with great success to treat childhood epilepsy and have been used for this purpose since the 1920s.^7-10 Since that time, ketogenic and other low carbohydrate, high fat (LCHF) diets have demonstrated a host of benefits for many other health conditions, weight and fat-loss, and for improving some sports performance (especially endurance).

When ketogenic diets were first being investigated, they relied heavily on fasting, and on extremely high-fat diets (with up to 80% of calories from fat) to achieve nutritional ketosis.^{11, 12}

In the 1970s researchers demonstrated that a ketogenic diet could have as little as 60% calories from fat and much more protein and carbs, and still achieve the same levels of blood ketones if the diet included a high proportion of medium-chain MCTs.^{13, 14} More recently, my team and I have demonstrated that MCTs significantly ‘boost’ ketone levels,  reduce symptoms of ‘keto-flu’, and might help induce ketosis more quickly.²

MCTs significantly ‘boost’ ketone levels,  reduce symptoms of ‘keto-flu’, and might help induce ketosis more quickly

Note: Exercise is also ketogenic, encouraging the creation of ketones for use as fuel. It has been found that combining 30min aerobic exercise with MCT (30 g) is more ketogenic than either exercise of MCT alone.¹⁵

Sleep

Increased ketones provide a ‘relaxing’ effect on the brain. This is likely to be due to a combined effect of protection against hypoglycaemia (low blood sugar),¹⁶ increased available adenosine (a relaxing neurotransmitter) and improved GABA-glutamate ratio, reducing over-excitation of neurons.¹⁷ Increased ketones also reduce inflammation,¹⁸ thereby reducing excitotoxicity (protecting neurons from this cytotoxic damage), and improve the structure and function of glial cells of the brain which support other neurons.¹⁹

There are plausible reasons why MCT might help to improve sleep

Interestingly, ketones also reduce oxidative stress in the brain and increase brain-derived neurotrophic factor (BDNF),²⁰ a trigger for improved brain repair and growth of new nerve cells.

So, there are plausible reasons why MCT might help to improve sleep. The effect of MCTs specifically on sleep has been studied in new-borns consuming formula in which 37% of the fat content was from MCTs. The new-borns taking the MCT formula slept on average 52 mins longer than the control oil (a long-chain fat).²¹

Gut health

Animal research suggests that medium-chain fatty acids (from MCTs) might help to improve the balance of beneficial to pathogenic (disease-causing) bacteria in the gastrointestinal system,²² and this effect is likely to occur in humans.²³ A formula containing MCT has also resulted in improved gut-barrier function (i.e. reduced ‘leaky-gut’),²⁴ and they have known anti-fungal activity.

Medium-chain fatty acids might help to improve the balance of beneficial to pathogenic bacteria in the gastrointestinal system

Anti-candida activity

Lauric acid from coconut oil (C12),^{25, 26} capric acid (C10) and caprylic acid (C8) help to combat candida (a pathogenic yeast) by reducing activity, adhesion, and biofilm formation of the yeast. 

Research has shown that capric acid and caprylic acid affect the yeast-to-hyphal progression (the development of yeast into a more mature mycelium, which is more virulent) of candida. This research suggests that all of the MCTs may be effective in treating Candida yeast infections.²⁷

²⁸

In human research, preterm infants supplemented with MCT oil experienced a significant reduction in candida load over a 3-week period, and candida significantly increased after supplementation was stopped. Thus, supplementation with MCT may be an effective method to reduce candida colonisation of the gut.²⁹

MCTs may be effective for treating Candida yeast infections

Improved physical performance

MCTs are useful for increasing fat utilisation during exercise. While the effects on performance have been somewhat equivocal, there are likely to be benefits to performance when MCTs can both provide fuel and improve fuel utilisation.

A 2018 study compared the effect of 6 g of MCT consumed along with carbohydrate (maltodextrin), compared to a carbohydrate only meal providing the same amount of energy, for two weeks, on moderate-intensity (50% peak V^･o₂) and high-intensity (70% peak V^･o₂) exercise. Fat oxidation was significantly increased in the MCT + carbohydrate trial during moderate-intensity exercise, and the duration of subsequent high-intensity exercise was extended significantly, compared with that observed in the carbohydrate-only trial. The authors concluded that continuous ingestion of 6 g MCT with maltodextrin could increase fat oxidation during moderate-intensity exercise and extend the duration of subsequent high-intensity exercise in recreational athletes, compared with the ingestion of isoenergic maltodextrin alone.³⁰

MCT with maltodextrin could increase fat oxidation during exercise and extend the duration of high-intensity exercise

Reduced effects of ageing

Elderly patients given just 6 g per day of MCT (C8 and C10 blend) had significantly improved strength and functional independence (ability to perform daily activities)^[i] compared to those taking a control oil.³¹

Brain health

The ketones we create when we take MCT oils increase ‘mitochondrial efficiency’ (how efficiently we use fuels, especially fat-for-fuel) and help to supplement the brain’s normal reliance on glucose.³² Impaired use of glucose by neurons is also a hallmark of Alzheimer’s disease and cognitive decline, and MCTs, which indirectly provide ketones (especially BOHB) can offset the effects of a glucose-deficient brain.

