Medium Chain Triglycerides and Intestinal Lymphangiectasia

Congenital Pulmonary Lymphangiectasia, Gastrointestinal lymphangiectasia, Wireless capsule endoscopy, Antiplasmin Therapy, Medium Chain Triglycerides, Octreotide Treatment, cutaneous lymphangiectasia, primary pulmonary lymphangiectasia, skin lymphangiectasia, support group resources, haemorrhagica conjunctivae, incontinentia pigmenti, Hemihypertrophy, Impaired neutrophil function, dilated lymphatics, eye lymphangiectasia, kidney lymphangiectasia, autologous blood therapy, protein-losing gastroenteropathy, double balloon enteroscopy, malabsorption syndromes, Osteomalacia

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Medium Chain Triglycerides and Intestinal Lymphangiectasia

Postby patoco » Tue Sep 26, 2006 9:34 am

Medium Chain Triglycerides (MCT)and Intestinal Lymphangiectasia

Lymphedema People

http://www.lymphedemapeople.com

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One methods used in helping to manage intestinal lymphangiectasia is to follow a specialized diet involving what is called medium chain triglycerides.

Here is some helpful information on MCT's, what they are and what they do.

Medium Chain Triglycerides

What do they do?

Medium-chain triglycerides (MCT) are a class of fatty acids. Their chemical composition is of a shorter length than the long-chain fatty acids present in most other fats and oils, which accounts for their name. They are also different from other fats in that they have a slightly lower calorie content1 and they are more rapidly absorbed and burned as energy, resembling carbohydrate more than fat.2

MCT have been shown to increase calorie burning compared with other fats.3 4 However, researchers estimate that half of the calories in the diet would have to be eaten as MCT for significant weight loss to occur.5 Obese women on a calorie-restricted diet using MCT for 24% of total calories, experienced no greater weight loss after three months, than when regular fat was used.6 Whether MCT would help people lose weight on a normal diet has not been adequately studied.

Since MCT is more rapidly used for energy than other fats, some athletes have been interested in its use, especially during prolonged endurance exercise.7 However, no effect on carbohydrate sparing or endurance exercise performance has been shown, with moderate amounts of MCT (30–45 grams).8 9 Trials using very large amounts (about 85 grams) have produced conflicting results. One study found increased performance when MCT was added to a 10% carbohydrate solution,10 and another study actually reported decreased performance, probably due to gastrointestinal distress, in athletes using MCT.11

Because some short-term studies have shown that MCT lowers blood glucose levels, a group of researchers investigated the use of MCT to treat people with type 2 (adult onset or non-insulin-dependent) diabetes mellitus.12 In nonhospitalized people with diabetes who consumed MCT for an average of 17.5% of their total calorie intake for 30 days, MCT did not improve diabetic control by most measures.13

Where are they found?

Medium chain triglycerides are found in coconut oil, palm kernel oil, and butter. MCT are also available as a supplement.

Who is likely to be deficient?

Most people consume adequate amounts of fat in their diets and many people consume excessive amounts, so extra fat intake as medium chain triglycerides is unnecessary.

How much is usually taken?

The best amount of medium chain triglycerides to take is currently unknown. Athletes are not likely to benefit from less than 50 grams during exercise. Larger amounts may possibly help some, but may also impair performance if not combined with carbohydrate.

Are there any side effects or interactions?

Consuming medium chain triglycerides on an empty stomach can lead to gastrointestinal upset. Anyone with cirrhosis or other liver problems should check with a doctor before using MCT. Two reports suggest that MCT may raise serum cholesterol and/or triglycerides.14 15 MCT is actually the preferred fatty acid source for cirrhotic patients, but only when used intermittently.16

At the time of writing, there were no well-known drug interactions with medium chain triglycerides.

