Medium Chain Tryglyceride Oil - MCT Powder

Med Hypotheses. 2015 Aug 10. pii: S0306-9877(15)00306-0. doi: 10.1016/j.mehy.2015.08.002. [Epub ahead of print]

Ketosis may promote brain macroautophagy by activating Sirt1 and hypoxia-inducible factor-1

McCarty MF1, DiNicolantonio JJ2, O'Keefe JH2.

Author information

  • 1Catalytic Longevity, 7831 Rush Rose Dr., Apt. 316, Carlsbad, CA 92009, United States. Electronic address: markfmccarty@gmail.com.

  • 2Preventive Cardiology Dept., St. Luke's Mid America Heart Institute, Kansas City, MO, United States.

Abstract

Ketogenic diets are markedly neuroprotective, but the basis of this effect is still poorly understood.

Recent studies demonstrate that ketone bodies increase neuronal levels of hypoxia-inducible factor-1α (HIF-1α), possibly owing to succinate-mediated inhibition of prolyl hydroxylase activity. Moreover, there is reason to suspect that ketones can activate Sirt1 in neurons, in part by increasing cytoplasmic and nuclear levels of Sirt1's obligate cofactor NAD(+). Another recent study has observed reduced activity of mTORC1 in the hippocampus of rats fed a ketogenic diet - an effect plausibly attributable to Sirt1 activation. Increased activities of HIF-1 and Sirt1, and a decrease in mTORC1 activity, could be expected to collaborate in the induction of neuronal macroautophagy. Considerable evidence points to moderate up-regulation of neuronal autophagy as a rational strategy for prevention of neurodegenerative disorders; elimination of damaged mitochondria that overproduce superoxide, as well as clearance of protein aggregates that mediate neurodegeneration, presumably contribute to this protection. Hence, autophagy may mediate some of the neuroprotective benefits of ketogenic diets.

Brain-permeable agents which activate AMP-activated kinase, such as metformin and berberine, as well as the Sirt1 activator nicotinamide riboside, can also boost neuronal autophagy, and may have potential for amplifying the impact of ketogenesis on this process. Since it might not be practical for most people to adhere to ketogenic diets continuously, alternative strategies are needed to harness the brain-protective potential of ketone bodies. These may include ingestion of medium-chain triglycerides or coconut oil, intermittent ketogenic dieting, and possibly the use of supplements that promote hepatic ketogenesis - notably carnitine and hydroxycitrate - in conjunction with dietary regimens characterized by long daily episodes of fasting or carbohydrate avoidance.

 

Metab Brain Dis. 2015 Feb;30(1):93-8. doi: 10.1007/s11011-014-9586-4. Epub 2014 Jul 9.

Effects of ketogenic diets on the occurrence of pilocarpine-induced status epilepticus of rats

Gama IR1, Trindade-Filho EM, Oliveira SL, Bueno NB, Melo IT, Cabral-Junior CR, Barros EM, Galvão JA, Pereira WS, Ferreira RC, Domingos BR, da Rocha Ataide T.

Author information

  • 1Faculty of Nutrition, Federal University of Alagoas (UFAL), Campus A. C. Simões, BR 104 Norte, Km 97, 57.072-970 - Tabuleiro do Martins, Maceió, AL, Brazil.

Abstract

Two sources of medium-chain triglycerides--triheptanoin with anaplerotic properties and coconut oil with antioxidant features--have emerged as promising therapeutic options for the management of pharmacoresistant epilepsy.

We investigated the effects of ketogenic diets (KDs) containing coconut oil, triheptanoin, or soybean oil on pilocarpine-induced status epilepticus (SE) in rats. Twenty-four adult male Wistar rats were divided into 4 groups and fed a control diet (7% lipids) or a KD containing soybean oil, coconut oil, or triheptanoin (69.8% lipids). The ketogenic and control diets had a lipid:carbohydrate + protein ratio of 1:11.8 and 3.5:1, respectively. SE was induced in all rats 20 days after initiation of the dietary treatment, through the administration of pilocarpine (340 mg/kg; i.p.). The latency, frequency, duration, and severity of seizures before and during SE were observed with a camcorder. SE was aborted after 3 h with the application of diazepam (5 mg/kg; i.p.). The rats in the triheptanoin-based KD group needed to undergo a higher number of seizures to develop SE, as compared to the control group (P < 0.05). Total weight gain, intake, energy intake, and feed efficiency coefficient, prior to induction of SE, differed between groups (P < 0.05), where the triheptanoin-based KD group showed less weight gain than all other groups, less energy intake than the Control group and intermediate values of feed efficiency coefficient between Control and other KDs groups.

