Medium-chain triglycerides oxidation

Jeukendrup, A.E, Saris, W.H., Van Diesen, R., Brouns, E, and Wagenmakers, A.J. Effect of endogenous carbohydrate availability on oral medium-chain triglyceride oxidation during prolonged exercise. J. Appl. Physiol. 80, 949-954, 1996. 

Biochemical stress can be minimized by using frequent feedings to minimize dependence on fatty acid oxidation, particularly for the liver. Meals should have a high-carbohydrate, low-fat content. Medium-chain triglycerides (synthetic or derived from coconut or palm kernel oils) can be used as these lipids can be oxidized independent of carnitine. These steps are particularly important when any external metabolic stress, such as a viral illness, is present. 

Fatty acid )5-oxidation defects often have an episodic character. In between the attacks of metabolic decompensation, plasma and urine parameters tend to virtually normal. On the other hand, several conditions have been recognized to yield metabolite profiles similar to those of fatty acid oxidation defects. Amongst these are feeding with medium-chain triglyceride containing feedstuffs, gastro-intestinal problems such as coeliac disease, and dysfunction of the respiratory chain. 

When the suspicion of a long-chain fatty acid oxidation defect is substantial, additional proof can be found by a medium-chain triglyceride (MCT) loading test. This should result in normal ketogenesis, except in patients with MCAD and HMGS deficiency. The value of the latter test is limited. 

More than 90% of the coconut oil fatty acids are saturated, which accounts for its excellent oxidative stability. It is the richest source of medium-chain triglycerides, which are composed of C-6, C-8 and C-10 fatty acids. Due to the high medium-chain triglycerides content, coconut oil is a major component of infant formulas and medical foods for people who cannot absorb longer chain fatty acids (Erickson 1990). 

Onge, M. P. St. Jones, P. J. H. (2003). 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. IJO., 27,1565-1571. 

---