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Both coconut oil and medium-chain triglyceride (MCT) oil are popular supplements to support health. And while they have some similarities, they also have some significant differences.
Coconut oil is the easiest to explain: it's the oil derived from coconuts. However, it is worth recognizing that there are different types of coconut oil, from minimally processed, cold-pressed virgin coconut oil to refined or even hydrogenated coconut oil. Virgin coconut oil is typically considered to be coconut oil derived from mature coconuts. The oil is extracted through mechanical or other "natural" means. Heat might be applied, but the resulting oil is not refined.
Refined coconut oil is often extracted from coconuts through harsher techniques, which can include the use of toxic chemical solvents. Once the oil is collected, it is refined, bleached, and deodorized. While not a perfect test, virgin coconut oil typically has a characteristic coconut smell and taste. In contrast, refined coconut oil has little scent or flavor, yielding a mostly flavorless off-white oil. Additionally, virgin coconut oil is much higher in phenolic compounds—antioxidant compounds found in numerous popular herbal products, including chocolate, green tea, blueberries, and pine bark extract. Generally, phenolics have antioxidant and anti-inflammatory properties.
As far as oil content goes, coconut oil is over 90% saturated fat. Of these fats, a large percentage are medium chain triglycerides (MCTs). The structure of a fat molecule includes a backbone with fatty acid chains that extend from the backbone. These fatty acid chains can vary in length and structure, giving them different properties. Generally, MCTs have between six and twelve links in their chain. On average, coconut is composed of around 60% MCTs, with the remainder being long-chain triglycerides. Palm kernel oil is the only other common food oil that contains significant MCTs, containing around 50%.
MCT oil is refined coconut or palm kernel oil that strips out the long-chain triglycerides, leaving behind the medium-chain fats. Products can vary based on the percentage of the different types of MCTs. The main medium-chain triglycerides include:
Both coconut oil and MCT oil are sources of medium-chain triglycerides, which have interesting effects on the body. MCT oil is just a more concentrated and refined version of MCTs as compared to coconut oil. However, in MCT products, lauric acid is sometimes removed because it acts similar to longer-chain fatty acids. Similarly, caproic acid is often removed because it is more likely to cause digestive upset for some individuals.
Based on the latest research, there are good reasons for so much interest in supplementing MCTs. Due to their structure, MCTs have unique properties: they are primarily utilized as an alternative fuel source. While other, long-chain fats can be stored in the body, MCTs are readily available to be burned for energy production. This process, called ketosis, is usually only accessible by eating a low carbohydrate diet or fasting. However, when added to the diet, MCTs are a simpler way of acquiring some of the benefits of using fats as a direct alternative energy source. When consumed, MCTs increase ketosis throughout the body.
First and foremost, it's worth addressing the largest concern around coconut oil. Since coconut oil is mainly saturated fat, many experts recommend against consuming coconut oil due to the potential risks of increased heart disease. While more data would be helpful, the available research does not suggest that coconut oil increases heart disease risk.
A meta-analysis in 2010 concluded that no evidence existed to support a link between dietary saturated fat and heart disease. A more recent meta-analysis compared replacing saturated fat with polyunsaturated fat and found no change in heart disease risk. A 2019 review article concluded that the American Heart Association's stance on the evidence for reducing saturated fat to reduce heart disease risk is overstated and needs re-evaluation.
While it is clear that coconut oil raises both good and bad cholesterol, the effects do not appear to raise heart disease risks. Studies of populations consuming larger quantities of coconut and coconut oil have not shown increased risk for heart disease. Based on the evidence that suggests saturated fat does not induce heart disease and that coconut consumption does not raise heart disease risks, it appears likely that coconut oil does not harm heart health. However, more research would still be useful to further our understanding and help confirm the current evidence.
While the evidence for weight management from coconut oil is mixed, there are some situations where coconut oil supplementation may provide advantages. A study in adults with heart disease who lost weight over three months maintained their weight management when given a diet that included coconut oil compared to a diet without.
Several studies exploring coconut oil supplementation combined with EGCG, a green tea extract, have shown benefits. In multiple sclerosis patients, the combination was found to increase fat loss, improve the waist-hip ratio and decrease body mass index. Inflammation was decreased by the combination as well.
Several studies in overweight women have also suggested that coconut oil might reduce abdominal fat, the dreaded "spare tire" of fat around the middle. However, it is worth noting that a study of coconut oil treatment for obesity in men found no benefits, although they also used one of the lowest doses of coconut oil of any of the studies—just one tablespoon per day.
Alzheimer's disease, at its core, appears to be a problem with energy metabolism in the brain. Based on this understanding, Alzheimer's disease has been described as diabetes type 3 with impaired brain glucose metabolism. One possible workaround is supplying an alternative fuel source. Both coconut oil and MCT oil can provide fats that the brain can utilize directly for fuel, bypassing glucose metabolism.
Studies giving patients with Alzheimer's disease coconut oil have shown improved cognitive function. One study compared coconut oil plus a healthy Mediterranean diet to just a Mediterranean diet alone. Improvements in different types of memory with coconut oil supplementation were notable. Interestingly, women with mild to moderate dementia responded best, although other groups also displayed improvements.
A separate study on Alzheimer's patients supplemented coconut oil over 21 days and found cognition benefits. Improvements in orientation and language construction reached significance. However, not all studies on coconut oil and Alzheimer's have found benefits. A study on coconut oil in Alzheimer's patients did not find cognitive improvements. Of note, a large percentage of patients dropped out of the study due to diarrhea from the intervention, which may have confounded the results. While the study started with 41 patients, only eight completed the six-month course of treatment in the coconut oil group.
Not surprisingly, some of the same benefits seen with coconut oil have also been explored with MCT oil.
A study compared MCT oil to long-chain fat consumption over 12 weeks. Subjects consuming the higher MCT oil diet lost 8.5 pounds as compared to 6 pounds on the diet containing long-chain fats. Other studies have shown similar results, with greater weight management in subjects consuming MCT oil as compared to other, more standard types of fat.
MCT oil also appears to increase satiety or fullness after meals, potentially helping with reduced calorie consumption. In addition, the oil appears to increase fat utilization for energy, improving energy production and calorie usage. Both effects may also be helpful for weight management. Compared to coconut oil, the data on MCT oil for helping with weight management appears to be a bit more robust. A review of the research even concluded that MCT oil might facilitate weight control when used to replace long-chain fats.
As we get older, frailty and memory loss are of increasing concern. In elderly individuals, early evidence suggests that supplementation with MCT oil can help to maintain weight and muscle mass. A separate small study on frail nursing home residents found similar results. The residents given MCT oil had improvements in muscle strength and daily functioning.
And similar to coconut oil, data also suggests the benefits of MCT oil for cognitive function. A recent meta-analysis of studies on MCT oil and dementia included 422 participants. The administration of MCT oil was shown to induce a mild state of ketosis. In addition, MCT oil was found to improve cognitive function when assessed through either of two cognitive function evaluations. Between coconut oil and MCT oil for improving cognition in dementia patients, the published evidence is stronger for the benefits of MCT oil. Based on what's known, it's not surprising that MCT oil is being seen as having potential anti-aging benefits and as a support for potentially increasing longevity.
Coconut oil and MCT oil are both sources of medium-chain fats that can help induce a state of ketosis. While the evidence is more robust for MCT oil, they both appear to have potential applications for improving cognition, dementia, and weight management based on the research. However, the research on MCT oil is a bit more robust in suggesting actual benefits in human clinical trials.
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By Dr. Scott Buesing, N.D.