MCTs also show neuroprotective properties and there is evidence that they help to reduce the risk of Alzheimer’s and cognitive decline.³³

MCT oils increase ‘mitochondrial efficiency’

For example, MCT supplemented diets improve mental performance and memory in those with Alzheimer’s Disease and other age-related cognitive declines .^34-36

A recent placebo-controlled trial has also shown a significant improvement in the cognitive scores^[ii] of mild to moderate severity Alzheimer’s patients taking 17 g of MCT per day.³⁷ There were also significant increase in cholesterol and HDL-c, BOHB, and androstenedione (a precursor to testosterone) and significant reductions in several fatty acids in the blood.^[iii]

In a study of 6 g MCT per day (with L-leucine and vitamin D) mental status scores in the MCT group improved by over 30% whereas, in the leucine + vitamin D + long-chain fat, and control groups, these measures were decreased (by 11.2% and 26.1% respectively).³⁸ This suggests that even relatively low doses of MCT improve brain health and mental performance.

Even relatively low doses of MCT improve brain health and mental performance

A 2020 meta-analysis of the available research showed that MCTs induce mild ketosis and improve cognition in people with Alzheimer’s disease.³⁹

MCTs have also been shown to aid cognition and protect against the effects of hypoglycaemia (low blood sugar) in diabetics.⁴⁰

Improved oxygen delivery

The addition of MCT to ghrelin treatment improved the aerobic capacity of underweight patients with chronic obstructive pulmonary disease.⁴¹

Support for weight management

Diets rich in MCTs promote greater fat-utilisation and weight/fat-loss than those containing the same amount of standard dietary fat.^{42, 43} 

Diets rich in MCTs promote greater fat-utilisation and weight/fat-loss than those containing the same amount of standard dietary fat

They have been shown to have a particularly positive effect on fat in and around the midsection (internal and external ‘belly fat’),⁴⁴ which we know to be a risk factor for cardiovascular disease and is an indicator of increased risk of metabolic syndrome (pre-diabetes).

MCTs could also help us to stick to a healthy diet more easily, by reducing voluntary food intake,⁴⁵ increasing the desired time between meals, and improving portion control.⁴⁶ Even relatively low intakes of MCT (as little as 15 g per day or 1 Tbsp.) as part of the diet, enhance how many calories we burn day-to-day.⁴⁷

MCTs could help us to stick to a healthy diet by reducing voluntary food intake

Improved cardiometabolic health

Consistently high triglycerides (fats in the blood) reading are a key indicator of heart disease and stroke risk and are a key marker for insulin resistance, prediabetes and carbohydrate tolerance. MCTs increase serum triglycerides less than standard dietary fats.^{48, 49}

MCTs increase fats in the blood less than standard dietary fats

Experimental studies demonstrate that dietary MCTs reduce fat deposition, increase thermogenic rate (calories burned) and fat burning. Additionally, several reports suggest that MCTs help preserve insulin sensitivity, both in animal models and patients with type 2 diabetes.⁵⁰

Greater muscle retention post-injury and while dieting

Due to the easily used nature of MCTs, they can help to reduce muscle and other tissue breakdown after injury or trauma,⁵¹ and improve fat-loss while helping to preserve muscle while dieting.⁵² 

Resistance to corticosteroid-induced damage

Corticosteroids are catabolic hormones that break down tissue. They are used to treat many inflammatory disorders and are extremely beneficial to these conditions but long-term use results in insulin resistance, obesity and cytotoxicity (damage to cells).

In a study of the effects of MCTs on glucocorticoid-treated children with leukaemia, it was found that those supplemented with MCT were more resistant to middle weight-gain compared to the control group.⁵³ This suggests a benefit to abdominal adiposity, a key marker of metabolic disorders and a risk factor for future health problems.

Which MCFAs increase ketones the most?

Based on the existing animal and human research, it’s probably fair to say that the shorter the chain length (of the fatty acid), the more easily the fatty acids are transported into the hepatic portal vein and carried to the liver for conversion to ketones.^54-57

The shorter the chain length of the fatty acid, the more easily it is converted to ketones

The actual ketogenic effect of the various medium-chain fatty acids from caproic (C6) to caprylic (C8), capric (C10) and lauric acids (C12) in humans has not been well studied.

