Does MCT oil raise cholesterol?

On average, no. The only meta-analysis of MCT oil itself pooled 7 randomized trials in adults lasting at least 2 weeks, and LDL cholesterol changed by 0.77 mg/dL (95% CI -5 to 6.6; metric: 0.02 mmol/L, -0.13 to 0.17), which is no change. That average hides what the oil replaced. When MCT oil stood in for mostly unsaturated oils such as olive or sunflower, total and LDL cholesterol went up. Against longer-chain saturated fats there was some evidence they went down. Triglycerides rose a little, by 12 mg/dL (0.14 mmol/L).

Unsettled. The answer depends on the comparison, and we cannot tell you by how much. The review tested the comparator formally (interaction P = 0.008 for LDL). The size of the LDL rise against unsaturated oils sits only in the full text, which we could not obtain. So the direction is known and the size is not.

What the trials found

The pooled answer

The 2021 meta-analysis included adults in trials of at least 2 weeks that compared MCT oil with another fat or oil, and it left out tube and intravenous feeding. Total cholesterol changed by 1.5 mg/dL (0.04 mmol/L), LDL by 0.02 and HDL by -0.01, with every interval crossing zero. Triglycerides rose by 12 mg/dL (95% CI 0.89 to 24; metric: 0.14 mmol/L, 0.01 to 0.27), which is about 12 mg/dL. The authors conclude that MCT oil does not affect total, LDL or HDL cholesterol but causes a small increase in triglycerides.

What it replaced decides the direction

The single trial that shows this most clearly was run on a metabolic ward, where every meal was controlled. In 9 middle-aged men with mildly high cholesterol, MCT oil gave total cholesterol of 227 mg/dL (5.87 mmol/L). Palm oil gave 5.79, which was not significantly different. High-oleic sunflower oil gave 5.22, and MCT oil was significantly higher than that. Nine men is a small trial. Its result lines up with the subgroup finding of the meta-analysis.

A second meta-analysis asked a narrower question. In 12 trials with 299 adults, mostly crossover studies, diets enriched with medium-chain fats raised HDL by 4.3 mg/dL (95% CI 2.7 to 5.8; metric: 0.11 mmol/L, 0.07 to 0.15) against diets enriched with long-chain saturated fats. LDL, total cholesterol and triglycerides did not change. Some of those diets used medium-chain fats in foods and not as pure MCT oil, and none of them compared it with a liquid unsaturated oil.

Trials at an everyday dose

In a 4-week double-blind crossover trial in 28 obese, insulin-resistant men, 20 g a day of MCT oil had no significant effect on the blood lipoprotein profile compared with corn oil. The trial was short and included only men.

In a 16-week weight-loss trial in 31 adults aged 19 to 50 with overweight, MCT oil and olive oil did not differ on any measure. Total cholesterol fell over time in both groups, and weight loss itself lowers cholesterol, so this trial cannot tell you what MCT oil does when added to an ordinary diet.

In a 90-day pilot in 40 moderately overweight adults with type 2 diabetes in urban China, 18 g a day of MCT oil was followed by a fall in serum cholesterol within the MCT group. That is a change over time inside one group, the abstract gives no size, and the group also lost weight. It is weak evidence in either direction.

Who should be careful

Not for everyone. Triglycerides are the one blood fat that moved in the pooled trials, up by 12 mg/dL (95% CI 0.89 to 24; metric: 0.14 mmol/L, 0.01 to 0.27). The review did not report a separate result for people who already have high triglycerides, so we cannot say whether the rise is larger in them.

Children on the medical ketogenic diet for epilepsy are the one group given large amounts of MCT over long periods. A systematic review of 45 prospective studies of the classic or MCT ketogenic diet found digestive upset in 40.6% of children and high blood lipids in 12.8%. Those diets are supervised treatment at doses far above a spoonful in coffee, and the review does not separate the MCT version from the classic one. We have no card on MCT oil and allergy, pregnancy or medicines, so this page says nothing about them.

What expert bodies say

The American Heart Association's 2017 advisory states that replacing saturated with unsaturated fats lowers LDL cholesterol, a cause of atherosclerosis. MCT oil is a saturated fat, and the advisory does not single it out. That fits the subgroup result above, where MCT oil raised LDL against unsaturated oils. We found no position from any expert body on MCT oil and cholesterol specifically.

How we searched

What would change this answer

• An adequately powered randomized trial of MCT oil at the amounts people actually use, against olive or canola oil, with LDL and apolipoprotein B as outcomes. We found none registered.
• The subgroup sizes from the 2021 meta-analysis, which would turn "LDL goes up against unsaturated oils" into a number.
• Trials that analyze people with high LDL or high triglycerides separately. The pooled analysis rests on 7 trials in adults, and we found none that did.
• Any trial of MCT oil that measures heart attacks or strokes. We found none.