References

1. Bach AC, Ingenbleek Y, Frey A. The usefulness of dietary medium-chain triglycerides in body weight control: fact or fancy? J Lipid Res 1996;37:708–26.
2. Bach AC, Babayan VK. Medium-chain triglycerides—an update. Am J Clin Nutr 1982;36:950–62.
3. Scalfi L, Coltorti A, Contaldo F. Postprandial thermogenesis in lean and obese subjects after meals supplemented with medium-chain and long-chain triglycerides. Am J Clin Nutr 1991;53:1130–3.
4. Seaton TB, Welle SL, Warenko MK, et al. Thermic effect of medium-chain and long-chain triglycerides in man. Am J Clin Nutr 1986;44:630–4.
5. Bach AC, Ingenbleek Y, Frey A. The usefulness of dietary medium-chain triglycerides in body weight control: fact or fancy? J Lipid Res 1996;37:708–26.
6. Yost TJ, Eckel RH. Hypocaloric feeding in obese women: metabolic effects of medium-chain triglyceride substitution. Am J Clin Nutr 1989;49:326–30.
7. Jeukendrup AE, Saris WH, Schrauwen P, et al. Metabolic availability of medium-chain triglycerides coingested with carbohydrates during prolonged exercise. J Appl Physiol 1995;79:756–62.
8. Jeukendrup AE, Wagenmakers AJM, Brouns F, et al. Effects of carbohydrate (CHO) and fat supplementation on CHO metabolism during prolonged exercise. Metabolism 1996;45:915–21.
9. Satabin P, Portero P, Defer G, et al. Metabolic and hormonal responses to lipid and carbohydrate diets during exercise in man. Med Sci Sports Exer 1987;19:218–23.
10. van Zyl CG, Lambert EV, Hawley JA, et al. Effects of medium-chain triglyceride ingestion on carbohydrate metabolism and cycling performance. J Appl Physiol 1996;80:2217–25.
11. Jeukendrup AE, Thielen JJHC, Wagenmakers AJM, et al. Effect of medium-chain triacylglycerol and carbohydrate ingestion during exercise on substrate utilization and subsequent cycling performance. Am J Clin Nutr 1998;67:397–404.
12. Eckel RH, Hanson AS, Chen AY, et al. Dietary substitution of medium-chain triglycerides improves insulin-mediated glucose metabolism in non-insulin dependent diabetics. Diabetes 1992;41:641–7.
13. Trudy J, Yost RN, Erskine JM, et al. Dietary substitution of medium-chain triglycerides in subjects with non-insulin dependent diabetes mellitus in an ambulatory setting: impact on glycemic control and insulin-mediated glucose metabolism. J Am Coll Nutr 1994;13:615–22.
14. Cater NB, Heller HJ, Denke MA. Comparison of the effects of medium-chain triacylglycerols, palm oil, and high oleic acid sunflower oil on plasma triacylglycerol fatty acids and lipid and lipoprotein concentrations in humans. Am J Clin Nutr 1997;65:41–5.
15. Hill JO, Peters JC, Swift LL, et al. Changes in blood lipids during six days of overfeeding with medium or long chain triglycerides. J Lipid Res 1990;31:407–16.
16. Fan ST. Review: nutritional support for patients with cirrhosis. J Gastroenterol Hepatol 1997;12:282–6.
Mednd

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Medium-chain triglycerides (MCT)

Description

Medium-chain triglycerides (MCTs) are a special class of fatty acids. Normal fats and oils contain long-chain fatty acids (LCTs). Compared to these fatty acids, MCTs are much shorter in length. Therefore, they resemble carbohydrates more than fat. As a result, they are more easily absorbed, digested, and utilized as energy than LCTs.

Medium-chain triglycerides are found naturally in milk fat, palm oil, and coconut oil. Commercial MCT oil, available as liquid and capsules, is obtained through lipid fractionation, the process in which MCTs are separated from other components of coconut oil. Medium-chain triglycerides were originally formulated in the 1950s as an alternative food source for patients who are too ill to properly digest normal fats and oils.

The long chains of LCTs require a lot of bile acids and many digestive steps to be broken down into smaller units that can be absorbed into the bloodstream. Once in the bloodstream, they are absorbed by fat cells and stored as body fat. In contrast, the medium-chain triglycerides are more water-soluble and are able to enter the bloodstream quicker because of their shorter lengths. Once in the bloodstream, they are transported directly into the liver. Thus, MCTs are an immediately available source of energy and only a tiny percent is converted into body fat.

