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Medium Chain Triglycerides: Brain Fuel or Just Hype?

Research around Medium Chain Triglycerides (or ‘MCT’s) has focused on beneficial effects for modifying body composition and increasing fat oxidation. Purified medium chain triglycerides, when added to a test diet, have been demonstrated to elicit a more significant decrease in appetite and an increase in fullness compared to coconut oil (source). But, could they also play a role in cognitive function?

Sourced from coconut or palm oil, medium chain triglycerides are fatty acids which are 6-10 carbon atoms in length. Although medium chain triglycerides can be found in coconut oil, only about 65% of the total fatty acid content found there is the medium chain variety. In order to become ‘pure’ medium chain triglyceride oil, fatty acids go through processing steps which include hydrolysis, filtering, and re-esterification.

These unique fatty acids are metabolized differently in both the brain and body compared to long-chain fatty acids, which would be found in foods such as meats, nuts, and avocado. While long-chain triglycerides need a ‘transporter’ (acetylcarnitine transfer system) to transfer into cellular energy pathways, medium chain triglycerides are able to cross into the liver and muscle without a transporter system, making them a much more available energy source (source).

What do Medium Chain Triglycerides have to do with Brain Function?

A unique benefit of medium chain triglycerides is that they are metabolized to ketone bodies, the same substances that would be produced through nutritional ketosis induced by a ketogenic diet. Once medium chain fatty acids get into the bloodstream, metabolism into ketone bodies (Acetate, Acetoacetate, and D-β-hydroxybutyrate) occurs in the liver (source). When the brain does not have enough glucose available-either through lack of availability or impaired utilization-ketones from MCT’s can be used to act as an alternate fuel source for brain activity.

Why would the brain not be using it’s primary fuel-glucose?

The brain becomes reliant on ketones as an energy source during periods of starvation or in cases where carbohydrate intake is too low to fuel the brain. In mild-moderate Alzheimer’s dementia, decreased activity of a glucose transporter called ‘Glut-1’ has been documented (source). Lack of fuel to brain cells could cause neuronal damage-not good! When glucose is not being transported across the blood brain barrier efficiently, the body can utilize ketones as an alternative energy source for brain cells with implications for cognition and memory. One study submitted to the FDA for clearance of Axona (a Medium Chain Triglyceride based Medical Food for memory loss) demonstrated improved scoring on the AD Assessement Scale-Cognitive sub scale over 45 and 90 days of the product trial. Additionally, medium chain triglycerides have been studied to increase neurogenesis (growth of neurons) and to decrease Amyloid-β plaque in Alzheimer’s pathology (source). Some other cases in which lower glucose brain metabolism has been seen include in young women with polycystic ovary syndrome, pre diabetes in older individuals, and genetic carriers of presenillin 1 (source).

Do you think that you or someone you love could benefit from experimenting with Medium Chain Triglycerides in their diet?

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About Sarah Ferreira

Sarah Ferreira,MS,MPH,RD,CDN,CNSC,IFNCP,CHWC is a Registered Dietitian Nutritionist with complementary certification as an Integrative and Functional Nutrition Certified Practitioner and Certified Health and Wellness Coach. She is the owner of Mindfully Nourished Solutions, where she uses a whole-person, whole-food approach to explore the impact of nutrition on mood and cognition. Her individualized approach integrates an assessment of nutritional, genetic, environmental, and lifestyle factors into a collaborative nutrition care plan using cutting-edge research designed to facilitate meaningful and restorative changes based around client goals and priorities.

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