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School of Dietetics and Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada, H9X 3V9
2To whom correspondence should be addressed. E-mail: jonesp{at}macdonald.mcgill.ca.
| ABSTRACT |
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KEY WORDS: medium-chain triglycerides satiety energy expenditure obesity
| INTRODUCTION |
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| Effect of MCT on Energy Expenditure. |
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Human studies have mainly compared the effects of MCT vs. LCT in single-meal or single-day experiments. Scalfi et al. (3
) evaluated the effects of a single mixed meal containing MCT on postprandial thermogenesis and examined possible differences in the thermic response between lean and obese men. Subjects consumed a meal containing 15% of energy from protein, 55% from carbohydrate and 30% from fat, in the form of corn oil (CO) and animal fat or MCT oil (56% octanoate, 40% decanoate) in random order. Energy expenditure measurements were conducted before and for 6 h after consumption of the meal. Total EE was 48 and 65% greater in lean and obese individuals, respectively, after MCT compared with LCT consumption. Similar results were obtained by Seaton et al. (4
) comparing the effects of MCT or CO on EE after a single meal. Energy expenditure peaked at 16% above baseline after MCT consumption compared with 5% for CO.
Dulloo et al. (5
) investigated the thermogenic effects of low-to-moderate amounts of MCT consumption in healthy adult men. Subjects were required to spend 24 h in a respiratory chamber on four separate occasions; during that time, diets differed in the ratio of MCT:LCT (0:30, 5:25, 15:15, 30:0) provided as added fat. The diet was given at a level 1.4 times energy requirements and the 30 g of added fat was distributed evenly across all meals. The authors found that EE between 0800 and 2300 h increased by 45, 135 and 265 kJ with 5, 15 and 30 g of MCT in the diet, respectively. Mean 24-h EE also increased by 162 and 475 kJ with 15 and 30 g of MCT in added fat, respectively. Thus, the greater effects of MCT than LCT on EE are evident not only in the few hours after the meal but for a much longer time.
Most results (3
5
) from single-day experiments indicated that replacing LCT for MCT in the diet could produce weight loss after prolonged consumption. However, when Flatt et al. (6
) compared diets rich in MCT, LCT and low in fat, they concluded that a low fat diet was more prudent when aiming for weight loss. However, MCT consumption resulted in greater EE at several time points compared with the low fat diet.
Few trials have been conducted over longer periods. One of those studies examined energy balance during the overfeeding of liquid formula diets containing MCT (61% octanoate, 32% decanoate) or LCT (32% oleate, 51% linoleate) for 7 d (7
). EE was measured on d 1 and 6 for 1015 min every 30 min for 6 h after meal consumption. The thermic effect of food (TEF) was identified as 8% of ingested energy after MCT consumption compared with 5.8% after LCT consumption on d 1. After 6 d, TEF was 12 and 6.6% of ingested energy with MCT and LCT consumption, respectively, indicating that the difference in EE between MCT and LCT persists even after a week of overfeeding.
The study of longest duration (14 d) published to date (8
) sought to determine whether fatty acid chain length influenced EE and substrate oxidation in women. Subjects consumed a controlled, weight maintenance diet containing 40% of energy as fat, either in the form of butter and coconut oil (MCT; 38.9% of fatty acids contained chains with <16 carbons) or beef tallow. Energy expenditure was measured before and for 5.5 h after breakfast. Postprandial total EE after MCT consumption was greater than after LCT consumption on d 7 but not d 14. The authors concluded that the effects of MCT consumption on EE may be transient.