Nutrition facts and the rest of what we know about MCT oil, including the weight and appetite trials, are on the MCT oil page.

Sources

1. ev-mctchol-01 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized trials · n = —
   MCT oil intake did not affect total cholesterol (0.04 mmol/L; 95% CI, -0.11 to 0.20; I2 = 33.6%), LDL cholesterol (0.02 mmol/L; 95% CI, -0.13 to 0.17; I2 = 28.7%), or HDL cholesterol (-0.01 mmol/L; 95% CI, -0.10 to 0.09; I2 = 74.1%) levels, but did increase triglycerides (0.14 mmol/L; 95% CI, 0.01-0.27; I2 = 42.8%).
   
   Who: Adults over 18 in randomized trials of at least 2 weeks comparing MCT oil with another fat or oil
   Effect: TC +0.04 mmol/L (95% CI -0.11 to 0.20); LDL +0.77 mg/dL (95% CI -5 to 6.6; metric: 0.02 mmol/L, -0.13 to 0.17); HDL -0.39 mg/dL (95% CI -3.9 to 3.5; metric: -0.01 mmol/L, -0.10 to 0.09)
   Certainty: The only MA specifically on MCT oil (C6-C10). 7 articles, LDL and HDL in 6. A mean of zero masks the dependence on the comparator (card 02).
   J Nutr, 2021 · checked 2026-10-07 · we read the abstract
2. ev-mctchol-02 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized trials, subgroup analysis · n = —
   Subgroup analyses showed that the effects of MCT oil on total cholesterol and LDL cholesterol differed based on the fatty acid profile of the control oil (Pinteraction = 0.003 and 0.008, respectively), with MCT oil increasing total cholesterol and LDL cholesterol when compared to a comparator consisting predominantly of unsaturated fatty acids, and with some evidence for reductions when compared to longer-chain SFAs.
   
   Who: Adults in 7 randomized trials, subgrouped by the fatty acid profile of the control oil
   Effect: comparator interaction P = 0.003 (TC) and P = 0.008 (LDL); size per subgroup not given in the abstract
   Certainty: Main answer to the question: MCT raises LDL if it replaces olive or sunflower oil, and may lower it if it replaces butter or palm oil. The subgroup effect size is only in the full text (no_pmc).
   J Nutr, 2021 · checked 2026-10-07 · we read the abstract
3. ev-mctchol-03 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized trials · n = —
   CONCLUSIONS: MCT oil does not affect total cholesterol, LDL cholesterol, or HDL cholesterol levels, but does cause a small increase in triglycerides.
   
   Who: Adults over 18 in randomized trials of at least 2 weeks; enteral and parenteral nutrition excluded
   Effect: triglycerides +12 mg/dL (95% CI 0.89 to 24; metric: 0.14 mmol/L, 0.01 to 0.27), I2 = 42.8%
   Certainty: Axis 6: the only lipid marker that shifted. 0.14 mmol/L ≈ 12 mg/dL. Whether there is an effect in people with hypertriglyceridemia separately is not visible from the abstract.
   J Nutr, 2021 · checked 2026-10-07 · we read the abstract
4. ev-mctchol-04 · Meta-analysis or systematic review · systematic review and meta-analysis of clinical trials · n = 299
   Diets enriched with MCFAs led to significantly higher high-density lipoprotein (HDL) cholesterol concentrations than diets enriched with LCSFAs (0.11 mmol/L; 95% CI: 0.07, 0.15 mmol/L) with no effect on triglyceride, low-density lipoprotein (LDL) cholesterol, and total cholesterol concentrations.
   
   Who: Adults (weighted mean age 38, BMI 24) in 11 crossover and 1 parallel trial
   Effect: HDL +4.3 mg/dL (95% CI 2.7 to 5.8; metric: 0.11 mmol/L, 0.07 to 0.15); apoA-I +0.08 g/L (95% CI 0.02 to 0.14); no effect on TG, LDL, TC (I2 49% TC, 58% LDL)
   Certainty: Comparison only with long-chain saturated fats, not with unsaturated oils. Some studies are MCFA diets, not pure MCT oil.
   Am J Clin Nutr, 2018 · checked 2026-10-07 · we read the abstract
5. ev-mctchol-05 · Randomized controlled trial(s) · randomized crossover metabolic-ward feeding trial · n = 9
   Rather than having a neutral effect, MCT oil produced total cholesterol concentrations that were not significantly different from those produced by palm oil (MCT oil: 5.87 +/- 0.75 mmol/L; palm oil: 5.79 +/- 0.72 mmol/L) but significantly higher than that produced by high oleic acid sunflower oil (5.22 +/- 0.52 mmol/L).
   
