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Coconut Oil and Medium Chain Triglycerides (MCT Oil) Review
Initial Posting: 3/3/19 Last Update: 8/3/19
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What is it? Medium chain triglycerides (MCTs) made from caprylic, capric, and, predominantly, lauric acids, make up more than half of virgin coconut oil, which also contains long chain triglycerides that cause it to be semi-solid at room temperature. The long chain triglycerides, as well as much of the lauric acid (which can act like a long chain triglyceride), can be removed to create refined coconut oil which is liquid and comprised mostly (about 85%) of caprylic and capric acids, or further refined to just MCT oil (about 95% or more of caprylic and/or capric acids). The oils can also be mixed with fibrous ingredients and sold as powdered oils. (See What It Is).
How is it used? Both virgin coconut oil and refined coconut oil can be used in foods and cooking or applied to the skin and hair. Refined coconut oil and MCT products have been consumed as part of diets because they are used mainly for energy rather than fat storage, and preliminary research suggests possible uses in treating Alzheimer's disease, epilepsy, fat-malabsorption, and other conditions, although benefits have yet to be proven. See What It Does.
What did CL find? All of the products passed ConsumerLab's tests, but some provided much better value than others. In fact, the cost to get 8 grams of MCTs ranged from just 7 cents to $1.68 — meaning you could pay more than 20 times as much to get the same amount of MCTs from one product than from another. (See What CL Found and use the Results table to compare amounts and costs of MCTs in products).
Top Picks — ConsumerLab selected Top Picks for virgin coconut oils, refined coconut oils, and MCT oils based on quality and cost.
What to look for? With virgin coconut oils, we found that it's not worth paying much, if anything, more for "extra" virgin. For higher concentrations of MCTs, make sure the product is a liquid (otherwise it's not really refined) and lists amounts of "Total MCTs" which should be at least 85% of the serving of oil, e.g., a 14-gram serving of oil should provide at least 12 grams (12,000 mg) of MCTs. If you want mostly MCTs made of caprylic and/or capric acids -- the shorter MCTs, make sure the amounts of these are listed and comprise 95% or more of the oil. (See ConsumerTips).
How much to take and when? Serving sizes have ranged from 1 teaspoon to several tablespoons daily, depending on the use. See the What It Does section for the dosage for specific uses.
Cautions: MCTs are saturated fats, so most of the fat in coconut oil is saturated fat. Although some evidence suggests that MCTs are less likely to be stored as fat than oils made from longer chain fatty acids, they may cause an increase in "bad" cholesterol. For details, see Concerns and Cautions.
Coconut Oil vs. MCT Oil with CL Founder, Dr. Tod Cooperman
What It Is:
Medium chain triglycerides (MCTs) are composed of glycerol attached to fatty acids of medium length chains of carbon atoms: caprylic, capric, and lauric acids which, respectively, are 8, 10, and 12 carbon atoms in length. Coconut oil contains each of these MCTs, although predominantly lauric acid, as well as long chain triglycerides that cause it be semi-solid at room temperature. The long chain fatty triglycerides, as well as much of the lauric acid (which can act like a long chain triglyceride), can be removed to create refined coconut oil which is liquid and comprised mostly (85% or more) of caprylic and capric acids, or further refined to just MCT oil (about 95% or more) of caprylic and/or capric acids. These oils can also be mixed with fibrous ingredients and sold as powdered oils.
On a technical note, most of the weight (92% or more) of an MCT is from the fatty acids, rather than the glycerol. When laboratories analyze these oils, they hydrolyze them (break them apart) and measure the fatty acids, but in this report we have converted those amounts back into triglyceride values, as this is usually how they are reported on product labels.
The MCTs are saturated fats unlike fats comprised of longer chain triglycerides that can be mono- or polyunsaturated and may be more healthful from a cardiovascular perspective (see Concerns and Cautions).