All animal studies (9
11
) and most human studies (3
5
,7
,8
) have shown that MCT consumption increases EE compared with a meal containing LCT. Investigators who found the greatest differences also concluded that MCT could be used in the treatment or prevention of human obesity (3
5
). However, the studies conducted to date have been short, ranging from a single meal (3
6
) to several days (7
,8
). Whether effects of MCT on EE and RQ are long lasting and result in actual measurable and sustainable changes in body composition of humans remain to be established.
| Effect of MCT on Fat Deposition. |
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Only one study evaluated the ability of MCT to facilitate weight reduction in humans (17
). Obese women (n = 16) consumed MCT (58% octanoate, 22% decanoate) or LCT (soy oil) in random order for either 4 wk if they were inpatients or 12 wk if they were outpatients, at a level of 191 kJ/d. There were no differences in weight loss or rate of weight loss between diet treatments. A liquid diet containing 24% of energy as MCT failed to increase the rate of weight loss compared with LCT. This lack of agreement with animal trials and EE experiments may have been due to the low fat content of the diets (1.5 g of total fat/d, of which 1.2 g was treatment fat) or to gender differences in the effects of MCT. Differences detected in EE with MCT and LCT consumption are considerably greater in males than females. When data are extrapolated from trials conducted in men (3
5
,7
), average EE was
460 kJ/d greater with MCT than with LCT consumption, with a peak difference between treatments of 669 kJ/d (7
). In contrast, data from White et al. (8
), who studied women, found differences in EE of 138 kJ/d between MCT and LCT consumption. Our own work with overweight women also revealed a difference in EE of
188 kJ/d (18
). From these preliminary data, it appears that women respond less readily to treatment with MCT than men.
| Effect of MCT on Food Intake and Satiety. Animal studies. |
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Given these results, Maggio and Koopmans (20
), in 1982, conducted a study to clarify the origin and the nature of the signals that terminate short-term food intake of mixed meals containing triglycerides (TG) with fatty acids of different chain lengths. Sprague-Dawley rats were intubated intragastrically and given free access to a liquid diet containing 21% of energy as fat. The TG infusions consisted of 70% TG (tributyrin, tricaprylin or triolein in different concentrations) and 30% carbohydrate. Shifting chain length from medium to long did not differentially affect food intake when the infusions were equicaloric. Therefore, the authors concluded that satiety may be related to the amount of energy ingested rather than to the physical characteristics of the specific nutrients. This was in contrast to results obtained by Denbow et al. (21
) who infused intrahepatically or intubated intragastrically white leghorn cockerels with isoenergetic quantities of tributyrate, tridecanoate or trioleate and measured feed consumption. Feed consumption with SCT and MCT infusion was suppressed within 1 h after intrahepatic infusion until 180 min. However, when infusions were given intragastrically, only SCT decreased feed intake. The authors concluded that these results reflect the relatively rapid rate of digestion and absorption of short-chain fatty acids (SCFA) from the gut along with oxidation of SCFA by the liver.
Furuse et al. (22
) also investigated the effects of two different levels of MCT on feed intake in rats. They further examined the capacity of endogenous cholecystokinin (CCK) to modulate feed intake with MCT. Feed intake of male Wistar rats fed diets containing CO, MCT or a 1:1 mixture of CO and MCT was determined every hour for 12 h and then at 2-h intervals for the following 12 h. In a separate trial, Devazepide (DVZ), a CCK-A receptor antagonist, was injected intraperitoneally 40 min before feeding and feed intake was measured at 1, 2, 3 and 6 h postinjection. Feed intake decreased in a dose-dependent manner with increased concentration of MCT in the diet and was enhanced 2 h after DVZ injection. After 3 h, intake of the MCT diet was less than that of the CO diet. The authors thus concluded that satiety is affected by carbon chain length in dietary TG sources.
| Effect of MCT on Food Intake and Satiety. Human studies. |
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Another clinical trial (24
) was designed to establish the influence of chain length and degree of saturation on food intake in normal-weight men. Breakfasts differing in the nature of the fat, i.e., olive oil, lard, MCT or a fat substitute, were served and food intakes at lunch and dinner were measured. Energy intake at lunch was lower after the MCT-containing breakfast than after all other breakfasts (3100 vs. 3715 kJ with the fat substitute, 3278 kJ with olive oil and 3798 kJ with lard) but there were no differences in food consumption at dinner.