Triheptanoin-based KD (MCT Oil + KD) may have a neuroprotective effect on the establishment of SE in Wistar rats.

 

 

J Allergy Clin Immunol. 2013 Feb;131(2):442-50. doi: 10.1016/j.jaci.2012.10.011. Epub 2012 Nov 22.

Dietary medium-chain triglycerides promote oral allergic sensitization and orally induced anaphylaxis to peanut protein in mice

Li J1, Wang Y, Tang L, de Villiers WJ, Cohen D, Woodward J, Finkelman FD, Eckhardt ER.

Author information

  • 1Graduate Center for Nutritional Sciences and Internal Medicine Department, Division of Digestive Diseases and Nutrition, University of Kentucky, Lexington, Ky 40536-0200, USA.

Abstract

BACKGROUND:

The prevalence of peanut allergies is increasing. Peanuts and many other allergen sources contain significant amounts of triglycerides, which affect absorption of antigens but have unknown effects on sensitization and anaphylaxis. We recently reported that dietary medium-chain triglycerides (MCTs), which bypass mesenteric lymph and directly enter portal blood, reduce intestinal antigen absorption into blood compared with long-chain triglycerides (LCTs), which stimulate mesenteric lymph flow and are absorbed in chylomicrons through mesenteric lymph.

OBJECTIVE:

We sought to test how dietary MCTs affect food allergy.

METHODS:

C3H/HeJ mice were fed peanut butter protein in MCT, LCT (peanut oil), or LCT plus an inhibitor of chylomicron formation (Pluronic L81). Peanut-specific antibodies in plasma, responses of the mice to antigen challenges, and intestinal epithelial cytokine expression were subsequently measured.

RESULTS:

MCT suppressed antigen absorption into blood but stimulated absorption into Peyer patches. A single gavage of peanut protein with MCT, as well as prolonged feeding in MCT-based diets, caused spontaneous allergic sensitization. MCT-sensitized mice experienced IgG-dependent anaphylaxis on systemic challenge and IgE-dependent anaphylaxis on oral challenge. MCT feeding stimulated jejunal-epithelial thymic stromal lymphopoietin, Il25, and Il33 expression compared with that seen after LCT feeding and promoted T(H)2 cytokine responses in splenocytes. Moreover, oral challenges of sensitized mice with antigen in MCT significantly aggravated anaphylaxis compared with challenges with the LCT. Importantly, the effects of MCTs could be mimicked by adding Pluronic L81 to LCTs, and in vitro assays indicated that chylomicrons prevent basophil activation.

CONCLUSION:

Dietary MCTs promote allergic sensitization and anaphylaxis by affecting antigen absorption and availability and by stimulating T(H)2 responses.

Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

 

Acta Med Iran. 2015;53(2):134-8.

The effect of massage with medium-chain triglyceride oil on weight gain in premature neonates

Saeadi R1, Ghorbani Z2, Shapouri Moghaddam A3.

Author information

  • 1Department of Neonatology, Neonatal Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Saeadi@gmail.com.

  • 2Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran. Ghorbani@gmail.com.

  • 3Department of Immunology, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran. telehealth.ir@gmail.com.

Abstract

Prematurity and poor weight gaining are important causes for neonatal hospitalization. The present study aimed to investigate the role of medium-chain triglyceride (MCT) oil via massage therapy as a supplementary nutritional method on the weight gain of Neonatal Intensive Care Units (NICU)-hospitalized neonates.