What It Does: Weight loss
During digestion, the MCTs in coconut oil caprylic and capric acid are primarily transported directly to the liver, and can also enter muscle cells quickly. This makes MCTs less likely to be deposited as fat and more readily available as a source of energy than longer-chain fatty acids. Due to their rapid absorption, MCTs may also help to increase satiety (i.e., making you feel "full" faster) (Clegg, Eur J Clin Nutr 2017).
For these reasons, the MCTs in coconut oil have been promoted as a healthy source of fat, and a source of fat and energy in ketogenic diets for weight loss. Ketogenic diets are high in fat and very low in carbohydrates, which supposedly forces the body to use glucose that is stored in the liver and muscles for energy. When these stores of glucose are reduced, the body eventually enters ketosis, a metabolic state in which fat in the body is converted into compounds (ketones) that can be used as an alternative source of energy.
In clinical studies, a dose of 5 grams or more of MCTs has been found to increase satiety, thermogenesis ("fat-burning") and decrease body fat compared to other types of fat. For example, a study among 64 men and women in Japan found that those who consumed margarine containing 5 grams of MCTs (caprylic and capric acids only) daily for three months while maintaining a diet of 2,100—2,400 kcal per day lost more body weight (9.3 lbs. vs 6.4 lbs.) and visceral fat (fat around the organs) than those on the same diet who consumed margarine containing 5 grams of long-chain triglycerides (LCT) (from vegetable oil) instead of MCTs (Nosaka, J Atheroscler Thromb 2003).
Several clinical trials have investigated the use of MCTs for improving high-intensity or endurance exercise performance, but the results have been inconsistent (Van, J Appl Physiol (1985) 1996; Misell, J Sports Med Phys Fitness 2001). In one small trial among cyclists, consuming a beverage containing a combination of carbohydrates and a high dose of MCTs (85 grams) during exercise worsened performance, most likely because it caused intestinal cramping (Jeukendrup, Am J Clin Nutr 1998). Another small study found that 15 g (about 1 tablespoon) of extra virgin coconut oil plus caffeine (6 mg/kg body weight -- amounting to over 400 mg) added to decaffeinated coffee ingested 60 minutes prior to a 1 mile run did not improve the running times or influence the perceived exertion ratings or lactate levels in thirteen recreational runners as compared to a placebo (warm water). The results surprised the researchers, as caffeine alone or from coffee has generally been found to improve treadmill and endurance performance (Borba, Nutrients 2019).
Muscle Strength and Function in Older Adults A 3-month study in Japan in which nursing home residents were put on an exercise program (20 minutes twice weekly) suggested that adding MCTs (6 grams daily) to their diets resulted in greater increases in muscle strength and function than if given the same amount of a control oil (long-chain fatty acids) (Abe, Am J Clin Nutr 2019). However, long-chain fatty acids are a poor choice as a control, as research in animals has shown that LCTs can impair exercise performance (Murray, Nutr Metab 2011). Consequently, the gains achieved by the nursing home residents could have been due to exercise alone and not MCTs.
Cognitive impairment and Alzheimer's disease
Coconut oil and, more specifically, MCTs, have sometimes been promoted as beneficial in Alzheimer's disease by providing an "alternative" fuel source for the brain. This is based on the premise that a reduced uptake of glucose in the brain has been found in conditions known to be risk factors for Alzheimer's disease, such as age (> 65 yrs), family history of Alzheimer's disease, and insulin resistance, as well as the premise that ketones can be a source of energy in the brain when glucose levels are low. Several preliminary studies suggest limited benefits.
