Beyond traditional coconut oil: metabolic effects of medium-chain triglyceride oil-mechanistic insights, lipid remodeling, and clinical implications in cardiometabolic health

Medium-chain triglyceride (MCT) oil and traditional coconut oil are frequently regarded as comparable lipid sources; however, their metabolic effects differ considerably due to variations in fatty acid composition, absorption pathways, and biological processing. Coconut oil contains substantial amounts of lauric acid and long chain saturated fatty acids (LCSFAs), whereas purified MCT oils are enriched with caprylic (C 8 ) and capric (C 10 ) fatty acids, which demonstrate distinct metabolic behavior. This review provides a comprehensive analysis of the mechanistic basis underlying MCT-mediated metabolic remodeling, with emphasis on lipid metabolism, mitochondrial function, circulating lipid regulation, and cardiometabolic implications. MCTs facilitate preferential oxidative metabolism through rapid portal absorption, enhanced mitochondrial β-oxidation, ketogenesis, and thermogenic responses. Furthermore, MCT-derived metabolic signaling influences key regulatory pathways, including activation of peroxisome proliferator-activated receptors ( PPARs ), suppression of sterol regulatory element-binding protein-1c ( SREBP-1c )-mediated lipogenesis, and modulation of the gut microbiota-lipid metabolism-inflammation axis. These mechanisms contribute to improved metabolic flexibility, altered lipid partitioning, and potential benefits in dyslipidemia, obesity, and insulin resistance. However, clinical outcomes remain dependent on formulation characteristics, dosage, duration of intervention, and individual metabolic status. Distinguishing purified MCT oil from conventional coconut oil is essential for accurate interpretation of lipid research and for developing targeted nutritional strategies aimed at improving cardiometabolic health.