This randomized clinical trial performed among 121 stable premature neonates hospitalized in the NICU of Qaem Educational Hospital, Mashhad, Iran. They were randomly divided into three groups: oil-massage, massage alone and control groups. These groups were compared on the basis of weight gain during a one-week interval. The three groups were matched for sex, mean gestational age, birth weight, head circumference, delivery, and feeding type (P>0.05). The mean weight gain on the 7th day in the oil massage group was 105±1.3gr and 52±0.1gr in the massage group; whereas 54±1.3gr weight loss was observed in the control group.

  • Significant differences were observed between the oil-massage group and the other two groups, respectively (P=0.002 and P=0.000). The findings of this study suggest that transcutaneous feeding with MCT oil massage therapy in premature neonates can result in accelerated weight gain in this age group with no risk of NEC.

 

Biomed J. 2013 Jan-Feb;36(1):9-15. doi: 10.4103/2319-4170.107154.

Medium-chain triglyceride ketogenic diet, an effective treatment for drug-resistant epilepsy and a comparison with other ketogenic diets

Liu YM1, Wang HS.

Author information

Abstract

The ketogenic diet (KD) is one of the most effective therapies for drug-resistant epilepsy.

The efficacy of the medium-chain triglyceride KD (MCTKD) is as excellent as the classic KD (CKD), which has been documented in several subsequent retrospective, prospective, and randomized studies. MCT oil is more ketogenic than long-chain triglycerides. Therefore, the MCTKD allows more carbohydrate and protein food, which makes the diet more palatable than the CKD. The MCTKD is not based on diet ratios as is the CKD, but uses a percentage of calories from MCT oil to create ketones.

There has also been literature which documents the associated gastrointestinal side effects from the MCTKD, such as diarrhea, vomiting, bloating, and cramps. Therefore, the MCTKD has been an underutilized diet therapy for intractable epilepsy among children. The author has used up to >70% MCTKD diet to maximize seizure control with gastrointestinal side effects optimally controlled. As long as health care professionals carefully manage MCTKD, many more patients with epilepsy who are not appropriate for CKD or modified Atkins diet or low glycemic index treatment will benefit from this treatment. A comparison between the MCTKD and other KDs is also discussed.

 

Nan Fang Yi Ke Da Xue Xue Bao. 2015 Aug;35(9):1312-5.

[Application of a lipid emulsion for parenteral nutrition support in intensive care patients following gastrointestinal surgeries]

[Article in Chinese]

Pan D1, Chen H, Li L.

Author information

  • 1Department of Gastrointestinal Surgery, First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China.E-mail:Pandun0220@163.com.

Abstract

OBJECTIVE:

To investigate the effect of parenteral nutrition support with a lipid emulsion formulation (containing soybean oil, medium chain triglycerides, olive oil, and fish oil [SMOF]) in intensive care patients following major gastrointestinal surgeries.

METHODS:

According to a randomized, prospective and case-controlled design, 72 intensive care patients following major gastrointestinal surgeries between January and December, 2014 were randomized equally into SMOF group and control group to receive parenteral nutrition support with SMOF and medium or long chain lipid emulsion, respectively. Before and at 4 and 9 days after commencement of parenteral nutrition support, the patients were examined for alanine aminotransferase (ALT), total bilirubin (TBIL), albumin (propagated), C-reactive protein (CRP), interleukin 6 (IL-6), and endotoxin levels. The patients' average length of stay in intensive care unit (ICU), the days of using antibiotics, and the incidence rate of postoperative complication were recorded.

RESULTS:

On day 4 postoperatively, the levels of CRP and IL-6 were significantly lower in SMOF group than in the control group (t=2.669 and 2.676, respectively; P<0.05), and on day 9, the patients in SMOF group showed significantly lower levels of ALT, TBIL, CRP and IL-6 (t=2.487, 3.497, 3.762, 2.180, respectively; P<0.05) than the control group, but ALB and endotoxin levels remained comparable between the two groups. The average length of stay in ICU and the days of using antibiotics were significantly shorter in SMOF group than in the control group (t=2.94 and 2.17, respectively; P<0.05); SMOF group showed a lower incidence of postoperative infections than the control group, but the difference was not statistically significant (χ² =1.047, P>0.05).

