Medium- versus long-chain triglycerides for 27 days increases fat oxidation and energy expenditure without resulting in changes in body composition in overweight women Medium-chain triglycerides increase energy expenditure and decrease adiposity in overweight men. Greater rise in fat oxidation with medium-chain triglyceride consumption relative to long-chain triglyceride is associated with lower initial body weight and greater loss of subcutaneous adipose tissue Medium-chain fatty acids: evidence for incorporation into chylomicron triglycerides in humans. Randomized clinical trial of new intravenous lipid (SMOFlipid 20%) versus medium-chain triglycerides/long-chain triglycerides in adult patients undergoing gastrointestinal surgery. Effects of dietary medium-chain triglyceride on weight loss and insulin sensitivity in a group of moderately overweight free-living type 2 diabetic Chinese subjects. Twenty-four-hour energy expenditure and urinary catecholamines of humans consuming low-to-moderate amounts of medium-chain triglycerides: a dose-response study in a human respiratory chamber. A medium chain triglyceride-based diet in patients with HIV and chronic diarrhea reduces diarrhea and malabsorption: a prospective, controlled trial. Changes in blood lipids during six days of overfeeding with medium or long chain triglycerides. Components of total energy expenditure in healthy young women are not affected after 14 days of feeding with medium-versus long-chain triglycerides. Dietary medium-chain triacylglycerols suppress accumulation of body fat in a double-blind, controlled trial in healthy men and women. Effects of margarine containing medium-chain triacylglycerols on body fat reduction in humans. The effects of 2-week ingestion of (−)-hydroxycitrate and (−)-hydroxycitrate combined with medium-chain triglycerides on satiety, fat oxidation, energy expenditure and body weight Value of VLCD supplementation with medium chain triglycerides Long-chain triglycerides reduce the efficacy of enteral feeds in patients with active Crohn's disease. Lipid infusion with different triglyceride cores (long-chain vs medium-chain/long-chain triglycerides): effect on plasma lipids and bilirubin binding in premature infants. Enhanced postprandial energy expenditure with medium-chain fatty acid feeding is attenuated after 14 d in premenopausal women. Structured medium and long chain triglycerides show short-term increases in fat oxidation, but no changes in adiposity in men. Pain on injection of propofol: propofol LCT vs propofol MCT/LCT with or without lidocaine pretreatment. Prevention of propofol pain: a comparative study. A comparison of propofol-LCT with propofol-LCT/MCT on pain of injection. Decreased fat and nitrogen losses in patients with AIDS receiving medium-chain-triglyceride-enriched formula vs those receiving long-chain-triglyceride-containing formula. Parenteral nutrition in ventilated patients with chronic obstructive pulmonary disease: long chain vs medium chain triglycerides. Comparison of diet-induced thermogenesis of foods containing medium- versus long-chain triacylglycerols. [The injection pain of propofol with different emulsion]. Does addition of lidocaine to medium- and long-chain triglyceride propofol emulsions significantly reduce pain on injection? Fat digestion modulates gastrointestinal sensations induced by gastric distention and duodenal lipid in humans. Fatty acid chain length, postprandial satiety and food intake in lean men Comparative Study between Propofol in a Long-chain Triglyceride and Propofol in a Medium/Long-chain Triglyceride during Sedation with Target-controlled Infusion
OBJECTIVE : To determine the effects of long-term consumption of medium chain ( MCT ) versus long chain triglycerides ( LCT ) on energy expenditure ( EE ) , substrate oxidation and body composition . HYPOTHESIS : MCT consumption will not result in greater EE , substrate oxidation , and body weight loss compared with LCT consumption . RESEARCH METHODS AND PROCEDURES : Seventeen healthy obese women participated in this r and omized , crossover inpatient trial . Meals were prepared and consumed on site for two periods of 27 days . Diets containing 40 % of energy as fat , with treatment fat comprising 75 % of the total fat , were design ed to supply each subject with their individual weight-maintaining energy needs . The MCT diet contained 67 % of treatment fat as MCT oil ( 49 % octanoate , 50 % decanoate ) whereas the LCT diet contained exclusively beef tallow as treatment fat . Body composition was assessed by magnetic resonance imaging ( MRI ) on day 1 and 28 of each phase while energy expenditure was measured on day 2 and 27 . RESULTS : Changes in total and subcutaneous adipose tissue volumes following consumption of MCT and LCT were not different ( −0.61±0.38 l vs −0.54±0.48 l and −0.58±0.35 l vs −0.48±0.40 l , respectively ) . Average EE and fat oxidation were greater ( P<0.05 ) during MCT than LCT consumption ( 0.95±0.019 vs 0.90±0.024 kcal/min , respectively , for EE and 0.080±0.0026 vs 0.075±0.0022 g/min , respectively for fat oxidation ) . DISCUSSION : These results show that long-term consumption of MCT  enhances EE and fat oxidation in obese women , when compared to LCT consumption . The difference in body composition change  between MCT and LCT consumption , although not statistically different , was consistent with differences predicted by the shifts in EE . It can be concluded that substitution of MCT for LCT in a targeted energy balance diet may prevent long-term weight gain via increased EE OBJECTIVE The objectives of this study were to compare the effects of diets rich in medium-chain triglycerides ( MCTs ) or long-chain triglycerides ( LCTs ) on body composition , energy expenditure , substrate oxidation , subjective appetite , and ad libitum energy intake in overweight men . RESEARCH METHODS AND PROCEDURES Twenty-four healthy , overweight men with body mass indexes between 25 and 31 kg/m(2 ) consumed diets rich in MCT or LCT for 28 days each in a crossover r and omized controlled trial . At baseline and after 4 weeks of each dietary intervention , energy expenditure was measured using indirect calorimetry , and body composition was analyzed using magnetic resonance imaging . RESULTS Upper body adipose tissue ( AT ) decreased to a greater extent ( p < 0.05 ) with functional oil ( FctO ) compared with olive oil ( OL ) consumption ( -0.67 + /- 0.26 kg and -0.02 + /- 0.19 kg , respectively ) . There was a trend toward greater loss of whole-body subcutaneous AT volume ( p = 0.087 ) with FctO compared with