Medium-chain triglycerides were first used in the mid-1900s to reduce seizures with the help of the ketogenic diet. In the 1980s, MCTs became popular in sports as a substitute for normal dietary fats or oils. They quickly became a favorite energy source for many athletes, such as marathon runners, who participate in endurance sports. These athletes require a quick source of energy, which is readily supplied by carbohydrates. However, diets high in carbohydrates may cause rapid increase in insulin production, resulting in substantial weight gain, diabetes, and other health problems. Dietary fats or oils are not a readily available source of energy. In addition, they are believed to make the body fatter. MCT is also a form of fat; therefore, it is high in calories. Yet, unlike normal fats and oils, MCTs do not cause weight gain because they stimulate thermogenesis (the process in which the body generates energy, or heat, by increasing its normal metabolic, fat-burning rate). A thermogenic diet, which is high in medium-chain triglycerides, has been proposed as a type of weight loss regime.

General use

Endurance sport nutrition

Medium-chain triglycerides are often used by athletes to increase their endurance during sports or exercise regimes. MCTs are an immediate source of energy, and as such, the body can use them as an alternative energy source for muscle during endurance exercise. However, if consumed in moderate amounts (30 to 45 grams), MCTs are not very effective in either decreasing carbohydrate needs or in enhancing exercise endurance. Increased consumption may help.

One study evaluated six athletes at different points during a 25-mile cycling trial.

They were given either a medium-chain triglyceride beverage, a carbohydrate drink, or a combined MCT-carbo-hydrate mixture. The fastest speed was achieved when the athletes used the MCT-carbohydrate blend. The worst performance was associated with sport drinks containing MCT alone (without carbohydrate). Therefore, to gain significant increases in endurance, it is generally recommended that an athlete consume at least 50 grams of MCTs per day in combination with some carbohydrates. However, dosages exceeding 30 grams often cause gastrointestinal upset, which can diminish an athlete's performance.

MCT products available in the market may have high water content or contain unwanted ingredients. Therefore, athletes should buy MCT-only products, and mix a small amount into carbohydrate soft drinks. Alternatively, they can purchase premixed MCT sport drinks, such as a brand known as SUCCEED.

Thermogenic diet

MCTs are popular among body builders because they help reduce carbohydrate intake, while allowing them ready access to energy whenever they need it. MCTs also have muscle-sparing effects. As a result, they can build muscles while reducing fats. However, this does not mean that these athletes will become healthier, because an improvement in body physique does not always correlate with higher fitness levels.

Pre-competition diet

Compared to carbohydrates, medium-chain triglycerides are a better and more efficient source of quick energy. They help conserve lean body mass because they prevent muscle proteins from being used as energy. Therefore, some athletes load up on medium-chain triglycerides the night before a competition. However, MCT intake should be raised gradually to allow the body to adapt to increasing MCT consumption.

If MCT consumption abruptly increases, incomplete MCT metabolism may occur, producing lactic acid in the body and a rapid rise of ketones in the blood, which can make the person ill.

Weight-loss diet

Studies have shown that MCT may increase metabolism, which is the rate that the body burns fat. It is believed that sustained increases in metabolic rate cause the body to burn more fat, resulting in weight loss. However, for any kind of meaningful weight loss, a person would have to consume more than 50% of total daily caloric intake in the form of medium-chain triglycerides.

Treatment of seizures

A ketogenic diet, or diet containing mostly medium-chain triglycerides, offers hope for those who have seizures that cannot be controlled by currently available drugs. Excessive consumption of MCTs produces ketones in the body; therefore, this type of diet is called a ketogenic diet. It has proven effective for some epileptic patients.


Nutritional supplements

MCTs are the preferred forms of fat for many patients with fat malabsorption problems.

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Many diseases cause poor fat absorption. For instance, patients with pancreatic insufficiency do not have enough pancreatic enzymes to break down LCTs. In children with cystic fibrosis, thick mucus blocks the enzymes that assist in digestion. Another fat absorption condition is short-bowel syndrome, in which parts of the bowel have been removed due to disease. Stressed or critically ill patients also have a decreased ability to digest LCTs. Unlike LCTs, medium-chain triglycerides are easily absorbed by patients with malabsorption conditions. These patients benefit most from oral preparations that contain MCTs as the primary source of fat (up to 85% of fat caloric intake). Several scientific studies have shown MCT to be effective in treating fat malabsorbtion, chronic diarrhea, and weight loss in patients with Acquired Immune Deficiency Syndrome (AIDS).