In a recent study, it was found that the increase in total ketones^[iv] wasn’t significantly different between C8 and a mixture of C8 and C10 fatty acids. Both C8 and C8-10 increased plasma BOHB by around 5-fold (first half of the day) to 1.5-fold (second half of the day of administration). Compared to C10, the area under the curve for BOHB was 62-fold lower during the 0–4-hour period and 1.5-fold lower during the 4–8-hour period.

This supports the idea that shorter chain lengths promote faster and greater increases in ketones. However, there is a ‘longer’ (albeit smaller) effect of longer MCFA chains. The shorter chains also have a stronger dose-effect. For example, at 400 μM of each MCFA in plasma total lipids, plasma ketones were about three times higher after C8 than after C10 and two times higher after C10 than C12. So, C8 is considered a very ketogenic MCFA with diminishing effects for the longer chains of C10 and C12.⁵⁸ While lauric acid (C12) does increase ketones over a time-frame of several hours because the total elevation in ketones is not as much as the shorter chain fats, there is debate about whether lauric acid is functionally ketogenic.

There is debate about whether lauric acid is functionally ketogenic

What are MCTs?

• Structurally, MCTs are lipids with fatty acids between 6 and 12 carbon chains in length
• There is debate as to whether lauric acid (C12) in particular is functionally an MCFA
• The most active MCTs are those containing 6-10 chain length fatty acids (caproic, caprylic, and capric acids) with the greatest ketogenic effect likely from the shortest MCFAs (C6 and C8)
• They can be transported directly to the liver, from the gut, to be converted into ketones
• Ketones provide a glucose-sparing fuel for the brain and central nervous system and most tissue throughout the body

Medium Chain Triglycerides (MCTs) are a particular type of dietary fat (or ‘lipid’). ‘Fat’ itself is the term lay-term we use for a ‘triglyceride’.

A triglyceride consists of a glycerol ‘backbone’ with three ‘fatty acids’ attached to it.

A triglyceride consists of a glycerol ‘backbone’ with three ‘fatty acids’ attached to it

Dietary fats that we eat are almost always triglycerides, but most contain long fatty-acid chains (greater than twelve carbons in length). MCTs are rarer in the diet and are found in small amounts in dairy foods and in palm and coconut oils. Coconut oils are especially rich in a medium-chain fatty acid called ‘lauric acid’ that is 12 carbons in length. The other medium-chain fatty acids (MCFA) are fatty acids comprised of 6–10 carbons in the chain. These MCTs are: caproic (C6), caprylic (C8), and capric (C10) acids.⁵⁹

Long-chain fats, which include most of the dietary fats that we eat, require the action of bile and phospholipids in the gut to break up the fat into smaller ‘packets’ for digestion and once they have been absorbed into the intestinal wall they are bundled up into chylomicrons (a protein transport molecule) so that they can be delivered to the body via the lymphatic system.

Medium Chain Triglycerides do not require the actions of bile, and rather than the standard absorption and transport pathways, they are instead absorbed into the hepatic portal vein and transported directly to the liver for conversion into bio-available ketone fuels.

Medium Chain Triglycerides do not require the actions of bile and are absorbed into the hepatic portal vein and transported directly to the liver for conversion into ketones

Early animal studies demonstrated the ketogenic (ketone producing) effect of MCTs and indicated an approximately nine-fold increase in ketone body production after ingestion of MCT versus LCT,^{60, 61} and it is well known that MCTs promote both an immediate boost in ketones and encourage the creation of ketones from other fat types in both animals ^{60, 61} and in humans.⁶²

What are ketone bodies?

The ketone bodies that we produce when on a ketogenic diet, when fasting, or when taking MCTs, are an alternate, brain- and body-friendly fuel derived from fatty acids and some amino acids.

The ketone bodies are acetoacetate, ß-hydroxybutyric acid (BOHB) and acetone.  These ketone bodies are produced through a process called ‘ketogenesis’ in the liver. Acetoacetate is the primary ketone body, and this is converted to BOHB, which functions as the main ketone ‘fuel’.^[v] BOHB can be used by most tissue in the body and most importantly is easily used by heart tissue as a preferred fuel, muscle tissue, and the brain and central nervous system (which usually relies on glucose for fuel.) A restriction of carbohydrate results in reduced insulin levels and reduced lipogenesis (the creation of fats). When liver glycogen (your stored carb reserve) becomes insufficient to supply the glucose necessary for normal fat oxidation and for the supply of glucose to the CNS, an alternative fuel source is needed.