OL consumption . Average energy expenditure was 0.04 + /- 0.02 kcal/min greater ( p < 0.05 ) on day 2 and 0.03 + /- 0.02 kcal/min ( not significant ) on day 28 with FctO compared with OL consumption . Similarly , average fat oxidation was greater ( p = 0.052 ) with FctO compared with OL intake on day 2 but not day 28 . DISCUSSION Consumption of a diet rich in MCTs results in greater loss of AT compared with LCTs , perhaps due to increased energy expenditure and fat oxidation observed with MCT intake . Thus , MCTs may be considered as agents that aid in the prevention of obesity or potentially stimulate weight loss OBJECTIVE : Medium-chain triglyceride ( MCT ) consumption has been shown to increase energy expenditure ( EE ) and lead to greater losses of the adipose tissue in animals and humans . The objective of this research was to examine the relationship between body composition and thermogenic responsiveness to MCT treatment . DESIGN : R and omized , crossover , controlled feeding trial , with diets rich in either MCT or long-chain triglyceride ( LCT ) ( as olive oil ) for periods of 4 weeks each . SUBJECTS : A total of 19 healthy overweight men aged ( x±s.e.m . ) 44.5±2.5 y with a body mass index of 27.8±0.5 kg/m2 . MEASUREMENTS : EE and body composition were measured using indirect calorimetry and magnetic resonance imaging , respectively , at the baseline and end point of each feeding period . EE was measured for 30 min before consumption of a st and ard meal and for 5.5 h following the meal . RESULTS : Body weight ( BW ) decreased ( P<0.05 ) by 1.03±0.25 kg with MCT consumption compared to 0.62±0.29 kg with LCT consumption . The difference in average EE  between MCT and LCT consumptions was related to initial BW , such that men with lower initial BW had a greater rise in EE  with MCT consumption relative to LCT on day 28 ( r=−0.472 , P=0.04 ) but not day 2 ( r=−0.368 , P=0.12 ) . Similar results were obtained with fat oxidation on day 28 ( r=−0.553 , P=0.01 ) . The greater rise in fat oxidation  with MCT compared to LCT consumption on day 2 tended to be related to greater loss of BW  after MCT vs LCT consumption ( r=−0.4075 , P=0.08 ) . CONCLUSION : These data suggest that shunting of dietary fat towards oxidation results in diminished fat storage , as reflected by the loss of BW and subcutaneous adipose tissue . Furthermore , MCT consumption may stimulate EE and fat oxidation to a lower extent in men of greater BW compared to men of lower BW , indicative of the lower responsiveness to a rapidly oxidized fat by overweight men The purpose of this study was to evaluate the fatty acid composition of chylomicron triglycerides isolated from subjects fed liquid-formula diets containing 40 % of total energy as medium- ( C8:0 and C10:0 ) or long-chain ( C16-C18 ) triglycerides ( MCT , LCT )  for 6 d. Medium-chain fatty acids ( MCFA ) comprised 8 % of total chylomicron triglyceride fatty acids after the first MCT meal . After 6 d of continued MCT feeding , chylomicron triglyceride MCFA content increased to 13 % . When subjects were fed the LCT ( soybean oil ) diet , C16:0 , C18:1 , and C18:2 comprised nearly 90 % of the chylomicron triglyceride fatty acids . The mass of triglyceride transported in chylomicrons isolated from subjects fed the MCT diet was approximately 20 % of that found when subjects consumed the LCT diet . We conclude that although total triglyceride production during MCT ingestion is low , the chylomicron triglycerides that are synthesized contain significant amounts of MCFA BACKGROUND SMOFlipid 20 % is intravenous lipid emulsion ( ILE ) containing long-chain triglycerides ( LCT ) , medium-chain triglycerides ( MCT ) , olive oil , and fish oil as a mixed emulsion containing α-tocopherol . The aim was to assess the efficacy of this new ILE in gastrointestinal surgery compared with MCT/LCT . METHODS In this prospect i ve study , 40 patients were r and omized to SMOFlipid 20 % or MCT/LCT ( Lipovenoes 20 % ) group . Clinical and biochemistry data were collected . Inflammatory markers ( CRP , IL-6 , IL-10 , TNF-α , TGF-β1 ) and oxidative stress ( ROS and superoxide ) were measured . RESULTS Thirty-five patients ( 17 males and 18 females ) with a mean age of 57 years completed the study . The patients ' demographic characteristics ( age , gender , height , body weight , and BMI ) were similar without significant differences between groups . The increment of triglyceride on day 6 from baseline was significantly lower in SMOFlipid group than in Lipovenoes MCT/LCT group . Inflammatory markers , as well as superoxide radical and total oxygen radical were not different between groups . CONCLUSIONS Despite the comparable effect on inflammatory response , because of its well-balanced fatty acid pattern , relatively low n-6:n-3 ratio , and high vitamin E content , SMOFlipid had a better triglyceride-lowering effect as compared with MCT/LCT in adult patients undergoing gastrointestinal surgery Prior studies of medium-chain triglyceride ( MCT ) suggest that MCT might be a useful tool for body fat mass management in obese nondiabetic humans . We now report a pilot study that tests if MCT is beneficial for moderately overweight subjects with type 2 diabetes mellitus . The study was conducted in a group of 40 free-living subjects in an urban area of China . The subjects were r and omized into 2 test groups , with one given MCT and the other corn oil as control for long-chain triglycerides ( LCTs ) . The test oil ( 18 g/d ) was administered as part of daily food intake for 90 days . All subjects completed the study with self-reported full compliance . Body weight , waist circumference ( WC ) , and serum sample s were analyzed on days 0 , 45 , and 90 . 