In a study among 39 men and women (average age 74) with mild cognitive impairment (MCI), a drink containing 30 grams of MCTs consumed daily for six months significantly increased brain ketone metabolism compared to placebo (230% increase vs. no change). Overall, those who consumed the MCT drink did not have improvements in general cognition compared to placebo, although they did have improvements in some specific measures of cognitive function, such as episodic and visual memory and word recall. Side effects such as stomach discomfort, reflux, bloating, diarrhea and constipation were twice as common among those who consumed MCTs. The MCTs in the drink consisted of 60% caprylic acid and 40% capric acid (Captex 355, Abitec Corp) blended with lactose-free milk. Half the drink was consumed with breakfast and the other half with dinner, and the amount consumed daily was gradually increased to 30 grams during the initial two weeks of the study, most likely to minimize gastrointestinal side effects (Fortier, Alzheimers Dement 2019).
Two clinical studies funded by the maker of a "medical food" containing caprylic acid triglycerides (Axona, by Accera) found that supplementation with MCTs increased ketone levels and improved certain measures of cognitive function in some individuals with probable or mild to moderate Alzheimer's disease (Henderson, Nutr Metab (Lond) 2009; Reger, Neurobiol Aging 2004). The standard daily dose given in these studies contained 20 to 40 grams of MCTs (95% of which was as caprylic acid triglycerides). However, an FDA warning letter sent to Accera in 2013 notes that "there are no distinctive nutritional requirements or unique nutrient needs for individuals with mild to moderate Alzheimer's disease," and other experts emphasize there is not enough evidence to know whether ketones produced from consuming coconut oil or MCT oil have a beneficial effect in Alzheimer's disease (Fernando, Br J Nutr 2015).
Supplementation with MCT oil was reported to reduce seizure frequency in a 43-year-old man with drug-resistant partial epilepsy. One month after beginning supplementation with 100% MCT oil (one tablespoon taken twice daily, gradually increased to four tablespoons twice daily), seizure frequency was reduced from six per day to one seizure every four days. The MCT oil was taken after breakfast and dinner with 8 ounces of water, to increase palatability. An attempt to increase the dose to five tablespoons twice daily was not tolerated due to excessive flatulence and diarrhea. The reporting physician noted that there is evidence MCT supplementation may modestly increase ketosis even in individuals who are not consuming a ketogenic diet (which has been shown to be an effective treatment in people with drug-resistant epilepsy), although ketone levels were not measured in this case (Azzam, Case Rep Neurol Med 2013).
Skin and hair
Applied topically, virgin coconut oil can be an effective moisturizer for dry skin (Agero, Dermatitis 2004).
Virgin coconut oil (5 mL applied twice daily over most of the body) was shown to reduce symptoms of atopic dermatitis (AD) by 68% in a two-month study that compared its effects to that of mineral oil which lead to only a 38% decrease (Evangelista, Int J Dermatol 2014). Virgin coconut oil (5 mL applied twice daily to affected skin) has also been shown to inhibit the growth of the bacteria Staphylococcus aureus on the skin in adults with AD, as compared to extra virgin olive oil (Verallo-Rowell, Dermatitis 2008).
Lauric acid has also been shown to inhibit the growth of P. acnes, the bacterium that causes acne. In fact, one study in mice found lauric was more effective in inhibiting P. acnes than benzoyl peroxide (Nakatsuji, J Invest Dermatol 2009). However, coconut oil is also comedogenic, meaning that it can clog pores. Therefore, it could potentially worsen acne is some people.
Coconut oil may slightly protect against UV radiation, having an estimated SPF value between 1 and 8 (Gause, Int J Cosmet Sci 2016; Kaur, Pharmacognosy Res 2010). However, it should not be used as a substitute for sunscreen, as the American Academy of Dermatology recommends using a product with an SPF of 30 or higher. There do not appear to by any published clinical studies on the effects of consuming coconut oil or applying it topically for antiaging effects or for preventing or reducing wrinkles.
Preliminary studies suggest that applying coconut oil to hair can help to prevent protein loss in hair strands, and, used as a pre-wash conditioner, coconut oil may help to prevent cuticle damage. It appears to do this by reducing the amount of water that is absorbed by, and subsequent swelling of, the hair shaft during washing, as well as by providing lubrication when brushing (Rele, J Cosmet Sci 1999; Rele, J Cosmet Sci 2003).