| Hormones Iinvolved in the Satiating Effect of MCT and LCT. |
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Several other studies have also reported that MCT do not stimulate CCK secretion in humans (26
28
), and trials have attempted to establish which hormone is responsible for the observed effects of MCT on food intake. Barbera et al. (26
) compared effects of MCT and LCT on sensations of satiety, gastric tone, gastric inhibitory peptide (GIP), pancreatic polypeptide and CCK. Subjects (n = 9) were infused with saline, LCFA (mainly oleate and linoleate) or MCFA (octanoate and decanoate) on three separate occasions in random order. LCFA infusion resulted in a greater rise in satiation than MCFA, but there was no difference between the two fats on the perception of fullness and bloating. The rise in gastric volume was also greater with LCFA infusion than MCFA infusion. Similarly, LCFA increased baseline levels of plasma CCK, GIP, neurotensin and pancreatic polypeptide compared with saline, whereas MCFA infusion did not. The authors thus concluded that MCFA induce gastric relaxation without increasing satiation or plasma levels of gut hormones. However, because Stubbs and Harbron (23
) and Van Wymelbeke (24
) have shown lower food intakes with diets rich in MCT, it is likely that other factors play a role in regulating energy balance with MCT consumption.
Maas et al. (27
) examined effects of MCFA and LCFA on peptide YY (PYY) release to determine whether PYY, which inhibits gastric acid secretion in humans, is involved in the enterogastrone effect of MCFA. These investigators had previously observed that infusions of MCFA suppressed gastrin-stimulated gastric acid secretion without the involvement of CCK (28
). Men (n = 14) were intraduodenally infused for 2.5 h with MCFA (56% octanoate, 43% decanoate), LCFA (CO) or saline in random order. The energy loads differed between MCFA and LCFA infusions, with the former providing a load of 11.6 kJ/min and the latter providing a load of 22.7 kJ/min. Both infusions increased plasma levels of PYY; however, LCFA resulted in a greater increase than MCFA infusion (10.3 vs. 2.8 pmol/L). LCFA inhibited gastrin-stimulated gastric acid secretion by 4.1 mmol/15 min compared with 2.7 mmol/15 min for MCFA. PYY is therefore involved in the enterogastrone effect of MCFA; however, MCFA are less potent at inducing PYY release than LCFA. Greater induction of PYY release by LCFA may be due to CCK discharge by LCFA because CCK has been shown to stimulate PYY secretion. Other hormones may therefore be involved in the mechanism by which MCFA inhibit gastric acid secretion. However, except for GIP, which is not released in response to MCFA, these have not been studied.
Recently, Feinle et al. (29
) investigated the ability of TG with fatty acids of varying chain lengths to induce gastrointestinal sensations and symptoms. Five different infusions were studied as follows: LCT (soybean oil), MCT, soy lecithin, Orlistat and sucrose polyester. LCT and MCT both increased gastric volume, with LCT causing the greater increase. All infusions resulted in increased feelings of fullness, bloating and nausea, and decreased hunger but effects were most pronounced with the LCT infusion. The authors concluded that the mechanism of action of fat in the generation of gastrointestinal symptoms required digestion of TG. Furthermore, because MCT do not release CCK, but do affect sensations of fullness, bloating and nausea, CCK-dependent and CCK-independent mechanisms must be involved.
In humans, MCFA do not stimulate CCK secretion. Therefore, CCK must not be the hormone responsible for their satiating effect (25
29
). Although MCT have been shown to induce satiety and to stimulate hormone secretion, no single hormone has been found to be strongly secreted due to MCT digestion. PYY has been found to be secreted in response to MCFA, yet it is still more potently secreted in response to LCT (27
).
| Potential Benefits to Consumption of MCT on Body Weight. |
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1070 kJ lower when meals contained MCT than when they contained LCT as the fat source (23
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| FOOTNOTES |
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3 Abbreviations used: BW, body weight; CCK, cholecystokinin; CO, corn oil; DVZ, Devazepide; EE, energy expenditure; FO, fish oil; GIP, gastric inhibitory peptide; LCFA, long-chain fatty acids; LCT, long-chain triglycerides; MCFA, medium-chain fatty acids; MCT, medium-chain triglycerides; PYY, peptide YY; SCFA, short-chain fatty acids; SCT, short-chain triglycerides; TEF, thermic effect of food; TG, triglycerides. ![]()
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