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 ) . No significant across-time difference for the above parameters was detected for the LCT group . These changes were associated with an involuntary reduction in energy intake in the MCT group ( P < .05 , repeated measures ) . A between-group comparison also shows reduced body weight , WC , and homeostasis model assessment of insulin resistance in the MCT group compared with the LCT group at the end of the study . Collectively , our results suggest a link between moderate consumption of MCT and improved risk factors in moderately overweight humans in a low-cost , free-living setting OBJECTIVE To determine whether medium-chain triglycerides , in low-to-moderate amounts consumed with meals ( at breakfast , lunch and dinner ) , can increase daily energy expenditure ( EE ) and 24-h urinary excretion of catecholamines in  humans  . DESIGN Dose-response study conducted under double-blind r and omised design . SETTING Respiratory chamber at the Faculty of Medicine , University of Geneva . SUBJECTS Eight healthy young men were recruited from the student population by advertisement in our Faculty . METHODS 24-h EE and urinary catecholamines were measured in each subject during stay in a respiratory chamber on four separate occasions . These were r and omised between four different combinations of medium-chain triglycerides ( MCT ) and long-chain triglycerides ( LCT ) , a total 30g/day , which was consumed with their habitual diet in three equal parts ( 10 g each ) at breakfast , lunch , and dinner in the following ratio of MCT : LCT ( g/g ) 0:30 , 5:25 , 15:15 and 30:0 . RESULTS 24-h EE increased significantly with increasing MCT : LCT ratio ( ANOVA , P < 0.001 ) , with the diet providing a total of 15 - 30 g MCT per day stimulating 24-h EE by 5 % : this corresponds to a mean absolute increase in daily EE of approximately 500kJ , with individual values varying between 268 kJ and 756 kJ. No significant differences were observed in respiratory quotient nor in urinary nitrogen losses across diets , but 24-h urinary noradrenaline was significantly increased ( ANOVA , P < 0.025 ) , whereas adrenaline and dopamine were unaltered . CONCLUSIONS This study suggests that relatively low-to-moderate intake of MCT ( 15 - 30 g per day ) as part of habitual diet may play a role in the control of human body composition by enhancing daily EE , and that this effect is mediated at least in part through activation of the sympathetic nervous system Our objective was to determine whether a medium-chained triglyceride (MCT)-based diet , compared to a long-chain triglyceride (LCT)-based diet , conveys a beneficial effect on diarrhea and fat malabsorption in human immunodeficiency virus (HIV)-infected individuals with chronic diarrhea and weight loss . A secondary objective was to evaluate the pathogens associated with the diarrhea and to evaluate whether the etiologic agent was a determinant of response to the nutritional intervention . Prospect i ve , r and omized double-blind comparative trial was conducted in 24 adult patients with HIV , diarrhea of greater than 4-wk duration , fat malabsorption , and loss of 10 - 20 % of ideal body weight , these patients were recruited from our outpatient infectious disease clinic . Evaluations of diarrheal pathogens were made by complete stool examination , upper and lower endoscopy with quantitative culture , and biopsy . Body composition determinations , and measurements of fat , carbohydrate , and vitamin absorption pre- and postintervention . Patients were r and omly assigned to one of two complete nutritional products with either medium- or long-chain triglyceride fat exclusively for 12 d followed by treatment of infectious pathogens . Ten patients were found to have Microsporidium and 9 patients had no identifiable pathogen . All patients responded to intervention with both nutritional products overall with 45 % fewer stools , decreased stool fat and weight , and a significant increase in urine nitrogen . The group that received the MCT product demonstrated significantly decreased stool number ( mean 4 to 2.5 ) , stool fat ( mean 14 to 5.4 g ) , and stool weight ( mean 428 to 262 g ) compared with baseline ( P < 0.01 for all ) . Patients with both species of microsporidia and with pathogen negative diarrhea had good response . We found that HIV patients with diarrhea , regardless of etiology , and documented fat malabsorption may benefit symptomatically from a diet composed of an MCT-based liquid supplement Although medium chain triglyceride ( MCT ) is less calorically dense than long chain triglyceride ( LCT ) , it produces a greater thermic effect following ingestion . We hypothesized that the previously observed high rate of thermogenesis produced by MCT overfeeding was due to hepatic de novo synthesis of long chain fatty acids ( LCFA ) from the excess medium chain fatty acids ( MCFA ) . To study this , we compared the effects of overfeeding MCT- and LCT-containing diets on blood lipid profiles .  Ten in-patient , nonobese males were overfed ( 150 % of estimated energy requirements ) two formula diets for 6 days each , in a r and omized crossover design . Diets differed only in the composition of the fat and contained either 40 % of energy as MCT or LCT ( soybean oil ) . The major differences between diets in the result ing pattern of blood lipids were : 1 ) a reduction in fasting serum total cholesterol concentrations with the LCT , but not the MCT diet ; and 2 ) a threefold increase in fasting serum triglyceride concentrations with MCT , but not LCT , diet . Moreover , 10 % of the fasting triglyceride fatty acids were medium chain and 40 % were 16:0 with the MCT diet . This compared to 1 % and 20 % for medium chain and 16:0 , respectively , with the LCT diet . In addition , there were increases in 16:1 , 18:0 , and 18:1 in the triglycerides during MCT feeding . The changes in fatty acids in triglycerides with MCT feeding are consistent with the hypothesis that excess dietary MCT cause a significant increase in the hepatic synthesis of these fatty acids from MCFA through de novo synthesis and /or chain elongation and desaturation . These processes could account for the higher rate of postpr and ial thermogenesis with MCT as compared to LCT OBJECTIVE To examine the effect of consumption of medium-chain triglycerides ( MCT ) vs. long-chain triglycerides ( LCT ) on total energy expenditure ( TEE ) and its components in young women during the second week of a 2-week feeding period . RESEARCH METHODS AND PROCEDURES Twelve healthy lean women ( age : 22.7+/-0.7 years , body mass index [ BMI ] : 21.5+/-0.8 kg/m2 ) were fed weight maintenance diets containing 15 % of energy as protein , 45 % as carbohydrate , and 40 % as fat , 80 % of which was treatment fat , for 2 weeks in a r and omized cross-over design separated by a 2-week washout period . Dietary fat was composed of triglycerides containing either 26 % medium-chain fatty acids ( MCFA ) and 74 % long-chain fatty acids ( LCFA ) , or 2 % MCFA and 98 % LCFA . Free-living TEE was measured from day 7 to 14 on each dietary treatment using doubly labeled water ( DLW ) . Basal metabolic rate ( BMR ) and thermic effect of food ( TEF ) were measured on days 7 and 14 using respiratory gas exchange analysis ( RGE ) for 30 minutes and 330 minutes , respectively . Activity-induced energy expenditure ( AIEE ) was derived as the difference between TEE and