MCT oil after 40

After forty, MCT oil is often chosen not for athletic achievements but for the sake of “energy for the brain,” weight control and muscle support. Some of these expectations have a scientific basis, some are only marketing. The editorial team analyzed studies conducted specifically on middle-aged and older people and formulated realistic conclusions.

Why MCTs are interesting for people after 40

Medium-chain triglycerides differ from ordinary fats by rapid absorption: they go directly to the liver, where they are oxidized or converted into ketone bodies. For this they do not need the carnitine transport system, on which long-chain fatty acids depend (St-Onge, Jones, 2002).

It is precisely the ketogenic property that makes MCTs interesting for researchers of aging. With age, some people experience reduced glucose uptake by certain areas of the brain, while the ability to use ketones is better preserved (Cunnane et al., 2020). MCT oil is a simple dietary way to moderately raise ketone levels without a strict diet.

Another direction is body composition. After 40, muscle mass gradually decreases, and fat more often accumulates in the abdominal area. Studies of MCTs in the context of body weight and muscles have been conducted both in middle-aged and in older people.

At the same time, it is worth remembering that most “age-related” MCT studies were conducted on people with cognitive impairments or weakened health, and not on healthy active 40- to 50-year-olds. Therefore the results need to be interpreted with caution.

MCTs and the brain: from hypothesis to studies

One of the first clinical studies in this direction is the work of Henderson and colleagues (2009) with the drug AC-1202 based on caprylic triglycerides in patients with mild to moderate Alzheimer’s disease. Some participants showed improvement in cognitive tests, and the effect depended on the APOE genotype.

Fortier and colleagues (2019) used a ketogenic drink with MCTs for six months in people with mild cognitive impairment. The study showed increased energy supply to the brain from ketones and improvement in certain cognitive measures, though not all.

These results are encouraging but limited: the samples are small, the duration is short, and the participants already had diagnosed impairments. There are no data that MCT oil prevents cognitive decline in healthy middle-aged people.

The editorial team considers the following formulation correct: MCTs are a promising direction of research in neurodegenerative diseases, but not a proven means “for memory” for healthy people. Any complaints about memory after 40 should be discussed with a doctor.

Muscles, sarcopenia and weight

An interesting Japanese study by Abe, Ezaki and Suzuki (2016) was conducted with frail elderly people in care facilities. A combination of MCTs with leucine and vitamin D for three months improved muscle strength and function compared with long-chain fats.

It is important that the effect was observed precisely for the combination, and the participants were very old, frail people. These data cannot be transferred to active people aged 40–60 who train. For them, the main tools for preserving muscles remain strength training and sufficient protein.

As for body weight, the meta-analysis by Mumme and Stonehouse (2015) showed a small additional reduction in weight and waist circumference when part of the usual fats is replaced with MCTs. For middle-aged people with a tendency to abdominal obesity, this may be a small but useful addition to a calorie deficit.

Let’s compare expectations and reality:

Lipids, liver and digestion

After 40, many people experience an increase in LDL cholesterol, so the choice of fats matters. Caprylic and capric acids are formally saturated, and the guidelines of the American Heart Association (Sacks et al., 2017) recommend replacing saturated fats with unsaturated ones.

Data on the effect of pure MCT oil on lipids are contradictory. The editorial team’s practical approach is not to increase the total intake of saturated fats, but to use MCT oil in moderation, as a replacement for part of other fats, and to monitor the lipid panel during preventive check-ups.

Since MCTs are absorbed mainly by the liver, people with liver diseases, in particular cirrhosis, should consume them only with a doctor’s approval. At the same time, people with impaired fat absorption are sometimes prescribed MCTs precisely as an easily digestible energy source.

Digestive tolerability is the main practical limitation. With age, functional bowel disorders occur more often, and for people with irritable bowel syndrome MCT oil can cause spasms and diarrhea even in small amounts.

Practical use and safety

For healthy adults after 40 who want to try MCT oil, the editorial team advises a gradual approach. It reduces the risk of gastrointestinal symptoms and makes it possible to assess individual tolerability.

• start with 5 ml per day together with food;
• over 1–2 weeks gradually increase to 15–20 ml, up to a maximum of 30 ml per day;
• divide the amount into several servings;
• replace, rather than add, fats in the diet;
• do not use for frying over high heat.

People with type 1 diabetes mellitus, especially those who experiment with ketogenic nutrition, should coordinate MCT intake with a doctor because of the effect on ketone levels. Patients taking SGLT2 inhibitors should also consult one.

MCT oil is calorie-dense, so with reduced physical activity, characteristic of many people after 40, uncontrolled consumption easily leads to an excess of energy and weight gain.

Editorial conclusions

MCT oil is an easily digestible energy source with a moderate ketogenic effect, which makes it interesting for research on brain aging.

The most encouraging data were obtained in people with cognitive impairments and in frail elderly people, not in healthy 40- to 60-year-olds.

For weight control MCTs can provide a small effect only as a replacement for other fats; for muscles the key remains training and protein.

We also recommend reading our articles about exogenous ketones after 40, about leucine and sarcopenia, and about omega-3 for the heart and brain.

References

1. St-Onge MP, Jones PJ. Physiological effects of medium-chain triglycerides: potential agents in the prevention of obesity. J Nutr. 2002;132(3):329–332.
2. Cunnane SC, Trushina E, Morland C, et al. Brain energy rescue: an emerging therapeutic concept for neurodegenerative disorders of ageing. Nat Rev Drug Discov. 2020;19(9):609–633.
3. Henderson ST, Vogel JL, Barr LJ, et al. Study of the ketogenic agent AC-1202 in mild to moderate Alzheimer's disease: a randomized, double-blind, placebo-controlled, multicenter trial. Nutr Metab (Lond). 2009;6:31.
4. Fortier M, Castellano CA, Croteau E, et al. A ketogenic drink improves brain energy and some measures of cognition in mild cognitive impairment. Alzheimers Dement. 2019;15(5):625–634.
5. Abe S, Ezaki O, Suzuki M. Medium-chain triglycerides in combination with leucine and vitamin D increase muscle strength and function in frail elderly adults in a randomized controlled trial. J Nutr. 2016;146(5):1017–1026.
6. Mumme K, Stonehouse W. Effects of medium-chain triglycerides on weight loss and body composition: a meta-analysis of randomized controlled trials. J Acad Nutr Diet. 2015;115(2):249–263.
7. Sacks FM, Lichtenstein AH, Wu JHY, et al. Dietary fats and cardiovascular disease: a presidential advisory from the American Heart Association. Circulation. 2017;136(3):e1–e23.