The CNS typically doesn’t use fat for fuel for two reasons:

1. The common dietary fats (consisting of long-chain fatty acids) are usually bound to a protein called ‘albumin’ and can’t cross the blood-brain barrier.
2. Use of fats in the brain demands more oxygen than using glucose, which can starve brain cells of oxygen. This results in oxidative damage and impaired fuel provision to those neurons.⁶³

Some dietary fats such as short-chain fatty acids like butyrate, medium-chain triglycerides, and ketones, are able to easily cross the blood-brain barrier (because they are not bound to albumin) and they do not promote the same raft of problems usually resulting from fat metabolism in the brain.⁶³

Short-chain fatty acids, medium-chain triglycerides, and ketones are able to easily cross the blood-brain barrier

Is coconut oil an MCT?

Coconut oil (CO) is the expressed oil from the flesh of the mature coconut. Coconut Oil contains medium-chain fatty acids from 6-12 chains in length and premium MCT oils are typically sourced from coconut oil (mainly due to the negative ecological impact of Palm Oil). However, most of the fat content of whole coconut oil comes from the C12 fatty acid, lauric acid.

Most of the fat content of whole coconut oil comes from the C12 fatty acid, lauric acid.

Coconut oil and lauric acid itself has many health benefits including improved HDL (“good”) cholesterol and reduced midsection fat,^64-66 but because of the slightly longer chain-length of lauric acid, less is transported directly to the liver when compared to the other MCTs. Animal studies have suggested that some (perhaps ~18%) of lauric acid can escape lymphatic digestion (and thus, enter the liver for conversion to ketones).⁵⁵ Later human research has shown that the effects of C12 on ketone production is small but there are temporal effects and there is an elevation of up to ~0.2 mmol/L up to 8 hours after ingestion of 20 ml of MCT containing only lauric acid.⁵⁸

How to use MCTs

General guidelines:

• Build up slowly to find your own tolerance level
• Start with 1 tsp. and build up by 1 tsp. per serve until you are taking somewhere between 1 and 2 Tbsp (3-6 tsp.), 1-3 times per day
• If you experience any stomach discomfort, cut the dose back by 1 tsp.

Ideas for use

In your morning coffee or tea

A great brain-boosting way to take your ketones is in your morning coffee or tea. Try a Tbsp. of MCT or MCT powder, with a dash of full-fat milk, cream, or coconut cream, in your coffee or tea. Give it a quick whizz with a hand blender for a creamy, latte-like consistency and add collagen protein if desired.

In smoothies

Adding MCTs to your smoothie is a great way to add MCTs to your day. Make sure that your smoothie also includes a good protein source, berries, and veggies for full ‘meal in a glass’ that will help to satisfy you and provide nutrient density.

On salads and veggies

MCTs can be used as a base for salad and veggie dressings. They are light and almost tasteless. Try adding a Tbsp. of MCT oil to olive oil, lemon juice or vinegar of your choice, and salt and pepper, for an easy, convenient, salad dressing that’s packed with nutrients and brain- and body-friendly fats. Adding some healthy fats to veggies will also improve the absorption of fat-soluble vitamins and carotenoids. 

Goal-specific use

For general use

Take 1-2 Tbsp., 1-3 times per day in coffee, tea, or a smoothie.

For performance

To improve fuelling for performance, take MCTs, according to your tolerance level, before training sessions or events with your standard pre-training meal or drink. If you are doing long events you can take small amounts of MCTs during the event as well. Be aware of your own tolerance levels so that you don’t develop ‘thunder pants’!

For focus, mood and cognition

To improve focus, mood, and cognition through the day, and to help preserve brain health and function as you age, take 1-2 Tbsp in a drink or with a protein shake. This can be taken whenever you feel that your mental energy is dropping, or if you are experiencing ‘brain fog’.

To help with sleep

Ketones can modulate the GABA-Glutamate ratio in the brain and increase relative adenosine levels, which is a science-nerdy way of saying that they can help the brain to relax and therefore help you to sleep better. Try taking a Tbsp. of MCTs around 30-60 min before bed to see if it helps you to drift off to sleep better. Again, this could be with a protein drink, fish oil, or sleep-aiding supplements like magnesium, or herbal teas like passionflower, chamomile, valerian etc.

To aid weight management and body composition

MCTs won’t magically strip fat from your body!

BUT the evidence does show us that MCTs can help us to reduce our energy intake (because we choose to eat less without realising it) and increase the calories we burn (for no other input from us) and reduce fat, maintain weight more effectively, and help us to reduce abdominal fat when substituted for other fats.

In other words, taking some MCTs can help you to lose weight and body fat if it helps you to eat less, or if you sub out some other fat (especially industrial seed oils) for MCT. BUT if you simply add energy (in the form of MCT) without eating any less and without changing anything else, thermodynamics tells us that you won’t lose any fat!

You can use MCTs in smoothies (according to your desired macro intake), or in hot drinks as a fat-fuel that can be used in place of meals to help you to maintain a fasting window.