the sum of BMR and TEF . RESULTS The average TEE while consuming the MCT diet ( 2246+/-98 kcal/day ) did not differ from that of the LCT diet ( 2186+/-138 kcal/day . BMR was significantly higher on the MCT diet on day 7 ( 1219+/-38 kcal/day vs. 1179+/-42 kcal/day ) , but not on day 14 ; there was no effect of diet on TEF . There were no differences in BMR , TEF , or AIEE between diets when expressed as percentages of TEE . On average , BMR , TEF , and AIEE represented 54.6 % , 8.2 % , and 37.2 % , respectively , of TEE . DISCUSSION Results suggest that between day 7 and day 14 feeding of MCT vs. LCT at these levels , TEE is not affected and that increases seen in energy expenditure following MCT feeding may be of short duration . Thus , compensatory mechanisms may exist which blunt the effect of MCT on energy components over the longer term We investigated the effect of long-term ingestion of dietary medium-chain triacylglycerols ( MCT ) on body weight and fat in humans . Using a double-blind , controlled protocol , we assessed the potential health benefits of MCT compared with long-chain triacylglycerols ( LCT ) in 78 healthy men and women [ body mass index ( BMI ) > or = 23 kg/m(2 ) : n = 26 ( MCT ) , n = 30 ( LCT ) ; BMI < 23 kg/m(2 ) : n = 15 ( MCT ) , n = 7 ( LCT ) ] . Changes in anthropometric variables , body weight and body fat during the 12-wk MCT treatment period were compared with those in subjects consuming the LCT diet . The subjects were asked to consume 9218 kJ/d and 60 g/d of total fat . The energy , fat , protein and carbohydrate intakes did not differ significantly between the groups . Body weight and body fat in both groups had decreased by wk 4 , 8 and 12 of the study . However , in the subjects with BMI > or = 23 kg/m(2 ) , the extent of the decrease in body weight was significantly greater in the MCT group than in the LCT group . In subjects with BMI > or = 23 kg/m(2 ) , the loss of body fat in the MCT group ( -3.86 + /- 0.3 kg ) was significantly greater than that in the LCT group ( -2.75 + /- 0.2 kg ) at 8 wk . In addition , in subjects with BMI > or = 23 kg/m(2 ) , the decrease in the area of subcutaneous fat in the MCT group was significantly greater than that in the LCT group at wk 4 , 8 and 12 . These results suggest that the MCT diet may reduce body weight and fat in individuals ( BMI > or = 23 kg/m(2 ) ) more than the LCT diet We found previously that the ingestion of margarine containing medium-chain triacylglycerols ( MCT ) result ed in a significant increase in postpr and ial thermogenesis when compared with long-chain triacylglycerols ( LCT ) . Diets that included margarine containing MCT and LCT were compared for 12 weeks in 73 subjects to investigate the effects  on body weight , body fat , areas of subcutaneous and visceral fat , serum total cholesterols , triglycerides , lipoproteins , plasma glucose , serum insulin , total ketone bodies , and the activities of aspartate aminotransferase , alanine aminotransferase , and gamma-glutamyltranspeptidase . We conducted a double-blind , controlled study and used blended rapeseed oil and soybean oil ( LCT ) as a comparison . Two groups ingested 2100 - 2400 kcal/day of energy , 65 - 73 g/day of total fat , and 14 g/day of test margarine ( 5 g/day of MCT or LCT ) . The subjects on the MCT diet demonstrated significant decreases in body fat weight ( - 3.8 + /- 2.4 kg vs - 2.4 + /- 1.7 kg ; MCT vs LCT , mean + /- SD ) , subcutaneous fat ( - 38.2 + /- 29.9 cm(2 ) vs - 22.6 + /- 19.3 cm(2 ) ) , and visceral fat ( - 12.2 + /- 11.2 cm(2 ) vs - 1.6 + /- 12.8 cm(2 ) ) after 12 weeks . There were no clinical differences in measured blood parameters . We suggest that the postpr and ial increase in thermogenesis and control of postpr and ial triglyceride levels may explain these results OBJECTIVE : Assessment of the effect of 2-week supplementation with (−)-hydroxycitrate ( HCA ) and HCA combined with medium-chain triglycerides ( MCT ) on satiety , fat oxidation , energy expenditure ( EE ) and body weight ( BW ) loss . DESIGN : Three intervention periods of 2 weeks separated by washout periods of 4 weeks . Double-blind , placebo-controlled , r and omised and cross-over design .SUBJECTS : Eleven overweight male subjects ( mean±s.d . ; age , 47±16 y ; body mass index , 27.4 ± 8.2 kg/m2).INTERVENTION : Subjects consumed three self-selected meals and four iso-energetic ( 420 kJ ) snacks daily with either no supplementation ( PLA ) , 500 mg HCA ( HCA ) or 500 mg HCA and 3 g MCT ( HCA+MCT ) . Each intervention ended with a 36 h stay in the respiration chamber . RESULTS : There was a significant BW loss during the 2 weeks of intervention ( PLA , −1.0 ± 0.4 kg , P<0.05 ; HCA , −1.5 ± 0.5 kg , P<0.01 ; HCA+MCT , −1.3 ± 0.2 kg , P<0.001 ) , but this reduction was not different between treatments . 24 h EE  ( PLA , 11.8 ± 0.2 MJ ; HCA , 11.7 ± 0.1 MJ ; HCA+MCT , 11.5 ± 0.1 MJ ) , 24 h RQ ( 0.85 ± 0.00 in all treatments ) and the area under the curve of the appetite-related parameters were not different between treatments . CONCLUSION : Two-week supplementation with HCA and HCA combined with MCT did not result in increased satiety , fat oxidation , 24 h EE or BW loss  compared to PLA , in subjects losing BW BACKGROUND : Medium chain triglycerides ( MCT ) are energetically less dense , highly ketogenic , and more easily oxidised than long chain triglycerides ( LCT ) . MCT also differ from LCT in their digestive and metabolic pathways . OBJECTIVE : To test the effects of MCT supplementation during a very low calorie diet (VLCD).SUBJECTS AND METHODS : Three groups of tightly matched obese women with body mass index ( BMI ) > 30 kg/m2 received an isoenergetic ( 578.5 kcal )  VLCD  ( Adinax ® , Novo Vital , Sweden ) enriched with MCT or LCT ( 8.0 and 9.9 g/100 g Adinax ® respectively ) or a low-fat ( 3 g/100 g ) and high-carbohydrate regimen . The diets were administered over 4 weeks . Body composition was measured with DEXA and appetite/satiety-according to Blundell . Beta hydroxybutyric acid concentration in plasma and nitrogen excretion in urine was measured during consecutive days of VLCD . The study was performed in a r and omised double-blind manner . RESULTS : The MCT group showed a significantly greater decrease in body weight during the first 2 weeks . The contribution of body fat to the total weight loss was higher while the contribution of fat-free mass ( FFM ) was lower . The MCT group had a higher concentration of ketone bodies in plasma and a lower nitrogen excretion in urine . Hunger feelings were less intense while satiety was higher . These differences were observed during the first 2 weeks of treatment and gradually declined during the third and fourth weeks . CONCLUSIONS : Replacement of LCT by MCT in the VLCD increased the rate of decrease of body fat and body weight and has a sparing effect on FFM . The intensity of hunger feelings was lower and paralleled the higher increase of ketone bodies . These effects gradually declined , indicating subsequent metabolic adaptation . Further studies are required to confirm the protein-sparing and appetite-suppressing effects of MCT supplementation during the first 2 weeks of VLCD treatment Elemental diets are effective treatments for active Crohn 's disease . To determine which dietary constituents are of therapeutic importance , the effectiveness of four separate feeds was related to their compositions , and the findings substantiated by meta- analysis of previous dietary studies . 