There is preliminary evidence that supplementation with MCTs may be helpful for individuals with conditions that interfere with the body's ability to absorb fat, such as AIDS-related fat malabsorption and pancreatitis.
See the Encyclopedia articles for more details about clinical studies with MCTs and coconut oil.
Quality Concerns and What CL Tested For:
Neither the Food and Drug Administration (FDA) nor any other federal or state agency routinely tests supplements for quality prior to sale.
ConsumerLab.com tested coconut oils and MCT oils to determine the amounts of MCTs and whether those matched the amounts listed on product labels. Products were also tested for rancidity and contamination with heavy metals.
What CL Found:
All of the products passed testing, containing their expected amounts of MCTs and found not to be rancid or contaminated with heavy metals.
The virgin (i.e., semi-solid) and refined (i.e., liquid) coconut oils were very similar in chemical composition to the competing products in their categories, but there was a great range in prices. There was greater chemical variation among the MCT products.
MCT fatty acids
As shown in the graph below, MCTs were found to represent about 62% of the triglycerides in virgin coconut oils and most of this was from lauric acid. In contrast, more than 85% of the triglycerides in the refined coconut oils and more than 95% of triglycerides in the MCT oils were caprylic and capric acids — which some people consider more desirable than lauric acid as they may be more readily used as energy.
As shown in the graph below, among virgin coconut oils, the cost to get 8 grams of MCTs (based on caprylic, capric, and lauric acids), which is roughly the amount in one tablespoon of oil, ranged from just 7 cents to a whopping $1.68. Only about two-thirds as much oil was needed to get the same amount of MCTs from refined coconut oils for which the cost ranged from 30 to 44 cents. Slightly less oil was needed to get 8 grams of MCTs from the MCT oils and more of this was as caprylic and/or capric acids. The cost to get 8 grams of MCTs from MCT oil ranged from 40 to 44 cents for oils and up to $1.53 from an MCT oil powder.
Top Picks Virgin (Semi-solid) Coconut Oils: Top Pick:Kirkland Signature [Costco] Organic Virgin Coconut Oil
The virgin coconut oils were very similar to one another. Each was a white, translucent, semi-solid with a buttery texture and a mild coconut fragrance and flavor. The fatty acid composition was also very similar -- about 70% MCTs, most of which was lauric acid (Sports Research and Viva Naturals were a bit higher due to slightly more caprylic and capric acid). Cost-wise, however, a bargain was to be had with Kirkland Signature: One tablespoon (13.8 grams) provided 8.9 grams (8,927.7 mg) of MCTs for just 7 cents. The next least expensive product was Trader Joe's Organic Virgin Coconut Oil (17 cents per tablespoon), and most others cost 24 to 36 cents per tablespoon, except for Sports Nutrition Organic Coconut Extra Virgin Oil in which the oil was in softgels and you would need to take about 11 softgels (costing about $1.54) to get an equivalent amount of MCTs from a tablespoon of the other products.
One product (Puritan's Pride Coconut Oil) was a virgin coconut oil with added MCTs. As a result, it had double the amounts of caprylic and capric acids relative to the virgin coconut oils. The added MCTs were noted on the label under Other Ingredients. This product is a softgel and, like the other oil in pill form -- Sports Research, is a more expensive way to get MCTs than from oils.
Note, two of the "extra" virgin coconut oils (Sports Research and Viva Naturals) contained only slightly more caprylic acid than the other virgin coconut oils and a third "extra" virgin oil (Vitacost) was no different than regular virgin oils. It does not seem worthwhile to pay much, if anything, extra for "extra" virgin coconut oil.