For muscle gain

Some recent research suggests that increased ketones after training might help to stimulate muscle growth when taken with protein. So, you could try adding a Tbsp. or so of MCTs to your post-workout protein drink.

For health conditions

A range of health conditions can benefit from MCTs including mental and mood disorders, neurodegenerative disorders, autoimmune and inflammatory conditions and cardiometabolic conditions.

If you have a condition, make sure that you consult with a qualified, registered health practitioner who is well versed in the research behind ketosis, ketogenesis, and MCTs, as well as your health condition, and take as directed.

Shameless plug: I am a registered clinical nutritionist with over two decades of experience using ketogenic diets and MCTs with clients. Oh yeah…I also did my masters and doctoral research in MCTs and ketogenesis ????

How do I use MCTs?

A lot of my readers and clients email me asking how I use MCTs, and supplements in general.

My current meal and supplement regimen looks like this:

Time	Food and Water	Supplement
On arising (around 6 am)	2 glasses of water Coffee with a dash of milk (I sometimes include collagen and MCT powder in this if I am training hard and/or feel I need additional calories)	1 serve Vita Biosa 2 caps Resveracel
Training (around 11 am)	Water during training,	Sometimes a combo of ketones, Lion’s Mane and Cordyceps tinctures before or training for an extra ‘kick’
After training (12 pm)	Water with smoothie –>	4 Tbsp. Clean Lean Protein, 1 scoop Good Green Stuff, 1 Tbsp. Melrose DHA+MCT Various mushroom powders
Meal #1 – Lunch (1-3 pm)	Meat, vegetables, olive oil or avocado (plus nuts, seeds, sprouts etc.)
After work shake (Around 4-5 pm)	4 Tbsp. Clean Lean Protein, 1 scoop Good Green Stuff, 1 Tbsp. Melrose Original or Pro-Rapid MCT Various mushroom powders
Meal #2 – Dinner Around 6-7 pm	Meat, vegetables, olive oil or avocado (plus nuts, seeds, sprouts etc.)

---

[i][i] Measured by Functional Independence Measure score

[ii][ii] Alzheimer’s Disease Assessment Scale–Cognitive Subscale

[iii] LysoPC (18:0), palmitic acid, linoleic acid, oleic acid, and 7,12-dimethylbenz[a]anthracene

[iv] Area under the curve (AUC)

[v] Technically BOHB is not a ketone body as the ketone moiety has been reduced to a hydroxyl group

References

1.         McAllister MJ, Waldman HS, Renteria LI, Gonzalez AE, Butawan MB, Bloomer R. Acute coffee ingestion with and without medium chain triglycerides decreases blood oxidative stress markers and increases ketone levels. Canadian Journal of Physiology and Pharmacology. 2019.

2.         Harvey CJdC, Schofield GM, Williden M, McQuillan JA. The effect of medium chain triglycerides on time to nutritional ketosis and symptoms of keto-induction in healthy adults: a randomised controlled clinical trial. J Nutr Metab. 2018;2018:9.

3.         Mingrone G, Greco AV, Castagneto M, De Gaetano A, Tataranni PA, Raguso C. Kinetics and thermogenesis of medium-chain monocarboxylic and dicarboxylic acids in man: sebacate and medium-chain triglycerides. JPEN J Parenter Enteral Nutr. 1993;17(3):257-64.

4.         Jiang ZM, Zhang SY, Wang XR, Yang NF, Zhu Y, Wilmore D. A comparison of medium-chain and long-chain triglycerides in surgical patients. Ann Surg. 1993;217(2):175-84.

5.         Lai H, Chen W. Effects of medium-chain and long-chain triacylglycerols in pediatric surgical patients. Nutrition. 2000;16(6):401-6.

6.         Sandström R, Hyltander A, Körner U, Lundholm K. Structured triglycerides were well tolerated and induced increased whole body fat oxidation compared with long-chain triglycerides in postoperative patients. JPEN J Parenter Enteral Nutr. 1995;19(5):381-6.

7.         Lefevre F, Aronson N. Ketogenic diet for the treatment of refractory epilepsy in children: a systematic review of efficacy. Pediatrics. 2000;105(4):e46.

8.         Keene DL. A systematic review of the use of the ketogenic diet in childhood epilepsy. Pediatr Neurol. 2006;35(1):1-5.

9.         Neal EG, Chaffe H, Schwartz RH, Lawson MS, Edwards N, Fitzsimmons G, et al. The ketogenic diet for the treatment of childhood epilepsy: a randomised controlled trial. Lancet Neurol. 2008;7(6):500-6.

10.       Levy RG, Cooper PN, Giri P, Pulman J. Ketogenic diet and other dietary treatments for epilepsy. The Cochrane Library. 2012.

11.       Livingstone S. Comprehensive Management of Epilepsy in Infancy, Childhood and Adolescence. Archives of Disease in Childhood. 1972;47(255):842-.