   Who: nine middle-aged men with mild hypercholesterolemia
   Effect: TC 5.87 (MCT) vs 5.79 (palm) vs 5.22 mmol/L (high-oleic sunflower)
   Certainty: Small sample, but strictly controlled feeding; consistent with the "versus unsaturated" subgroup in meta-analysis 34255085.
   Am J Clin Nutr, 1997 · checked 2026-10-07 · we read the abstract
6. ev-mctchol-06 · Randomized controlled trial(s) · double-blind randomized crossover trial, 4 weeks per phase · n = 28
   Compared with corn oil, MCT supplements had no significant effect on plasma lipoprotein profile or TRL apo B-48 and VLDL apo B-100 kinetics.
   
   Who: 28 obese, insulin-resistant men
   Effect: no significant difference in plasma lipoprotein profile or apoB-48 / VLDL apoB-100 kinetics vs corn oil
   Certainty: The dose of 20 g/day is close to household (1-1.5 tbsp). Short, men only.
   Am J Clin Nutr, 2014 · checked 2026-10-07 · we read the abstract
7. ev-mctchol-07 · Randomized controlled trial(s) · randomized controlled trial, 16 weeks, weight-loss diet · n = 31
   After controlling for body weight, there was a significant effect of time on fasting serum glucose (P = 0.0177) and total cholesterol (P = 0.0386) concentrations, and on diastolic blood pressure (P = 0.0413), with reductions in these variables occurring over time; there was no time-by-diet interaction for any of the parameters studied.
   
   Who: Thirty-one men and women, age 19-50 y and body mass index 27-33 kg/m(2)
   Effect: no time-by-diet interaction for any parameter; total cholesterol fell over time in both groups
   Certainty: Weight-loss context: weight loss itself lowers cholesterol, so the result does not transfer to adding MCT to a usual diet.
   J Am Coll Nutr, 2008 · checked 2026-10-07 · we read the abstract
8. ev-mctchol-08 · Randomized controlled trial(s) · randomized controlled pilot trial, 90 days · n = 40
   The MCT group showed an across-time reduction in body weight and WC, an increase in serum C-peptide concentration, a reduction in homeostasis model assessment of insulin resistance, and a decrease in serum cholesterol concentration (P < .05, repeated measures).
   
   Who: 40 free-living subjects with type 2 diabetes, moderately overweight, urban China
   Effect: serum cholesterol decreased in the MCT group across time (P < .05, repeated measures), within-group; size not given in the abstract
   Certainty: Within-group comparison, not between groups; accompanying spontaneous calorie reduction. Weak evidence.
   Metabolism, 2007 · checked 2026-10-07 · we read the abstract
9. ev-mctchol-09 · Observational data · systematic review of prospective studies (7 randomized) · n = —
   The most common AEs included gastrointestinal disturbances (40.6%), hyperlipidemia (12.8%), hyperuricemia (4.4%), lethargy (4.1%), infectious diseases (3.8%) and hypoproteinemia (3.8%).
   
   Who: children receiving the classic or medium-chain triglyceride ketogenic diet for refractory epilepsy
   Effect: gastrointestinal disturbances 40.6%; hyperlipidemia 12.8%; severe adverse events at most 0.5%
   Certainty: Therapeutic ketogenic diet under supervision, MCT doses much higher than household; the share of the MCT variant specifically cannot be singled out from the abstract. Hence level C.
   World J Pediatr, 2017 · checked 2026-10-07 · we read the abstract
10. ev-mctchol-10 · Position of an expert body · presidential advisory · n = —
    Replacement of saturated with unsaturated fats lowers low-density lipoprotein cholesterol, a cause of atherosclerosis, linking biological evidence with incidence of CVD in populations and in clinical trials.
    
    Who: General population, American Heart Association presidential advisory
    Effect: saturated to unsaturated fat swap lowers LDL cholesterol (position, no new pooled estimate)
    Certainty: Position on saturated fats in general; there is no separate AHA statement on MCT oil. Corresponds to a MA subgroup: versus unsaturated oils MCT raises LDL.
    Circulation, 2017 · checked 2026-10-07 · we read the abstract
11. ev-mctchol-11 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized trials · n = —
    Seven articles were included in the meta-analysis; LDL cholesterol and HDL cholesterol were reported in 6 studies.
    
    Who: Adults over 18; trials of at least 2 weeks; enteral and parenteral nutrition excluded
    Effect: 7 articles; LDL and HDL in 6
    Certainty: Axis 9: evidence only on blood markers; no clinical events in any RCT; children and people with high LDL were not analyzed separately.
    J Nutr, 2021 · checked 2026-10-07 · we read the abstract