Many MCT products can be found in local health food stores or ordered through pharmacies. Before purchasing these products, patients should consult their doctors or registered dietitians for advice concerning appropriate dosage and use. MCT oil is not used for cooking. However, it can be used for tube feeding in critically ill patients. Healthy people may take it orally, by itself or mixed with water, juice, ice cream, or pudding.

Preparations

Available medium-chain triglyceride products include:

·MCT oil
·sports drinks
·energy bars
·meal replacement beverages

Precautions

·People with hepatic encephalopathy, brain and nervous system damage
that occurs as a complication of liver disorders, should not take MCT.

·High consumption of medium-chain triglycerides can cause abdominal pain, cramps, and diarrhea.

·Long-term high-level MCT consumption is associated with increased risk of heart disease and other conditions. Even moderate consumption of medium-chain triglycerides can increase cholesterol and triglyceride levels. Therefore, no more than 10% of a person's diet should come from MCTs.

·Diabetic athletes and those with liver disease should not use MCT products.

·MCT oil should not completely replace all dietary fats, as this would result in a deficiency of other fatty acids- essential fatty acids- that the human body needs from food sources. To avoid essential fatty acid deficiencies, a person should also include omega-3 and omega-6 fatty acids in their diets. Good sources of omega-3 include fish, fish oils, or flaxseed oil. Omega-6 fatty acids are often found in vegetable oils and evening primrose oil. The omega-3 fats have several additional health benefits, such as alleviating inflammation and protecting the body against heart disease.

·A person should not take medium-chain triglyceride products on an empty stomach, as this may cause gastric upset.

·MCT oil is not for cooking. It is usually consumed in its uncooked form as sport bars, or mixed with a carbohydrate drink, protein shake, or other products.

·MCT oil leaches into plastic bags and containers. Therefore, non-plastic containers should be used for MCT oil storage.

Side effects

There are a few adverse effects associated with MCT use. Eating foods containing medium-chain triglycerides on an empty stomach often causes gastrointestinal upset. Regular consumption of MCTs may increase cholesterol and triglyceride blood levels.

Interactions

There have been no reported interactions between MCTs and other drugs.
Resources

BOOKS
Antonio, Jose, and Jeffery Stout. Supplements for Endurance Athletes. Champaign, IL: Human Kinetics, 2002.
Ivy, John, and Robert Portman. The Performance Zone: Your Nutrition Action Plan for Greater Endurance and Sports Performance (Teen Health Series). North Bergen, NJ: Basic Health Publications, Inc., 2004.
Ryan, Monique. Sports Nutrition for Endurance Athletes. Boulder, CO: Velo Press, 2002.
Stapstrom, Carl E. Epilepsy and the Ketogenic Diet: Clinical Implementation & the Scientific Basis. Totowa, NJ: Humana Press, 2004.

PERIODICALS

(No author). "Medium-Chain Triglycerides May Help Promote Weight Loss." Obesity, Fitness & Wellness Week (March 29, 2003): 5.
(No author). "Medium Chain Triglycerides." Alternative Medicine Review (October 2002): 418-20.
Donnell, S.C., et al. "The Metabolic Response to Intravenous Medium-Chain Triglycerides in Infants After Surgery." Alternative Medicine Review (February 2003): 94.
St-Onge, M.P., and P.J. Jones. "Physiological Effects of Medium-Chain Triglycerides: Potential Agents in the Prevention of Obesity." Alternative Medicine Review (June 2002): 260.
St-Onge, M.P., et al. "Medium-Chain Triglycerides Increase Energy Expenditure and Decrease Adiposity in Overweight Men." Obesity Research (March 2003): 395-402.

ORGANIZATIONS

American Dietetic Association (ADA) Consumer Information Hotline. (800)366-1655..