76 patients with active Crohn 's disease were recruited . 17 were r and omised to an amino acid-based elemental diet ( E028 ) , 22 to E028 with added long-chain triglyceride ( E028 LCT ) , 18 to a semi-elemental , peptide based diet ( Pepdite 2 + ) and 19 received E028 with added medium-chain triglyceride ( E028 MCT ) .  Disease activity fell in all groups and remission rate was negatively correlated with the amount of energy derived from LCT ( r = -0.97 , p = 0.016 ) . Inflammatory indices fell in the groups ( E028 + E028 MCT ) containing least LCT . No other dietary constituents correlated with remission rate . A meta- analysis of published studies confirmed a negative correlation between remission rate and LCT ( r = -0.63 , p = 0.006 ) but not other constituents . The association between dietary LCT and remission rate may have pathogenic significance and allow the development of more effective enteral feeds The possible beneficial effects of infusing a lipid emulsion containing 50 % by weight of medium-chain triglycerides ( MCT ) compared with a st and ard long-chain triglyceride ( LCT ) emulsion were studied in 18 premature neonates ( gestational age less than 34 weeks ) requiring parenteral nutrition . The infants were assigned in a double-blind manner to receive one of the two lipid emulsions over 17 hours a day as a supplemental regimen for total parenteral nutrition . A lipid load of 1 g/kg per day was initiated on the third day of life and was increased at the rate of 1 g/kg per day until a maximal dose of 3 g/kg per day was obtained on the fifth day of life and maintained thereafter . Both bound and unbound bilirubin decreased with both infusion regimens during the study period . Despite a marked increase in plasma free fatty acid levels ( 260 % in the MCT/LCT group compared with 210 % in the LCT group ) , the fraction of unbound ( free ) bilirubin was significantly lower in the MCT/LCT group ( 34 % vs 13 % ) . Free fatty acid levels , corrected to albumin , were positively correlated to the percentage of free bilirubin only for the LCT lipid infusion . The finding of a significant elevation of plasma cholesterol levels only in the MCT/LCT group is now under investigation . Use of the MCT-containing emulsion was not associated with a higher frequency of adverse effects than the commonly used LCT-containing emulsion . ( ABSTRACT TRUNCATED AT 250 WORDS BACKGROUND Medium-chain triacylglycerols ( MCTs ) are reported to enhance human energy expenditure ( EE ) , although few studies have involved women and the duration of such effects is only known for periods of approximately 7 d. OBJECTIVE This study was conducted to determine whether women consuming mixed , MCT-enriched or long-chain triacylglycerol (LCT)-enriched diets showed changes in EE or substrate oxidation after 7 and 14 d. DESIGN Twelve nonobese , premenopausal women were fed isoenergetic mixed diets enriched in either MCTs or LCTs during separate , 14-d feeding periods . Each meal contained 40 % of energy as fat ( 80 % of which was the treatment fat ) , 45 % as carbohydrate , and 15 % as protein . On days 7 and 14 of each trial , basal metabolic rate ( BMR , kJ/min ) , total energy expenditure ( TEE , kJ/min ) , and thermic effect of feeding ( deltakJ/min ) after a st and ardized breakfast were measured by respiratory gas exchange . RESULTS On day 7 , the mean ( + /-SEM ) BMR ( 3.58+/-0.11 kJ/min ) with the MCT diet was greater ( P = 0.0003 ) than that with the LCT diet ( 3.43+/-0.11 kJ/min ) . The mean postpr and ial TEE on day 7 was significantly greater ( P = 0.04 ) with the MCT diet ( 4.36+/-0.04 kJ/min ) than with the LCT diet ( 4.23+/-0.04 kJ/min ) ; by day 14 , postpr and ial TEE was still greater with the MCT diet , but not significantly so . No significant differences in the thermic effect of feeding were evident between diets . CONCLUSIONS Results from this longest controlled MCT feeding study to date suggest that short-term feeding of MCT-enriched diets increases TEE , but this effect could be transient with continued feeding BACKGROUND Medium chain triglycerides ( MCT ) have been suggested as modulators of human energy expenditure ( EE ) and thus may influence total and regional body fat distribution . OBJECTIVE To investigate in overweight men the effects of structured medium and long chain triglycerides on EE , substrate oxidation and body adiposity , compared to extra virgin olive oil ( OO ) . METHODS In a 6 week single-blind crossover study , 23 overweight men were r and omly assigned to consume a st and ard high-fat diet of which 75 % total fat was provided as either structured medium and long chain triglycerides referred to as structured oil ( StO ) , or OO .  