12.       Livingston S, Pauli LL, Pruce I. KETOGENIC DIET IN TREATMENT OF CHILDHOOD EPILEPSY. Developmental Medicine and Child Neurology. 1977;19(6):833-4.

13.       Huttenlocher PR. Ketonemia and Seizures: Metabolic and Anticonvulsant Effects of Two Ketogenic Diets in Childhood Epilepsy. Pediatr Res. 1976;10(5):536-40.

14.       Huttenlocher P, Wilbourn A, Signore J. Medium‐chain triglycerides as a therapy for intractable childhood epilepsy. Neurology. 1971;21(11):1097-.

15.       Vandenberghe C, Castellano C-A, Maltais M, Fortier M, St-Pierre V, Dionne IJ, et al. A short-term intervention combining aerobic exercise with medium-chain triglycerides (MCT) is more ketogenic than either MCT or aerobic exercise alone: a comparison of normoglycemic and prediabetic older women. Applied Physiology, Nutrition, and Metabolism. 2018;44(1):66-73.

16.       Schutz PW. Neuroprotective effects of ketone bodies during hypoglycemia: University of British Columbia; 2011.

17.       Hertz L, Chen Y, Waagepetersen HS. Effects of ketone bodies in Alzheimer’s disease in relation to neural hypometabolism, β-amyloid toxicity, and astrocyte function. Journal Of Neurochemistry. 2015;134(1):7-20.

18.       Youm Y-H, Nguyen KY, Grant RW, Goldberg EL, Bodogai M, Kim D, et al. The ketone metabolite β-hydroxybutyrate blocks NLRP3 inflammasome-mediated inflammatory disease. Nat Med. 2015;21(3):263-9.

19.       Gzielo K, Soltys Z, Rajfur Z, Setkowicz ZK. The Impact of the Ketogenic Diet on Glial Cells Morphology. A Quantitative Morphological Analysis. Neuroscience. 2019.

20.       Kim SW, Marosi K, Mattson M. Ketone beta-hydroxybutyrate up-regulates BDNF expression through NF-κB as an adaptive response against ROS, which may improve neuronal bioenergetics and enhance neuroprotection (P3.090). Neurology. 2017;88(16 Supplement).

21.       Telliez F, Bach V, Leke A, Chardon K, Libert J-P. Feeding behavior in neonates whose diet contained medium-chain triacylglycerols: short-term effects on thermoregulation and sleep. The American Journal of Clinical Nutrition. 2002;76(5):1091-5.

22.       Zhou S, Wang Y, Jacoby JJ, Jiang Y, Zhang Y, Yu LL. Effects of Medium- and Long-Chain Triacylglycerols on Lipid Metabolism and Gut Microbiota Composition in C57BL/6J Mice. Journal of Agricultural and Food Chemistry. 2017;65(31):6599-607.

23.       Rial SA, Karelis AD, Bergeron K-F, Mounier C. Gut Microbiota and Metabolic Health: The Potential Beneficial Effects of a Medium Chain Triglyceride Diet in Obese Individuals. Nutrients. 2016;8(5):281.

24.       Yang LF, Jiang Y, Yao J, Zhu FJ, Zhang DX, Ding D, et al. Effect of high amounts of medium chain triglyceride and protein enteral nutrition on gut barrier function during the perioperative period in patient with malignant obstructive jaundice. Parenteral & Enteral Nutrition. 2017;24(6):351-4.

25.       Ogbolu DO, Oni AA, Daini OA, Oloko AP. In Vitro Antimicrobial Properties of Coconut Oil on Candida Species in Ibadan, Nigeria. Journal of medicinal food. 2007;10(2):384-7.

26.       Gunsalus KTW, Tornberg-Belanger SN, Matthan NR, Lichtenstein AH, Kumamoto CA. Manipulation of Host Diet To Reduce Gastrointestinal Colonization by the Opportunistic Pathogen &lt;span class=&quot;named-content genus-species&quot; id=&quot;named-content-1&quot;&gt;Candida albicans&lt;/span&gt. mSphere. 2016;1(1):e00020-15.

27.       Jadhav A, Mortale S, Halbandge S, Jangid P, Patil R, Gade W, et al. The Dietary Food Components Capric Acid and Caprylic Acid Inhibit Virulence Factors in Candida albicans Through Multitargeting. Journal of medicinal food. 2017;20(11):1083-90.

28.       Sudbery PE. Growth of Candida albicans hyphae. Nature Reviews Microbiology. 2011;9:737.

29.       Arsenault AB, Gunsalus KTW, Laforce-Nesbitt SS, Przystac L, DeAngelis EJ, Hurley ME, et al. Dietary Supplementation With Medium-Chain Triglycerides Reduces Candida Gastrointestinal Colonization in Preterm Infants. The Pediatric Infectious Disease Journal. 2019;38(2):164-8.