OTHER

Klein, Samuel. "Lipid Metabolism During Exercise." Health-World Online. Abstract from NIH Workshop: The Role of Dietary Supplements for Physically Active People.
PDRhealth.com article. "Medium-Chain Triglycerides." .
Healthline

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Super page with low-fat and MCT recipes:

http://www.littleleakers.com/RECIPES/maindishes.html

Little Leakers website:

http://www.littleleakers.com/

……………

MCT Cookbook

http://www.fodsupport.org/pdf/Lowfat_Re ... CT_Oil.pdf

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Medium-Chain Triglycerides

TRADE NAMES

MCT Oil (Mead Johnson)

DESCRIPTION

Medium-chain triglycerides, commonly abbreviated MCT or MCTs, are medium-chain fatty acid esters of glycerol. Medium-chain fatty acids are fatty acids containing from six to 12 carbon atoms. These fatty acids are constituents of coconut and palm kernel oils and are also found in camphor tree drupes. Coconut and palm kernel oils are also called lauric oils because of their high content of the 12 carbon fatty acid, lauric or dodecanoic acid.

Medium-chain triglycerides used for nutritional and other commercial purposes are derived from lauric oils. In the process of producing MCTs, lauric oils are hydrolyzed to medium-chain fatty acids and glycerol. The glycerol is drawn off from the resultant mixture, and the medium-chain fatty acids are fractionally distilled. The medium-chain fatty acid fraction used commercially is mainly comprised of the eight carbon caprylic or octanoic acid and the 10 carbon capric or decanoic acid. There are much smaller amounts of the six carbon caproic or hexanoic acid and the 12 carbon lauric acid in the commercial products. The caprylic- and capric-rich mixture is finally re-esterified to glycerol to produce medium-chain triglycerides that are mainly glyceral esters of caproic (C6) caprylic (C8), capric (C10) and lauric acid (C12) in a ratio of approximately 2:55:42:1.

MCTs are represented by the following chemical structures:

Medium-chain triglycerides
R represents the alkyl moieties primarily of C8, caprylic
(octanoic) and C10, capric (decanoic) acids.

Caprylic Acid

Capric acid

MCT is also known as fractionated coconut oil. In a process called interesterification, long-chain fatty acids, such as oleic and linoleic acid, are introduced into the final product. MCT derivatives produced by the interesterification process are referred to as structural lipids or structural triglycerides. Unlike most natural oils of animal or vegetable origin, MCT is stable and resistant to oxidation owing mainly to the saturation of the medium-chain fatty acids.

ACTIONS AND PHARMACOLOGY

ACTIONS

MCT's major action is as an energy-yielding substrate, particularly beneficial for those with malabsorption syndromes. MCT is also ketogenic.

MECHANISM OF ACTION

The physiology and biochemistry of medium-chain triglycerides are very different from those of long-chain triglycerides. MCT is rapidly absorbed from the small intestine, intact or following hydrolysis, into the portal circulation. From there, it is transported to the liver. Long-chain triglycerides are first hydrolyzed in the small intestine to long-chain fatty acids. They are in turn re-esterified in the mucosal cells of the small intestine to long-chain triglyerides, which are then carried by chylomicrons and transported via the lymphatic system to the systemic circulation. The systemic circulation in turn distributes the long-chain triglycerides to various tissues of the body, including adipose tissue and the liver.

Since MCT, in contrast with long-chain fatty acids, does not require pancreatic enzymes or bile salts for digestion and absorption, MCT is better handled in those with malabsorption syndromes than are the long-chain fatty acids. These syndromes include pancreatic disorders, hepatic disorders, gastrointestinal disorders and disorders of the lymph system.

Medium-chain fatty acids are taken up by hepatocytes and converted to medium-chain fatty acyl CoA which enters mitochondria without requiring the aid of carnitine. On the other hand, long-chain fatty acids, which are also converted to their coenzyme A esters in cells, including hepatocytes, require that they be converted from coenzyme A esters to carnitine esters in order to be transported across the mitochondrial membrane. Within the hepatocyte mitochondria, medium-chain fatty acyl CoA is converted to acetoacetate and beta-hydroxybutyrate and subsequently to carbon dioxide, water and energy. The oxidation of MCT produces 8.3 kilocalories of energy per gram ingested.