EE and body composition were measured using indirect calorimetry and magnetic resonance imaging , respectively , at weeks 1 and 6 of each phase . RESULTS Body weight decreased ( p<0.01 ) from baseline to end-point during consumption of both the StO ( -1.46+/-0.4k g ) and OO ( -1.17+/-0.4 kg ) ; however , no significant treatment differences were observed . There were no changes in body composition among treatment groups . No differences between diets for EE measurements were reported . Fat oxidation rates did not differ between oils , but were reduced ( p<0.05 ) in the StO group between baseline ( 0.0020+/-0.0003 g/kg fat free mass per min ) in comparison to after week 6 ( 0.0013+/-0.0001 g/kg fat free mass per min ) . No differences in carbohydrate oxidation rate were noted across diets or time . CONCLUSION The present structured medium and long chain triglyceride oil increases short-term fat oxidation but fails to modulate body weight or adiposity through a change in EE BACKGROUND Pain on injection was a disadvantage of propofol long-chain triglyceride ( LCT ) and reduces patient satisfaction . Based on a systematic review , the recommended method to attenuate this pain was a previous administration of lidocaine under tourniquet for 30 - 120 seconds before injection of propofol ( pretreatment of lidocaine ) . Recently , propofol medium-chain triglyceride/long-chain triglyceride ( MCT/LCT ) emulsion was proposed for its ability to decrease pain on injection . The authors conducted a double-blind r and omized controlled trial to compare the incidence and severity of pain on injection between the new propofol MCT/LCT and the propofol LCT with and without lidocaine pretreatment . MATERIAL AND METHOD 360 adult patients with ASA physical status I-III who underwent general anesthesia were assigned into 4 groups by computer-generated r and omization ; Group I - pretreatment of lidocaine 1 % and propofol LCT Group I - pretreatment oflidocaine 1 % and propofol MCT/LCT Group III - pretreatment of saline and propofol MCT/LCT and Group IV- pretreatment of saline and propofol LCT mixed with lidocaine 1 % . All groups received pretreatment under tourniquet for 60 seconds . Evaluators who were blinded to the injected drugs recorded pain intensity ( none , mild , moderate and severe ) after the first 30 % of total induction dose ofpropofol was injected at a rate of 1 ml/s by question ing patients . Data was analyzed by using Kruskal-Wallis testfor ordinal data . Post hoc analysis was performed by using the Mann-Whitney U-test with Bonferroni 's correction on pairwise comparisons and was considered significant with p value of less than 0.05 . RESULTS Patients in an individual group had insignificant differences in their demographic data . The incidences of pain in Group I , II , III and IV were 61.1 % , 46.7 % , 62.2 % and 55.6 % respectively with an average incidence of 56 % ( p = 0.006 ) . There were 15.6 % , 5.6 % , 23.3 % and 24.4 % of patients in Group I , II , III and IV who rated pain intensity as severe . Pain on injection of propofol MCT/LCT with lidocaine pretreatment was less than propofol MCT/LCT alone ( p = 0.001 ) . CONCLUSION The incidence of pain on injection of propofol MCT/LCT was not different from that caused by propofol LCT with pretreatment of lidocaine and the intensity of pain on propofol MCT/LCT injection decreased significantly when using lidocaine pretreatment . Therefore , the authors could conclude that an injection of new propofol MCT/LCT solution was an alternative in reducing pain sensation to propofol LCT with pretreatment of lidocaine . Additionally , pain of propofol MCT/LCT injection could be alleviated by pretreatment of lidocaine with a 60 seconds tourniquet time before the injection ofpropofol A common drawback of propofol is pain on injection and lignocaine is commonly mixed with propofol to reduce the incidence and severity of this pain . In this study we sought to draw a comparison between the effectiveness of propofol medium chain and long chain triglyceride ( MCT/LCT ) alone , propofol medium chain and long chain triglyceride ( MCT/LCT ) premixed with lignocaine , and propofol long chain triglyceride ( LCT ) premixed with lignocaine , in preventing propofol pain on injection . 300 patients were r and omly divided into three equal groups . Group A received propofol-MCT/LCT premixed with normal saline , Group B received propofol-MCT/LCT premixed with 20 mg lignocaine and Group C received propofol-LCT premixed with 20 mg lignocaine . The incidence of pain in Group A was 63 % compared to 15 % in Group B ( X2 = 48.242 , p < 0.001 ) , whereas in Group C the incidence of pain was 24 % compared to 63 % in Group A ( X2 = 30.247 , p < 0.001 ) . There was no significant difference in incidence of pain between Groups B and C ( X2 = 2.5 , p = 0.11 ) . To conclude , propofol MCT/LCT alone provides no advantage to reduce pain on injection in comparison to propofol MCT/LCT premixed with lignocaine and propofol LCT premixed with lignocaine . Also , there is no significant difference in pain on injection between propofol LCT and propofol MCT/LCT as soon as lignocaine is added BACKGROUND Propofol-Lipuro 1 % is consisting of long-chain triglycerides ( LCT ) and medium-chain triglycerides ( MCT ) that have been reported to reduce injection pain . OBJECTIVE To compare the incidence and intensity of injection pain with 1 % Propofol-LCT with 1 % Propofol-LCT/MCT in female population s for minor surgery under total intravenous anesthesia ( TIVA ) . MATERIAL AND METHOD One hundred and ten female patients were double-blind r and omized into two groups . Group long-chain triglycerdes ( L ) received 1 % propofol-LCT while group long-chain triglycerides/medium-chain triglycerides ( L/M ) received 1 % propofol-LCT/MCT . All patients received no benzodiazepine premedication and fentanyl 1 microg/kg was given 3 minutes before propofol injection . The propofol 1 mg/kg was manually injected at 0.5 mL/sec . The verbal rating score ( VRS 0 - 10 ) was recorded on pain of injection . VRS > 4 indicates a significant response to pain . RESULTS There was a significantly greater incidence and intensity of injection pain in group L compared with group L/M ( p < 0.001 and p = 0.013 respectively ) . CONCLUSIONS Propofol-LCT/MCT is superior to propofol-LCT on reducing pain of injection OBJECTIVE The purpose of this study was to compare two enteral formulas , differing only in fat source , for product acceptance , tolerance , and effect on fat malabsorption and nutritional status in subjects with acquired immune deficiency syndrome ( AIDS ) . DESIGN The double-blind , r and omized 15-day trial was divided into a 3-day period in which solid food was consumed followed by a 12-day experimental period in which liquid formulas were consumed . SETTING /SUBJECTS Twenty-three men and one woman with AIDS and fat malabsorption completed the study . The study was conducted in the General Clinical Research Center , University of Alabama Hospital , University of Alabama at Birmingham . Laboratory assays were performed in the Department of Nutrition Sciences . INTERVENTIONS After 3 days of consuming a controlled , solid food diet containing 100 g fat per day from mixed sources to document fat malabsorption , subjects were r and omly assigned to one of two groups . Each group received a liquid formula containing 35 % of energy as fat for 12 days . One group received a formula containing 85 % medium-chain triglycerides ( MCTs ) and the control group received a formula containing 100 % long-chain triglycerides . MAIN OUTCOME MEASURES Determinations included stool number , consistency , weight , and fat and nitrogen content ; urine nitrogen and creatinine levels ; and body weight . STATISTICAL ANALYSIS PERFORMED Subject demographic and other baseline characteristics were compared using two- sample t tests ; stool and urine assessment s were compared between groups at the initial experimental period using two- sample t tests ; changes from initial to final experimental periods were assessed by means of analysis of covariance ; changes in pooled intake , body weight , and the number and consistency of bowel movements were also assessed using analysis of covariance . All statistical tests were two-tailed and considered significant at P < .05 . RESULTS Within-group comparisons indicated that subjects fed the MCT formula showed significantly decreased stool fat and stool nitrogen content ( P = .01 and P = .03 , respectively ) and increased fat absorption ( P = .03 ) , whereas those fed the control formula did not . Differences in stool fat between the groups were not statistically significant . However , the difference in fat absorption from the initial to final formula period was significant ( P = .04 ) . Subjects consuming the MCT formula also tended to have a decreased number of bowel movements and abdominal symptoms , whereas subjects fed the control formula showed no improvement . All subjects maintained their body weights . APPLICATIONS There may be advantages to using an MCT-based formula in the treatment of AIDS-associated malabsorption AIM The aim of this study was to assess the usefulness of a lipid formulation containing a physical mixture of medium ( MCT ) and long chain triglycerides ( LCT ) compared with a long chain triglycerides emulsion in patients affected by chronic obstructive pulmonary disease with acute respiratory failure . METHODS Twenty-four patients requiring mechanical ventilation were r and omly selected in 2 groups and received total parenteral nutrition . Twelve patients received a MCT/LCT emulsion ( 50:50 ) , the others used a 100 % LCT emulsion .  Nutritional status , metabolic rate , time of ventilatory support and weaning were evaluated . RESULTS Both groups showed an improvement of all nutritional parameters evaluated ; oxygen uptake , carbon dioxide output and respiratory gas exchange ratio were similar in both groups . The duration of mechanical ventilation was not significantly different ; however , the time of weaning in the MCT/LCT group was significantly shorter . The longer weaning time in the LCT group patients could be related to vasoactive intermediates deriving from long chain fatty acids . The T-cell subsets , which were evaluated for both groups , showed a significant decrease of T helper-T suppressor ratio in the LCT group . CONCLUSION MCT/LCT emulsion is an effective lipid supplementation and should be considered the therapy of choice in COPD patients ; however , the relationship between lipid emulsions administered and length of weaning requires further investigations The purpose of this study was to investigate the effect of 5 - 10 g of medium-chain triacylglycerols ( MCT ) on diet-induced thermogenesis  in healthy humans . The study compared diet-induced thermogenesis after ingestion of test foods containing MCT and long-chain triacylglycerols ( LCT ) , using a double-blind , crossover design . Eight male and eight female subjects participated in study 1 and study 2 , respectively . In both studies , the LCT was a blend of rapeseed oil and soybean oil . In study 1 , the liquid meals contained 10 g MCT ( 10 M ) , a mixture of 5 g MCT and 5 g LCT ( 5M5L ) , and 10 g LCT ( 10L ) . In study 2 , the subjects were given a meal ( s and wich and clear soup ) with the mayonnaise or margarine containing 5 g of MCT or LCT .  Postpr and ial energy expenditure was measured by indirect calorimetry before and during the 6 h after ingestion of the test meals . Diet-induced thermogenesis was significantly greater after 5M5L and 10 M Ingestion as compared to 10L ingestion . Ingestion of the mayonnaise or margarine containing 5 g MCT caused significantly larger diet-induced thermogenesis as compared to that of LCT . These results suggest that , in healthy humans , the intake of 5 - 10 g of MCT causes larger diet-induced thermogenesis than that of LCT , irrespective of the form of meal containing the MCT BACKGROUND Incidence and intensity of pain on intravenous injection of propofol were assessed with emulsion of long-chain/medium-chain triglycerides ( LCT/MCT , 50 : 50 ) and only long-chain triglycerides ( LCT , 100 ) in patients undergoing different elective surgical interventions in this prospect i ve , r and omized , cross over and double-blinded study . METHODS 1 ) Forty six patients were assigned to two groups .  One group received 0.2 mg x kg(-1 ) LCT/ MCT propofol prior to LCT propofol administration . The other group received 0.2 mg x kg(-1 ) LCT propofol prior to LCT/MCT propofol administration .  Pain elicited upon question ing was assessed with each injection in the two groups . Patients were asked to grade the pain as VAS of 0 to 100 mm . 2 ) Fifty one patients were r and omly assigned to two groups . One group received 0.4 mg x kg(-1 ) LCT propofol . The other group received 0.4 mg x kg(-1 ) LCT/MCT propofol . Patients were asked to grade the pain as VAS of 0 to 100 mm . RESULTS Pain of LCT propofol injection was stronger than LCT/MCT propofol . As incidence of 0.4 mg x kg(-1 ) propofol injection , VAS on LCT/MCT propofol and LCT propofol gave score as 0 and 23.5 ( P=0.0019 ) . CONCLUSIONS Propofol with emulsion of long- and medium-chain triglycerides appears to reduce the injection pain than with emulsion of only long-chain triglycerides BACKGROUND Propofol formulated with medium- and long-chain triglycerides ( MCT/LCT ) causes less pain on injection than st and ard Propofol , but the incidence of pain persists between 28 and 67 percent . Such a broad range begs the question so the authors wanted to clarify whether the addition of lidocaine to medium- and long-chain triglyceride emulsion propofol results in any clinical ly significant lessening of pain on injection . The authors conducted a r and omized , prospect i ve , double-blinded study to compare the injection pain felt following the administration of propofol-MCT/LCT ( Propofol-Lipuro ) to propofol-MCT/LCT plus 20 mg lidocaine for the induction of anesthesia . MATERIAL AND METHOD The present study included 270 non-premedicated ASA I-II adult patients scheduledfor elective surgery under general anesthesia . Patients