Cognitive performance
Under fasting conditions, ingesting MCTs rapidly increases the serum concentrations of ketone bodies (beta-hydroxybutyrate, acetoacetate, and acetone).[1] Similarly, regular supplementation of MCTs also increases serum ketone body concentrations.[2] Because ketone bodies serve as an alternative energy source for the brain when glucose availability is low,[3] it is plausible that providing the brain with a source of ketone bodies — as shown in some studies[4][5][6][7][8] — is the mechanism by which MCTs might enhance cognitive function. Preclinical studies in rodents support this concept,[9][10][11] and some clinical trials have indeed found that supplementation with exogenous ketones can improve aspects of cognitive function in people under conditions of metabolic stress (e.g., fasting, hypoxia, or exercise)[12][13][14][15][16][17] and in people with neurodegenerative conditions.[18] However, the effects are highly variable, and several clinical trials do not find a benefit of exogenous ketones on cognitive function.[19][20][21]
Muscle strength and function
The mechanism by which MCTs can augment exercise-induced increases in muscle strength[22][23][24] is not completely understood but might involve blocking the expression of MuRF-1 (and thereby stimulating muscle protein synthesis while inhibiting muscle protein breakdown),[25] increasing the concentration of plasma acyl-ghrelin (thereby stimulating growth hormone secretion),[26] or activation of the sympathetic nervous system and upregulation of peroxisomal proliferator-activated receptor gamma coactivator-1alpha (PGC-1alpha, which promotes mitochondrial biogenesis).[26]
Body weight
The mechanism by which MCTs influence body weight[27][28] might involve changes in appetite hormone secretion,[29] reductions in energy intake,[29][30] or increases in fat oxidation rates,[29][31][32][33] but not all the studies confirm these effects.[29][30][34] Evidence from rodent studies and in vitro experiments also shows that MCTs might promote the browning of white adipose tissue, which would enhance lipolysis (fat breakdown) and energy expenditure.[35] However, such mechanisms are poorly understood and require more research.