MCTs are therefore easier to metabolize, which could be advantageous to those who are critically ill and those with carnitine deficiencies.
MCT is ketogenic. The metabolism of MCT in hepatocytes produces two so-called ketone bodies, acetoacetate and beta-hydroxybutyrate. These ketone bodies are carried by the bloodstream to other tissues of the body, where they are used for energy production, as well as for other biochemical processes. It is believed that ketosis may raise the seizure threshold and reduce seizure severity. This is still hypothetical but is the rationale for the use of ketogenic diets in the treatment of seizure disorders.

PHARMACOKINETICS

MCT is rapidly absorbed from the small intestine, intact or hydrolyzed, after ingestion and is transported to the liver via the portal circulation. Medium-chain fatty acids are transported into hepatocytes and converted to medium-chain fatty acyl CoA esters. Medium-chain fatty acyl CoAs (mainly of caprylic and capric acids) are transported into mitochondria, where they are metabolized to acetoacetate and beta- hydroxybutyrate. The first mitochondrial enzyme in this process is medium-chain acyl CoA dehydrogenase. Acetoacetate and beta-hydroxybutyrate may be further metabolized in the liver to carbon dioxide, water and energy, and may enter some other metabolic pathways in the liver or be transported by the systemic circulation to other tissues, where they undergo metabolism mainly to CO2, H2O and energy. Very little ingested MCT is deposited in the body as fat.

INDICATIONS AND USAGE

Though MCT's are being promoted in the supplement marketplace for weight loss and to increase athletic performance, numerous studies have shown that MCT's are ineffective for achieving these goals. On the other hand, MCT does appear to be helpful for nutritional support in a number of conditions, including enteral and total parenteral nutrition in some infants and surgical patients, as well as in some of those who are critically ill with immunosuppression, pulmonary disease, liver disease, neurologic injury and various malabsorption syndromes. MCT may also be useful in some with epilepsy and other disorders characterized by seizures. There is preliminary evidence that MCT may be helpful in some cancers and may have some positive effects on immunity.

RESEARCH SUMMARY

A large number of studies have sought to determine whether MCT can promote long-chain fatty acid oxidation, inhibit the rate of muscle glycogen depletion, and enhance exercise and athletic performance. Many of these studies have tested subjects, some of them elite athletes, on bicycle ergometers. Some of these trials have been randomized, double-blind, placebo-controlled. Almost all have found no effect of MCT on rates of long-chain fatty acid oxidation, muscle glycogen utilization or performance. "At present," one research group concluded, "there is insufficient scientific evidence to recommend that athletes either ingest fat, in the form of MCTs, during exercise, or "fat adapt' in the weeks prior to a major endurance event to improve athletic performance."

It should be noted that some have reported that exercise performance is actually impaired in some taking high doses of MCT. This diminished performance was associated with increased gastrointestinal complaints, primarily intestinal cramping.

Research on weight loss associated with MCT intake is not as abundant but presents a mixed and mostly negative conclusion. MCT diets have been compared with LCT (long-chain triglyceride) diets and show no superiority. There are no convincing data that diets high in MCT are effective for weight loss.

MCT shows considerable promise, on the other hand, for the nutritional support of some premature infants, surgical patients and the critically ill, particularly those needing total parenteral nutrition (TPN). Lipid emulsions containing significant quantities of MCT as part of TPN have demonstrated significant benefits in some with pulmonary diseases, AIDS, liver disease, neurologic injury and several other illnesses.

AIDS patients, for example, who were suffering from fat malabsorption and chronic diarrhea with weight loss, were significantly benefited by a 12-week regimen of MCT. There was a significant decrease in stool number, stool fat and stool weight compared with baseline, regardless of the etiology of the diarrhea.

Surgical patients have shown more improvement in some studies, using MCT, compared with LCT. The same is true in some patients with some forms of liver disease. MCT is more readily utilized than LCT and is not deposited in the liver. MCT combined with LCT was found to be superior to LCT alone in septic patients with ARDS. Nutritional support with MCT has also helped prevent gestational hyperlipidemic pancreatitis, with resulting successful childbirth.

