A ketogenic drink improves cognition in mild cognitive impairment: Results of a 6-month RCT

BENEFIC randomized adults with mild cognitive impairment to a ketogenic MCT drink (15 g twice daily) or placebo for six months; 39 and 44 participants were analyzed. Free and cued recall (p=0.047), category fluency (p=0.024), naming (p=0.033) and Trail-Making Test errors (p=0.017) all improved versus placebo. Several cognitive changes correlated with blood ketone levels, supporting the mechanism: ketones partially bypass the brain glucose-use deficit seen in MCI. A companion imaging cohort (N=52) showed brain ketone metabolism rose 230% at the same dose. Limitations: small sample, modest completion, and a population with diagnosed MCI - not healthy adults. The evidence does not support MCT oil as a general nootropic. GI effects (diarrhea, cramps) are dose-limiting and require slow titration from about 5 g/day. The 30 g/day trial dose adds roughly 250 kcal. APOE4 status did not clearly modify effects in this trial, though the wider literature is unresolved.

This kMCT drink improved cognitive outcomes in MCI, at least in part by increasing blood ketone level.