30.       Nosaka N, Suzuki Y, Suemitsu H, Kasai M, Kato K, Taguchi M. Medium-chain Triglycerides with Maltodextrin Increase Fat Oxidation during Moderate-intensity Exercise and Extend the Duration of Subsequent High-intensity Exercise. Journal of Oleo Science. 2018;67(11):1455-62.

31.       Abe S, Ezaki O, Suzuki M. Medium-chain triglycerides (8:0 and 10:0) are promising nutrients for sarcopenia: a randomized controlled trial. The American Journal of Clinical Nutrition. 2019;110(3):652-65.

32.       Henderson ST. Ketone Bodies as a Therapeutic for Alzheimer’s Disease. Neurotherapeutics. 2008;5(3):470-80.

33.       Chatterjee P, Fernando M, Fernando B, Dias CB, Shah T, Silva R, et al. Potential of coconut oil and medium chain triglycerides in the prevention and treatment of Alzheimer’s disease. Mechanisms of Ageing and Development. 2020;186:111209.

34.       Reger MA, Henderson ST, Hale C, Cholerton B, Baker LD, Watson GS, et al. Effects of β-hydroxybutyrate on cognition in memory-impaired adults. Neurobiology of Aging. 2004;25(3):311-4.

35.       Cunnane SC, Courchesne-Loyer A, St-Pierre V, Vandenberghe C, Pierotti T, Fortier M, et al. Can ketones compensate for deteriorating brain glucose uptake during aging? Implications for the risk and treatment of Alzheimer’s disease. Annals of the New York Academy of Sciences. 2016;1367(1):12-20.

36.       Kimoto A, Ohnuma T, Toda A, Takebayashi Y, Higashiyama R, Tagata Y, et al. Medium-chain triglycerides given in the early stage of mild-to-moderate Alzheimer’s disease enhance memory function. Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society. 2017;17(6):520-1.

37.       Xu Q, Zhang Y, Zhang X, Liu L, Zhou B, Mo R, et al. Medium-chain triglycerides improved cognition and lipid metabolomics in mild to moderate Alzheimer’s disease patients with APOE4−/−: A double-blind, randomized, placebo-controlled crossover trial. Clinical Nutrition. 2019.

38.       Abe S, Ezaki O, Suzuki M. Medium-Chain Triglycerides in Combination with Leucine and Vitamin D Benefit Cognition in Frail Elderly Adults: A Randomized Controlled Trial. Journal of Nutritional Science and Vitaminology. 2017;63(2):133-40.

39.       Avgerinos KI, Egan JM, Mattson MP, Kapogiannis D. Medium Chain Triglycerides induce mild ketosis and may improve cognition in Alzheimer’s disease. A systematic review and meta-analysis of human studies. Ageing Research Reviews. 2020;58:101001.

40.       Page KA, Williamson A, Yu N, McNay EC, Dzuira J, McCrimmon RJ, et al. Medium-Chain Fatty Acids Improve Cognitive Function in Intensively Treated Type 1 Diabetic Patients and Support In Vitro Synaptic Transmission During Acute Hypoglycemia. Diabetes. 2009;58(5):1237-44.

41.       Miki K, Kitada S, Miki M, Hui S-P, Shrestha R, Yoshimura K, et al. A phase II, open-label clinical trial on the combination therapy with medium-chain triglycerides and ghrelin in patients with chronic obstructive pulmonary disease. The Journal of Physiological Sciences. 2019;69(6):969-79.

42.       St-Onge M-P, Ross R, Parsons WD, Jones PJH. Medium-Chain Triglycerides Increase Energy Expenditure and Decrease Adiposity in Overweight Men. Obesity Research. 2003;11(3):395-402.

43.       Tsuji H, Kasai M, Takeuchi H, Nakamura M, Okazaki M, Kondo K. Dietary Medium-Chain Triacylglycerols Suppress Accumulation of Body Fat in a Double-Blind, Controlled Trial in Healthy Men and Women. The Journal of Nutrition. 2001;131(11):2853-9.

44.       St-Onge M-P, Bosarge A. Weight-loss diet that includes consumption of medium-chain triacylglycerol oil leads to a greater rate of weight and fat mass loss than does olive oil. The American Journal of Clinical Nutrition. 2008;87(3):621-6.

45.       Clegg ME. Medium-chain triglycerides are advantageous in promoting weight loss although not beneficial to exercise performance. International journal of food sciences and nutrition. 2010;61(7):653-79.

46.       Van Wymelbeke V, Himaya A, Louis-Sylvestre J, Fantino M. Influence of medium-chain and long-chain triacylglycerols on the control of food intake in men. The American Journal of Clinical Nutrition. 1998;68(2):226-34.