MCT's usefulness in drug-resistant epilepsy was demonstrated in a trial with 50 children, eight of whom achieved complete control of seizures (four without further use of anticonvulsant drugs). In another trial, five of 17 MCT-treated subjects with previously intractable drug-resistant seizures achieved complete control of seizures with diminished or discontinued use of drugs. Five others had some improvement. Other types of intractable seizures have also yielded to MCT supplementation. Seven girls with Rett syndrome who suffered from drug-resistant seizures were given MCT therapy; five showed clinical benefit.

There is very preliminary evidence that MCT may have some positive effects on immunity and may exert some anti-cancer effects. Compared with LCT, MCT enhanced macrophage response in an animal model and suppressed Malassezia infection in vitro. This is significant, in particular, since lipophilic Malassezia species frequently grow on standard lipid infusions and can induce catheter-associated sepsis in newborns and immunocompromised patients receiving parenteral lipids.

In an animal model of cachexia-inducing colon adenocarcinoma, an MCT regimen reduced weight loss and was associated with a marked reduction in tumor size. LCT, on the other hand, did not have these effects. In vitro studies have indicated that MCT is significantly cytotoxic against some human tumor cells. More research is underway.

CONTRAINDICATIONS, PRECAUTIONS, ADVERSE REACTIONS
CONTRAINDICATIONS


MCT is contraindicated in those with hepatic encephal- opathy.

PRECAUTIONS

Great caution should be exercised in the use of MCT in those with diabetes, acidosis, ketosis, cirrhosis and the inborn error of metabolism, medium-chain acyl CoA dehydrogenase deficiency. Those with cirrhosis may accumulate free fatty acids and glycerol if given MCT.

ADVERSE REACTIONS

Adverse effects reported include diarrhea, nausea, vomiting, irritability and, with high doses (over 80 grams taken at one time), intestinal cramping.

INTERACTIONS

DRUGS

Theoretically, MCT may facilitate the uptake of some lipophilic drugs.

NUTRITIONAL SUPPLEMENTS

MCT may facilitate the absorption of vitamin E, magnesium and calcium. Theoretically, MCT may facilitate the absorption of the fat-soluble vitamins A, D and K, carotenoids, lipophilic polyphenols and supplemental long-chain fatty acids (ALA, EPA, DHA, GLA).

FOODS

MCT may facilitate the absorption of magnesium, calcium, fat-soluble vitamins and other lipophilic nutrients (carotenoids, flavonoids) and long-chain fatty acids in foods.

HERBS

Theoretically, MCT may facilitate the absorption of lipophilic substances in herbs.

OVERDOSAGE

There are no reports of overdosage with MCT.

DOSAGE AND ADMINISTRATION

Medium-chain triglycerides are available in several medical food products, many for use in a hospital setting. Doses of these medical food products are as prescribed by a physician.

MCT (100 percent) is available as a nutritional supplement. Those with malabsorption syndromes typically use one tablespoon up to three times a day with food or as directed by a physician. One tablespoon is equivalent to approximately 15 grams of MCT.

Those who use MCT as a supplement for any other reason typically use one tablespoon once to three times daily taken with food.

Doses greater than 80 grams (over five tablespoons) taken at one time may cause intense intestinal cramping.