Refined (Liquid) Coconut Oils: Top Pick:Nature's Way Coconut Premium Oil
The refined coconut oils were very similar to one another. Each was a clear liquid with a faint coconut fragrance and flavor. The fatty acid composition was nearly identical across products -- about 85% MCTs, broken out as 50% caprylic acid, 38% capric acid, and 7% lauric acid. Cost-wise, however, Nature's Way was the least expensive at 47 cents per tablespoon versus 62 to 69 cents, respectively, for Garden of Life or Nutiva.
MCT Oils: Top Pick:Zenwise Health MCT Oil
Although 92 to 100% of the triglycerides in the three of the MCT oil products were caprylic and/or capric acids, the ratios of these varied by product. Bulletproof Brain Octane Oil was, as labeled, 100% caprylic acid. Zenwise Health MCT Oil and Perfect Keto MCT Oil Powder were, respectively 68% and 53% caprylic acid, with most of the remainder being capric acid.
Zenwise was, by far, the least expensive of the MCT oils, making it our Top Pick in this category. Zenwise cost 40 cents per tablespoon versus 73 cents for Bulletproof. Perfect Keto (containing acacia fiber to bind the oil) was several times more expensive per gram of MCTs than the other MCT Oils. Only if you are seeking MCT oil exclusively for caprylic acid (the shortest of the MCTs and, perhaps, the easiest to convert to energy) would it be worth paying more for Bulletproof.
Test Results by Product:
Listed below are the test results for 13 products, organized by type of coconut oil. Eleven were selected by ConsumerLab.com and two others (each denoted with a CL flask) are included for having passed the same evaluation through the Quality Certification Program.
Also shown are the suggested, labeled serving sizes and amounts of MCTs listed on the product labels. Products listed as "Approved" contained their expected amounts of MCTs and met ConsumerLab.com's additional quality criteria (see Passing Score). The full list of ingredients is available for each product by clicking on the word "Ingredients" in the first column, although some notable features are listed in the last column as are price and cost comparisons.
RESULTS OF CONSUMERLAB.COM TESTING OF COCONUT AND MCT OILS
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Product Name, Serving Size, and Suggested Daily Serving on Label
Click on "Ingredients" for Full Listing
Claimed Amount of Oil and Medium Chain Triglycerides (MCTs) Per Labeled Serving
† Values calculated from free fatty acids reported by lab which hydrolyzed all triglycerides to free fatty acids. To convert to triglycerides, values were increased by a factor reflecting the glycerol portion lost. These percentages were 5.90% for virgin coconut oils, 6.35% for coconut oil with MCT oil, 7.44% for refined coconut oils, 8.16% for Bulletproof, 5.32% for Perfect Keto and 7.78% for Zenwise.
1 Heavy metals tested are lead, cadmium, arsenic, and mercury. Rancidity based on peroxide values: A value above 5 meq/kg indicates spoilage for coconut oil; above 1 meq/kg indicates spoilage for MCT oil. For details, see How Products Were Evaluated.
2 Total MCTs calculated as the sum of caprylic, capric and lauric acids.
3 Not tested but claimed on label.
4 Label describes these (which CL assume are triglyceride values) as amounts that organic coconut oil "typically contains", as opposed to specific amounts in product.
Unless otherwise noted, information about the products listed above is based on the samples purchased by ConsumerLab.com (CL) for this Product Review. Manufacturers may change ingredients and label information at any time, so be sure to check labels carefully when evaluating the products you use or buy. If a product's ingredients differ from what is listed above, it may not necessarily be of the same quality as what was tested.
The information contained in this report is based on the compilation and review of information from product labeling and analytic testing. CL applies what it believes to be the most appropriate testing methods and standards. The information in this report does not reflect the opinion or recommendation of CL, its officers or employees. CL cannot assure the accuracy of information.
Copyright ConsumerLab.com, LLC, 2019. All rights reserved. Not to be reproduced, excerpted, or cited in any fashion without the express written permission of ConsumerLab.com LLC.
What to Consider When Buying and Using:
ConsumerLab's tests found virgin and "extra virgin" coconut oils to be similar in chemical composition, so it may not be worth paying more for "extra" virgin coconut oil.