CONCLUSION:

  • For intensive care patients following major gastrointestinal surgeries, postoperative parenteral nutrition support with SMOF can effectively reduce the release of inflammatory mediators, protect important visceral functions, reduce postoperative complications, shorten the length of ICU stay, and improve the prognosis of the patients.

 

Neurosci Lett. 2008 Mar 21;434(1):66-70. doi: 10.1016/j.neulet.2008.01.032. Epub 2008 Jan 19.

Effects of short-term and long-term treatment with medium (MCT oil) and long-chain triglycerides ketogenic diet on cortical spreading depression in young rats

de Almeida Rabello Oliveira M1, da Rocha Ataíde T, de Oliveira SL, de Melo Lucena AL, de Lira CE, Soares AA, de Almeida CB, Ximenes-da-Silva A.

Author information

  • 1Laboratório de Eletrofisiologia e Metabolismo Cerebral, Instituto de Ciências Biológicas e da Saúde, Universidade Federal de Alagoas, 57.010-020, Maceió, AL, Brazil.

Abstract

The ketogenic diet (KD) is a high fat and low carbohydrate and protein diet. It is used in the clinical treatment of epilepsy, in order to decrease cerebral excitability.

KD is usually composed by long-chain triglycerides (LCT) while medium-chain triglycerides (MCT) diet is beginning to be used in some clinical treatment of disorders of pyruvate carboxylase enzyme and long-chain fatty acid oxidation. Our study aimed to analyze the effects of medium- and long-chain KD on cerebral electrical activity, analyzing the propagation of the phenomenon of cortical spreading depression (CSD). Three groups of weaned rats (21 days old) received, for 7 weeks, either a control (AIN-93G diet), or a MCT-KD (rich in triheptanoin oil), or a LCT-KD (rich in soybean oil). They were compared to another three groups (21 days old) receiving the same diets for just 10 days. CSD propagation was evaluated just after ending the dietary treatments.

Results showed that short-term KD treatment resulted in a significant reduction of the CSD velocity of propagation (control group: 4.02+/-1.04mm/min; MCT-KD: 0.81+/-1.46mm/min and LCT-KD: 2.26+/-0.41mm/min) compared to the control group. However, long-term treatment with both KDs had no effect on the CSD velocity (control group: 3.10+/-0.41mm/min, MCT-KD: 2.91+/-1.62mm/min, LCT-KD: 3.02+/-2.26mm/min) suggesting that both short-term KDs have a positive effect in decreasing brain cerebral excitability in young animals. These data show for the first time that triheptanoin has an effect on central nervous system.

 

J Am Coll Nutr. 1995 Apr;14(2):202-8.

Effects of a ketogenic diet on tumor metabolism and nutritional status in pediatric oncology patients: two case reports

Nebeling LC1, Miraldi F, Shurin SB, Lerner E.

Author information

  • 1Nutrition Department, Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA.

Abstract

OBJECTIVE:

Establish dietary-induced ketosis in pediatric oncology patients to determine if a ketogenic state would decrease glucose availability to certain tumors, thereby potentially impairing tumor metabolism without adversely affecting the patient's overall nutritional status.

DESIGN:

Case report.

SETTING:

University Hospitals of Cleveland.

SUBJECTS:

Two female pediatric patients with advanced stage malignant Astrocytoma tumors.

INTERVENTIONS:

Patients were followed as outpatients for 8 weeks. Ketosis was maintained by consuming a 60% medium chain triglyceride oil-based diet.

MAIN OUTCOME MEASURES:

Tumor glucose metabolism was assessed by Positron Emission Tomography (PET), comparing [Fluorine-18] 2-deoxy-2-fluoro-D-glucose (FDG) uptake at the tumor site before and following the trial period.

RESULTS:

Within 7 days of initiating the ketogenic diet, blood glucose levels declined to low-normal levels and blood ketones were elevated twenty to thirty fold.

  • Results of PET scans indicated a 21.8% average decrease in glucose uptake at the tumor site in both subjects. One patient exhibited significant clinical improvements in mood and new skill development during the study. She continued the ketogenic diet for an additional twelve months, remaining free of disease progression.

 

CONCLUSION:

While this diet does not replace conventional antineoplastic treatments, these preliminary results suggest a potential for clinical application which merits further research.

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