HOW SUPPLIED

Oil

LITERATURE

Babayan VK. Medium chain length fatty acid esters and their medical and nutritional applications. J Am Oil Chem Soc. 1981; 58:49A-51A.
Bach AC, Ingenbleek Y, Frey A. The usefulness of dietary medium-chain triglycerides in body weight control: fact or fancy? J Lipid Res. 1996; 37:708-726.
Bach AC, Babayan VK. Medium-chain triglycerides: an update. Am J Clin Nutr. 1982; 36:950-962.
Craig GB, Darnell BE, Weinsier RL, et al. Decreased fat and nitrogen losses in patients with AIDS receiving medium-chain-triglyceride-enriched formula vs. those receiving long-chain-triglyceride-containing formula. J Am Diet Assoc. 1997; 97:605-611.
Fan, ST. Review: nutritional support for patients with cirrhosis. Gastroenterol Hepatol. 1997; 12:282-286.
Greenberger NJ, Skillman TG. Medium-chain triglycerides. Physiologic consideration and clinical implications. N Engl J Med. 1969; 280:1045-1058.
Haas RH, Rice MA, Trauner DA, Merritt TA. Therapeutic effects of a ketogenic diet in Rett syndrome. Am J Med Genet Suppl. 1986; 1:225-246.
Hawley JA, Brouns F, Jeukendrup A. Strategies to enhance fat utilization during exercise. Sports Med. 1998; 25:241-257.
Hinton PS, Peterson CA, McCarthy DO, Ney DM. Medium-chain compared with long-chain triacylglycerol emulsions enhance macrophage response and increase mucosal mass in parenterally fed rats. Am J Clin Nutr. 1998; 67:1265-1272.
Jeukendrup AE, Thielen JJ, Wagenmakers AJ, et al. Effect of medium-chain triacylglycerol and carbohydrate ingestion during exercise on substrate utilization and subsequent cycling performance. Am J Clin Nutr. 1998; 67:397-404.
Jiang ZM, Zhang SY, Wang XR, et al. A comparison of medium-chain and long-chain triglycerides in surgical patients. Ann Surg. 1993; 217:175-184.
Kimoto Y, Tanji Y, Taguchi T, et al. Antitumor effect of medium-chain triglyceride and its influence on the self-defense system of the body. Cancer Detect Prev. 1998; 22:219-224.
Kimura T, Fukui E, Kageyu A, et al. Enhancement of oral bioavailability of d-alpha-tocopherol acetate by lecithin-dispersed aqueous preparation containing medium-chain triglycerides in rats. Chem Pharm Sci. 1989; 37:439-441.
Mizushima T, Ochi K, Matsumura N, et al. Prevention of hyperlipidemic acute pancreatitis during pregnancy with medium-chain triglyceride nutritional support. Int J Pancreatol. 1998; 23:187-192.
Papamandjaris AA, MacDougall DE, Jones PJ. Medium chain fatty and metabolism and energy expenditure: obesity treatment implications. Life Sci. 1998; 62:1203-1215.
Papavassilis C, Mach KK, Mayser PA. Medium-chain triglycerides inhibit growth of Malassezia: implications for prevention of systemic infection. Crit Care Med. 1999; 27:1781-1786.
Ruppin DC, Middleton WRJ. Clinical use of medium chain triglycerides. Drugs. 1980; 20:216-224.
Sanchez R, Hendler S. Delivery formulation for probucol. 1996; U.S. Patent No. 5, 494, 936
Sills MA, Forsythe WI, Haidukewych D, et al. The medium chain triglyceride diet and intractable epilepsy. Arch Dis Child. 1986; 61:1168-1172.
Smirniotis V, Kostopanagiotou G, Vassiliou J, et al. Long chain versus medium chain lipids in patients with ARDS: effects on pulmonary haemodynamics and gas exchange. Intensive Care Med. 1998; 24:1029-1033.
Tisdale MJ, Brennan RA. A comparison of long-chain triglycerides and medium-chain triglycerides on weight loss and tumour size in a cachexia model. Br J Cancer. 1988; 58:580-583.
Trauner DA. Medium-chain triglyceride (MCT) diet in intractable seizure disorder. Neurology. 1985; 35:237-238.
Wanke CA, Pleskow D, Degirolami PC, et al. A medium chain triglyceride-based diet in patients with HIV and chronic diarrhea reduces diarrhea and malabsorption: a prospective, controlled trial. Nutrition. 1996; 12:766-771.

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Re: Medium Chain Triglycerides and Intestinal Lymphangiectas

Postby sammysosa » Sat Oct 22, 2011 2:10 pm

I have high blood pressure and my triglyceride levels are usually not where they need to be - these MCTs would not affect me negatively would they?

Cheers,

Low glycemic shakes
Last edited by sammysosa on Wed Oct 26, 2011 8:07 pm, edited 1 time in total.
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Re: Medium Chain Triglycerides and Intestinal Lymphangiectas

Postby patoco » Sun Oct 23, 2011 9:59 am

Hey Sammy :)

They shouldn't, but just to make sure in your personal condition be sure to check with the doctor. The MCT diet should be harmless.

Pat
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