Medium Chain Triglycerides in Paediatric Practice

Gracey, Michael; Burke, Valerie; Anderson, Charlotte M.

doi:10.1136/adc.45.242.445

Cited by 27 publications

(5 citation statements)

References 51 publications

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“…Medium chain triglycerides (MCT) have been used by a number of workers in CF and were reported to be beneficial in decreasing fat losses (Kuo and Huang, 1965;Gracey et al, 1970). Although two of our patients showed increased steatorrhea when MCT were fed, it is worth noting that, in all but one child, the concomitant variation in BA and fat excretion was still present.…”

Section: Discussionmentioning

confidence: 61%

Relationship between bile acid malabsorption and pancreatic insufficiency in cystic fibrosis.

Weber¹,

Roy²,

Chartrand³

et al. 1976

Gut

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SUMMARY Bile acid loss (mg/M2 24h) in the stools of 43 cystic fibrosis (CF) children with pancreatic insufficiency was 751 1 + 48-3, while that of six without clinical evidence of pancreatic disease (133.4 15 9) did not differ from values in 25 controls (109.8 ± 9.8). There was a good correlation between the degree of bile acid (BA) and fat sequestration. Concomitant changes in bile acid and fat loss were observed in one group of six patients studied on and off pancreatic enzymes as well as in a second group of seven children treated with pancreatic supplements and maintained on a normal diet followed by a low fat diet supplemented with medium chain triglycerides. Administration of NA bicarbonate led to a significant decrease in fat loss (15-8 ± 2-7 -* 103 1 9) without any simultaneous change in bile acid excretion (533-1 ± 58-3 --500 4 ± 58 6). Qualitative bile acid patterns in controls, in infants after an ileal resection, and in patients with CF or with coeliac disease showed that the percentage of primary BA followed closely the total amount excreted except in situations where antibiotics were administered. The exact mechanism for the increased loss of BA in CF is unknown. It is found in all age groups and is related to the presence and degree of pancreatic insufficiency. The possibility that unhydrolysed triglycerides may interfere with the intestinal absorption of bile acid needs further confirmation.

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Section: Discussionmentioning

confidence: 61%

Relationship between bile acid malabsorption and pancreatic insufficiency in cystic fibrosis.

Weber¹,

Roy²,

Chartrand³

et al. 1976

Gut

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“…Unfortunately, MCTs are sometimes considered to be unpalatable and may cause abdominal distension, nausea and vomiting due to their high osmolarity, and all these factors together can result in poor dietary compliance. 31 …”

Section: Dietary Measuresmentioning

confidence: 99%

Chylous Ascites: A Review of Pathogenesis, Diagnosis and Treatment

Bhardwaj

Vaziri

Gautam

et al. 2018

Journal of Clinical and Translational Hepatology

171

266

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Chylous ascites (CA) is a rare form of ascites that results from the leakage of lipid-rich lymph into the peritoneal cavity. This usually occurs due to trauma and rupture of the lymphatics or increased peritoneal lymphatic pressure secondary to obstruction. The underlying etiologies for CA have been classified as traumatic, congenital, infectious, neoplastic, postoperative, cirrhotic or cardiogenic. Since malignancy and cirrhosis account for about two-thirds of all the cases of CA in Western countries, in this article we have attempted to reclassify CA based on portal and non-portal etiologies. The diagnosis of CA is based on the distinct characteristic of the ascitic fluid which includes a milky appearance and a triglyceride level of >200 mg/dL. The management consists of identifying and treating the underlying disease process, dietary modification, and diuretics. Some studies have also supported the use of agents such as orlistat, somatostatin, octreotide and etilefrine. Paracentesis and surgical interventions in the form of transjugular intrahepatic portosystemic shunt (commonly known as TIPS), peritoneal shunt, angiography with embolization of a leaking vessel, and laparotomy remain as treatment options for cases refractory to medical management.

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“…Medium-chain triglycerides, constituents of coconut and palm kernel oils, are medium-chain fatty acid esters of glycerol. Medium-chain triglycerides have a favorable safety profile and are used to treat a variety of disorders ( 10 – 12 ). They offer a readily available noncarbohydrate fuel source because they are rapidly absorbed and quickly metabolized into medium-chain fatty acids ( 10 ).…”

mentioning

confidence: 99%

Medium-Chain Fatty Acids Improve Cognitive Function in Intensively Treated Type 1 Diabetic Patients and Support In Vitro Synaptic Transmission During Acute Hypoglycemia

Page

Williamson²,

Yu³

et al. 2009

Diabetes

132

108

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OBJECTIVE-We examined whether ingestion of mediumchain triglycerides could improve cognition during hypoglycemia in subjects with intensively treated type 1 diabetes and assessed potential underlying mechanisms by testing the effect of ␤-hydroxybutyrate and octanoate on rat hippocampal synaptic transmission during exposure to low glucose.RESEARCH DESIGN AND METHODS-A total of 11 intensively treated type 1 diabetic subjects participated in stepped hyperinsulinemic-(2 mU ⅐ kg Ϫ1 ⅐ min Ϫ1 ) euglycemic-(glucose ϳ5.5 mmol/l) hypoglycemic (glucose ϳ2.8 mmol/l) clamp studies. During two separate sessions, they randomly received either medium-chain triglycerides or placebo drinks and performed a battery of cognitive tests. In vitro rat hippocampal slice preparations were used to assess the ability of ␤-hydroxybutyrate and octanoate to support neuronal activity when glucose levels are reduced.RESULTS-Hypoglycemia impaired cognitive performance in tests of verbal memory, digit symbol coding, digit span backwards, and map searching. Ingestion of medium-chain triglycerides reversed these effects. Medium-chain triglycerides also produced higher free fatty acids and ␤-hydroxybutyrate levels compared with placebo. However, the increase in catecholamines and symptoms during hypoglycemia was not altered. In hippocampal slices ␤-hydroxybutyrate supported synaptic transmission under low-glucose conditions, whereas octanoate could not. Nevertheless, octanoate improved the rate of recovery of synaptic function upon restoration of control glucose concentrations.CONCLUSIONS-Medium-chain triglyceride ingestion improves cognition without adversely affecting adrenergic or symptomatic responses to hypoglycemia in intensively treated type 1 diabetic subjects. Medium-chain triglycerides offer the therapeutic advantage of preserving brain function under hypoglycemic conditions without causing deleterious hyperglycemia. Diabetes

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Medium Chain Triglycerides in Paediatric Practice

Cited by 27 publications

References 51 publications

Relationship between bile acid malabsorption and pancreatic insufficiency in cystic fibrosis.

Relationship between bile acid malabsorption and pancreatic insufficiency in cystic fibrosis.

Chylous Ascites: A Review of Pathogenesis, Diagnosis and Treatment

Medium-Chain Fatty Acids Improve Cognitive Function in Intensively Treated Type 1 Diabetic Patients and Support In Vitro Synaptic Transmission During Acute Hypoglycemia

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