were allocated r and omly into two groups to receive either propofol-MCT/LCT alone or propofol-MCT/LCT plus 20 mg lidocaine . The study solution was injected at 1 mL/second by one anesthesiologist and patients grade d any associated pain using a four-point scale . RESULTS The overall incidence of pain on injection was 31/133 ( 23 % ) in the propofol-MCT/LCT plus lidocaine group vs. 45/135 ( 33 % ) in the propofol-MCT/LCT alone group . The difference in the incidence of pain on injection between groups failed to achieve statistical significance ( p = 0.23 ) and no significant difference in intensity of pain between the two study groups occurred CONCLUSIONS The authors concluded that the addition of lidocaine ( 20 mg ) to the propofol-MCT/LCT does not significantly reduce the incidence or severity of the pain on injection BACKGROUND AND AIMS It is unclear whether fat digestion is required for the induction of gastrointestinal sensations and whether different fats have different effects . We investigated the effect of fat digestion and of medium-chain triglycerides ( MCTs ; C < 12 ) and long-chain triglycerides ( LCTs ; C > 16 ) on gastrointestinal sensations . METHODS In a double-blind study , 15 healthy subjects were studied on 5 occasions during which LCT or MCT emulsions ( 2 kcal/min ) , with or without 120 mg tetrahydrolipstatin ( THL , lipase inhibitor ) , or sucrose polyester ( SPE , nondigestible fat ) were infused intraduodenally in r and omized order . After 30 minutes , the proximal stomach was distended in 1 mm Hg steps/min . Intensity of gastrointestinal sensations ( on a 0 - 10 visual analog scale ) , plasma cholecystokinin ( CCK ) levels , and gastric volumes were assessed throughout . RESULTS LCT and MCT increased gastric volume at baseline pressure compared with SPE , and LCT more than MCT . THL entirely abolished this effect ( volumes [ mL ] : LCT , 213 + /- 19 ; LCT-THL , 39 + /- 3 ; MCT , 155 + /- 12 ; MCT-THL , 43 + /- 5 ; SPE , 44 + /- 5 ) . Only LCT increased plasma CCK levels ( pmol/L per 30 minutes : LCT , 21 + /- 2 ; LCT-THL , 9 + /- 1 ; MCT , 9 + /- 1 ; MCT-THL , 11 + /- 1 ; SPE , 9 + /- 1 ) . During distentions , intragastric volumes were greater during infusion of LCT and MCT than during the respective THL conditions or SPE , but plasma CCK levels did not change . The intensity of sensations increased ( hunger decreased ) more with LCT than with MCT . During infusion of THL or SPE , the effects were smaller than during LCT or MCT . CONCLUSIONS Fat digestion is required for the modulation of gastrointestinal sensations during gastric distention . The effects of fat depend on the fatty acid chain length and are not entirely explained by release of CCK High-fat diets are associated with obesity , and the weak satiety response elicited in response to dietary lipids is likely to play a role . Preliminary evidence from studies of medium ( MCT ) and long chain triglycerides ( LCT ) supports greater appetite suppression on high-MCT diets , possibly a consequence of direct portal access , more rapid oxidation and muted lipaemia . No data is as yet available on high-SCT diets which also have direct hepatic access . In this study SCT- ( dairy fats ) , MCT- ( coconut oil ) and LCT-enriched ( beef tallow ) test breakfasts ( 3.3 MJ ) containing 52 g lipid ( 58 en% fat ) were investigated in a r and omized , cross-over study in 18 lean men . All participants were required to complete the 3 study days in r and omised order . Participants rated appetite sensations using visual analogue scales ( VAS ) , and energy intake ( EI ) was measured by covert weighing of an ad libitum lunch meal 3.5 h postpr and ially . Blood sample s were collected by venous cannulation . There were no detectable differences between breakfasts in perceived pleasantness , visual appearance , smell , taste , aftertaste and palatability ( P>0.05 ) . There was no significant effect of fatty acid chain length on ratings of hunger , fullness , satisfaction or current thoughts of food , nor did energy ( mean , sem : SCT : 4406 , 366 kJ ; MCT : 4422 , 306 kJ ; LCT : 4490 , 324 kJ ; P>0.05 ) or macronutrient intake at lunch differ between diets . The maximum difference in EI between diets was less than 2 % . Postpr and ial lipaemia also did not differ significantly . We conclude that there was no evidence that fatty acid chain length has an effect on measures of appetite and food intake when assessed following a single high-fat test meal in lean participants This study was performed to compare the pharmacological characteristics of propofol in an emulsion of both medium- and long-chain triglycerides ( MCT/LCT ) with those of propofol in an LCT emulsion , by measuring the sedative level and the plasma concentration of propofol during sedation using a target-controlled infusion ( TCI ) technique . Forty ASA 1 or 2 adult patients who required spinal anaesthesia for surgery were enrolled in this study . The patients were divided into two groups : a propofol LCT group ( n=20 ) and a propofol MCT/LCT group ( n=20 ) . Propofol was injected intravenously at target blood concentrations of 2.0 , 3.0 and 4.0 μg.ml–1 . The bispectral ( BIS ® ) index was recorded , and arterial blood was drawn to measure the actual plasma concentrations of propofol at each predicted concentration . Propofol was assayed by high-performance liquid chromatography . Propofol MCT/LCT was associated with significantly less pain than propofol LCT ( P<0.05 ) . There were no significant differences between the two groups in BIS ® index or in plasma concentration of propofol at each predicted concentration . Computer-generated TCI of propofol MCT/LCT during sedation is comparable with that of propofol LCT with respect to pharmacokinetics and pharmacodynamics . The formulation of MCT/LCT has a beneficial effect with respect to less pain on injection
No differences were seen in blood lipid levels .
Replacement of LCTs with MCTs in the diet could potentially induce modest reductions in body weight and composition without adversely affecting lipid profiles .
BACKGROUND Medium-chain triglycerides ( MCTs ) may result in negative energy balance and weight loss through increased energy expenditure and lipid oxidation .
However , results from human intervention studies investigating the weight reducing potential of MCTs , have been mixed .
OBJECTIVE To conduct a systematic review and meta- analysis of r and omized controlled trials comparing the effects of MCTs , specifically C8:0 and C10:0 , to long-chain triglycerides ( LCTs )  on weight loss and body composition in adults .