Virgin coconut oils contain approximately 62% MCTs, but this is predominantly from triglycerides of lauric acid. This would not be the right choice if you are looking for a product high in caprylic acid and/or capric acid (see What It Does).
For higher concentrations of MCTs, make sure the product is a liquid (i.e. refined coconut oil or MCT oil) and lists the amount of "Total MCTs," which should be at least 85% of the serving of oil, e.g., a 14-gram serving should provide at least 12 grams (12,000 mg) of MCTs. If you only want MCTs of caprylic and/or capric acids, make sure the amounts of these are listed on the label and comprise 95% to 100% of the total oil.
Epilepsy: 1 to 4 tablespoons of 100% MCT oil twice daily was reported to reduce seizure frequency in a man with drug-resistant partial epilepsy (Azzam, Case Rep Neurol Med 2013). However, if you have a seizure disorder, consult your physician before using. Do not attempt to treat a seizure disorder without medical supervision.
Alzheimer's disease: The standard daily dose given in studies provided 20 to 40 grams of MCTs (95% of which was as caprylic acid triglycerides).
Cooking and storage:
Coconut oil has a relatively low smoke point of 350°F compared to other common cooking oils such as extra virgin olive oil (383°F), safflower (413°F) and canola (460°F). It's low smoke point makes it less suitable for frying, but it can be used for cooking and baking at temperatures below 350°F (Katragadda, Food Chem 2010; Foster Nutr Bull 2009).
Coconut oil has a high saturated fat content, so you may want to limit your daily intake. The saturated fats, however, make it (as well as MCT oil) very stable, so that it does not require refrigeration -- although this will give virgin coconut oil a harder consistency if that is desired.
Concerns and Cautions:
Although coconut oil appears to be generally well-tolerated, it may cause diarrhea, loose stools, stomach ache, nausea and vomiting in some individuals. This is more likely to occur within the first week of consuming/supplementing with coconut oil and when it is consumed on an empty stomach (Chinwong, Evid Based Complement Alternat Med 2017). Diarrhea, vomiting, bloating, and cramps can also occur when supplementing with MCT oil (Azzam, Case Rep Neurol Med 2013); (Liu, Biomed J 2013).
Although allergic and anaphylactic reactions can occur from eating coconut fruit (i.e. coconut meat), this is unlikely to occur with refined coconut oil, as coconut proteins (which can trigger allergic reactions) are removed during the oil extraction process (Gomez, Allergol Immunopathol (Madr). Skin reactions such as rash and hives have been reported after topical use of coconut oil (Anagnostou, Children (Basel) 2017).
Most of the fat in coconut oil (82%) is saturated fat and the percentage approaches 100% as the oil is refined to just MCT oils. The American Heart Association (AHA) recommends limiting saturated fats to 5% to 6% of total daily calories, i.e., about 13 grams of saturated fat per day for an adult, and this approximately the amount in one tablespoon (14 grams) serving of the coconut oil. The AHA advises against use of coconut oil because it can increase LDL ("bad") cholesterol with, in the opinion of the AHA, no favorable offsetting effects (Sacks, Circulation 2017). However, it should be noted that not all studies have found coconut oil to have negative effects on cholesterol levels in healthy individuals. For example, a study in Thailand among healthy young adults (average age 21) found that 15 mL of virgin coconut oil taken twice daily for two months increased HDL cholesterol by 5.72 mg/dL, but did not significantly increase total cholesterol, LDL cholesterol or triglyceride levels, compared to a control (Chinwong, Evid Based Complement Alternat Med 2017).
To further assist consumers, ConsumerLab.com licenses its flask-shaped CL Seal of Approved Quality (see The CL Seal) to manufacturers for use on labels of products that have passed its testing. ConsumerLab.com will periodically re-evaluate these products to ensure their compliance with ConsumerLab.com's standards.
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