Supplementing with Medium Chain Triglycerides

(MCTs) is NOT beneficial for the general population

Ian Scriven, Jared Winkel, Maxamillian Purvine

 Introduction
What are medium chain triglycerides?

● MCT’s are 6-12 carbon triglycerides as compared to 14+ carbons of long chain triglycerides.
● 8.3 kcal/g

Where are they found?

● Coconut Oil
● Pure MCT oil, developed in 1950’s

What's the big deal?

● Directly absorbed into the portal system, compared to LCT which requires more complex
transportation and digestion before being available in the blood.
● Believed to be a magic cure for weight loss, improved cognitive function and mood enhancement.
 Metabolic Pathways of MCT

● Absorbed through aqueous unstirred layer in intestines

via passive diffusion
● MCT’s bypass the lymphatic system and can go directly
to the liver via the portal vein.
● Do not require chylomicrons
○ MCTs bind to albumin for transport after passive diffusion
into the portal system
 Metabolism continued

● Enter the Hepatocyte

● Metabolized to MCFA
● MCFA enter the mitochondria
● Oxidized into Acetyl-CoA
● Can form ketone bodies or citrate in the TCA
cycle
● Some MCT/MCFA end up undergoing
lipogenesis and end up as TG transported by
chylomicrons in the lymphatic system
 Latest Research
In a literature review by Driskell, J. A. (2007), the following side effects were observed from
various studies. Studies ranged between 1 day and 7 weeks.

● Abdominal cramps
● Diarrhea
● Decreased bowel transit time to 56+/- 6 min v.s 105 +/- 9 min of LCTG. - 7 day rest between
treatments, 4 treatments total
● High doses of MCT’s may lead to elongation and re-esterification into LCFA to be stored in adipose
tissue.
○ This can negate some of the benefits that supplementation with MCTs suggest
● MCT elongation and lipogenesis can increase postprandial thermogenesis via energy expenditure. -
Randomized crossover design - 10 males, 2 diets, 6 day each diet.
 Effects on Cholesterol
● MCT use at 40% total caloric intake (Swift et al. 1992)
○ HDL decreased by 15%
○ Plasma triglycerides increased by 42%
○ Plasma triglycerides unchanged by LCT (Long Chain Triglycerides)
● Healthy male subjects

Caprylic acid, a common medium chain triglyceride.

 Effects on Cholesterol
● MCT vs linoleic acid supplementation at 60 g/day (Van Schalkwijk et al. 2014)
○ Total cholesterol increased by 15%
○ VLDL increased by 30%
○ LDL increased by 18%
○ Triglycerides increased by 23%
○ HDL was the same for both groups
● Subjects
○ 12 obese males - healthy
○ Randomized double blind
○ Cross-over
 Effects on Cholesterol
● MCT vs oleic acid replacement at 70 g/day (Tholstrup et al. 2004)
○ Total cholesterol increased by 11%
○ VLDL increased by 32%
○ LDL to HDL ratio increased by 12%
● Subjects
○ 17 young healthy males
○ Randomized double blind
○ Cross-over
 Latest Research Continued
● MCT vs corn oil supplementation at 20 g/day (Tremblay et al. 2014)
○ 4 weeks of supplementation
■ Examined impact on kinetics of Apo B-48 and Apo B-100
○ No significant effect on plasma lipoprotein levels or on intestinal expression of genes involved in
fatty acid metabolism.
● Subjects
○ 28 obese men
■ Insulin resistant
● This was not done on a healthy population, but shows no benefit in short term
supplementation with a group that has previous medical conditions.
 Nutritional considerations when supplementing with
MCTs
● 70%-75% of the daily recommended saturated fat per 1 tablespoon serving
● 100-140 calories per 1 tablespoon serving
● When added on top of normal diet instead of replacing LCT, this can be a substantial increase in
calories and saturated fat, especially when multiple servings are used to supplement with.
 Cost of supplementation with MCT oil
● MCT oil supplements come in a variety of forms either as pills, powders, or most popularly, oils.
● Prices can range from $20.00-$30.00 for a 32 oz bottle and the quality and sources of the product vary with the brand.
● Most bottles recommend beginning supplementation with 1 tablespoon per day and state that this can be increased to a
serving as large as 3 tablespoons per day.
● A $25.00 32 oz bottle containing 63 servings at 1-3 tablespoons per day for one year would be an additional $145.00 -
$435.00 per year.
● This number can vary greatly based on brand and frequency of use but is still substantial when the lack of substantiating
research and possible side effects are considered.
 Conclusion
● Research on the benefits of supplementation with MCT oils has not been conducted in long term
trials
● The financial cost of frequent use of MCT oil is substantial and is not feasible for many people
● If someone does not use MCT oil to replace equal portion of LCT in their diet they are simply
adding calories and saturated fats to their diet which negates the claims that using MCT oil can aid
in weight loss.
● There are many possible effects of using MCT oil because of its unique mode of digestion, but the
present research and cost of use does not substantiate the benefit of supplementation for the
general population.
 References
1.) Castell, L., Stear, Samantha J., & Burke, Louise. (2015). Nutritional supplements in sport, exercise and health : An A-Z guide. London ; New
York: Routledge/Taylor & Francis Group.

2.) Driskell, J. (2007). Sports Nutrition Fats and Proteins. Hoboken: CRC Press.

3.) Schalkwijk, D. B., Pasman, W. J., Hendriks, H. F., Verheij, E. R., Rubingh, C. M., Bochove, K. V., . . . Graaf, A. A. (2014, July 21). Dietary
Medium Chain Fatty Acid Supplementation Leads to Reduced VLDL Lipolysis and Uptake Rates in Comparison to Linoleic Acid
Supplementation. Retrieved November 28, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4105472/?report=reader

4.) Shah ND LB. The Use of Medium-Chain Triglycerides in Gastrointestinal Disorders. Practical Gastroenterology. 2017. [In Press]

5.) Swift, L. L., Hill, J. O., Peters, J. C., & Greene, H. L. (1992, November). Plasma lipids and lipoproteins during 6 d of maintenance feeding
with long-chain, medium-chain, and mixed-chain triglycerides. Retrieved November 28, 2017, from
https://www.ncbi.nlm.nih.gov/pubmed/1415007

6.) Tholstrup, T., Ehnholm, C., Jauhiainen, M., Petersen, M., Høy, C., & Lund, A. P. (2004, April 01). Tine Tholstrup. Retrieved November 28,
2017, from http://ajcn.nutrition.org/content/79/4/564.full

7.) Tremblay, A. J., Lamarche, B., Labonte, M. E., Lapine, M. C., Lemelin, V., & Coutoure, P. (n.d.). Effects of Medium-Chain Triglycerides on
Chylomicron Secretion and Expression of Genes That Regulate Intestinal Lipid Metabolism in Men With Dyslipidemia Associated With
the Metabolic Syndrome - Full Text View. Retrieved November 28, 2017, from https://clinicaltrials.gov/show/NCT01806142