47.       Dulloo AG, Fathi M, Mensi N, Girardier L. Twenty-four-hour energy expenditure and urinary catecholamines of humans consuming low-to-moderate amounts of medium-chain triglycerides: a dose-response study in a human respiratory chamber. Eur J Clin Nutr. 1996;50(3):152-8.

48.       Calabrese C, Myer S, Munson S, Turet P, Birdsall TC. A cross-over study of the effect of a single oral feeding of medium chain triglyceride oil vs. canola oil on post-ingestion plasma triglyceride levels in healthy men. Altern Med Rev. 1999;4(1):23-8.

49.       Kasai M, Maki H, Nosaka N, Aoyama T, Ooyama K, Uto H, et al. Effect of Medium-chain Triglycerides on the Postprandial Triglyceride Concentration in Healthy Men. Bioscience, Biotechnology, and Biochemistry. 2003;67(1):46-53.

50.       Nagao K, Yanagita T. Medium-chain fatty acids: Functional lipids for the prevention and treatment of the metabolic syndrome. Pharmacological Research. 2010;61(3):208-12.

51.       Lindgren BF, Ruokonen E, Magnusson-Borg K, Takala J. Nitrogen sparing effect of structured triglycerides containing both medium-and long-chain fatty acids in critically ill patients; a double blind randomized controlled trial. Clinical Nutrition. 2001;20(1):43-8.

52.       Krotkiewski M. Value of VLCD supplementation with medium chain triglycerides. Int J Obes Relat Metab Disord. 2001;25(9):1393-400.

53.       Zhang R, Chen J, Zheng H, Li Y, Huang H, Liang Z, et al. Effects of medium chain triglycerides on body fat distribution and adipocytokine levels in children with acute lymphoblastic leukemia under chemotherapy. Medicine. 2019;98(33):e16811-e.

54.       Thomson ABR, Keelan M, Garg ML, Clandinin MT. Intestinal aspects of lipid absorption: in review. Canadian Journal of Physiology and Pharmacology. 1989;67(3):179-91.

55.       Mu H, Hoy CE. Effects of different medium-chain fatty acids on intestinal absorption of structured triacylglycerols. Lipids. 2000;35(1):83-9.

56.       McDonald GB, Saunders DR, Weidman M, Fisher L. Portal venous transport of long-chain fatty acids absorbed from rat intestine. American Journal of Physiology – Gastrointestinal and Liver Physiology. 1980;239(3):G141-G50.

57.       Bloom B, Chaikoff IL, Reinhardt WO. Intestinal lymph as pathway for transport of absorbed fatty acids of different chain lengths. American Journal of Physiology–Legacy Content. 1951;166(2):451-5.

58.       St-Pierre V, Vandenberghe C, Lowry C-M, Fortier M, Castellano C-A, Wagner R, et al. Plasma Ketone and Medium Chain Fatty Acid Response in Humans Consuming Different Medium Chain Triglycerides During a Metabolic Study Day. Frontiers in nutrition. 2019;6:46-.

59.       Marten B, Pfeuffer M, Schrezenmeir J. Medium-chain triglycerides. International Dairy Journal. 2006;16(11):1374-82.

60.       Bach A, Schirardin H, Weryha A, Bauer M. Ketogenic response to medium-chain triglyceride load in the rat. J Nutr. 1977;107(10):1863-70.

61.       Yeh YY, Zee P. Relation of ketosis to metabolic changes induced by acute medium-chain triglyceride feeding in rats. The Journal Of Nutrition. 1976;106(1):58-67.

62.       St-Onge M-P, Ross R, Parsons WD, Jones PJH. Medium-chain triglycerides increase energy expenditure and decrease adiposity in overweight men. Obes Res. 2003;11(3):395-402.

63.       Schonfeld P, Reiser G. Why does brain metabolism not favor burning of fatty acids to provide energy[quest] – Reflections on disadvantages of the use of free fatty acids as fuel for brain. J Cereb Blood Flow Metab. 2013;33(10):1493-9.

64.       Assunção M, Ferreira H, dos Santos A, Cabral C, Jr., Florêncio TMT. Effects of Dietary Coconut Oil on the Biochemical and Anthropometric Profiles of Women Presenting Abdominal Obesity. Lipids. 2009;44(7):593-601.

65.       Ekanayaka RAI, Ekanayaka NK, Perera B, De Silva PGSM. Impact of a Traditional Dietary Supplement with Coconut Milk and Soya Milk on the Lipid Profile in Normal Free Living Subjects. Journal of Nutrition and Metabolism. 2013;2013:11.

66.       Mensink RP, Zock PL, Kester AD, Katan MB. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr. 2003;77(5):1146-55.

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