Medium+Chain+Triglycerides


 * Medium Chain Triglycerides **

**This statement has not been evaluated by FDA. This product is not intended to diagnose, treat, cure of prevent any disease.

**Other Names **
1,2,3-Propanetriol Trioctanoate, AC-1202, Acide Caprique, Acide Caproïque, Acide Caprylique, Acide Laurique, Capric Acid, Caproic Acid, Caprylic Acid, Caprylic Triglycerides, Lauric Acid, MCT, MCT's, MCTs, Medium-Chain Triacylglycerols, Medium-Chain Triglycerides, TCM, Triacylglycérols à Chaîne Moyenne, Tricaprylin, Triglycérides à Chaîne Moyenne, Triglycérides Capryliques, Triglicéridos de Cadena Media (TCMs), Trioctanoin. (WebMD, 2015)

**Definition **
 A triglyceride is a type of lipid that the body utilizes as an energy source. There are short chain triglycerides (SCT), medium chain triglycerides (MCT), and long chain triglyceride (LCT). Each consisting of a glycerol and three fatty acids attached. Medium chain triglycerides consist of 6-12 carbons per fatty acid chain. MCTs differ from SCTs and LCTs in the terms that their fatty acids are absorbed from the intestines and transported directly to the liver via the portal vein. From the liver they are able to transport across the mitochondrial membrane without the reliance of carnitine and are then easily degraded to energy via beta-oxidation. (Mayo Clinic 2012; Nosaka 2009; St-Onge 2002).

**Usage **
 For reasons explained above, MCTs are frequently used for treating medical conditions such as food absorption diseases consisting of excessive diarrhea, steatorrhea, Celiac Disease, and liver disease. Also, for other conditions consisting of AIDs, gallbladder disease, Alzheimer’s Disease, cystic fibrosis, and seizures in children. (WebMD 2015; NYU Medical 2014)

 Other more common uses consist of weight control/reduction and as ergogenic agents in recreational and non-recreational athletes. (Nosaka 2009; NYU Medical 2014; St-Onge 2002; WebMD 2015).

In support of this, a review completed by St-Onge et al. on the physiological effects of medium Chain triglycerides as potential agents in preventing obesity showed that smaller studies done, ranging from one day to two weeks, had results consisting of MCT increasing energy expenditure when compared to LCT. Also, that weight loss showed stronger with low fat diets in comparison to MCT; however they also pointed out that men respond better than women to MCTs affects. Overall, this review showed positive results in MCTs favor in comparison to LCT regarding increasing energy expenditure and decreasing total energy intake supporting weight control, but differences in sex may make a difference in overall outcome and should be considered.

Also in support, Nosaka et al. performed a double-blinded crossover study comparing medium chain triglycerides to long chain triglycerides over the duration of 2 weeks on recreational cycling athletes. From this study, when the participants ingested the MCT their exercise time to exhaustion was significantly longer than when ingesting the LCT. Also, their blood lactate and rate of perceived exertion was less than when ingesting the LCT, but was not statistically significant. However, even though not statistically significant, when viewing the figures within the study a clear difference is seen. It is important to note that even though this study showed positive results much more research is needed to solidly justify MCT supplementation, since most studies performed on humans show negative results. It is also important to note that the reason for these differences could be based on study design and methods. Nosaka et al. pointed out in their discussion that most other studies used only one day to give the participants their MCT dose (larger dose ~85g) and then tested them; where the Nosaka study used several days worth of administering smaller doses of MCT (6g per day) before testing. Another difference in study design/methods lies in the fact that others focused solely on high intensity work for their test subjects where in the Nosaka study they focused on a moderate to high intensity workload. These differences brings up questions in the fact that duration and amount of dosage as well as the type of event type (anaerobic vs. aerobic) potentially plays a large role in the mechanism to how MCT function. These types of issues or differences explain greatly to why more testing is needed.

In contrast, Angus et al. performed a double-blind, randomized, placebo controlled study on eight trained cycling/triathlete male athletes testing the differences on performance between a carbohydrate, carbohydrate + MCT, or a placebo solution. They were given the beverage throughout the test in smaller increments and the test consisted of completing a 100km cycling distance (2.5-3 hours). The results here showed an improvement in completion time for both the CHO and CHO + MCT in comparison to placebo. Also, that the plasma glucose levels was maintained at or above resting values throughout all trials, but decreased in placebo trial by the time of completion. The study also showed the rate of CHO oxidation was not different between groups for the first 90 min, but thereafter was reduced in placebo and maintained in CHO and CHO + MCT groups. Overall, this study showed that the addition of CHO during competition does make a difference when compared to placebo and the addition of MCT did not reflect any benefit. In their discussion they felt the reason that the MCT did not reflect any benefit could have been from the high intensity level the athletes were working at, increasing their dependence on CHO vs. fat oxidation. Also, the ingesting of CHO increases insulin secretion thus reducing fat oxidation. This is an example of a study showing negative results. This study only used MCT the day of in comparison to using them for several days prior, used CHO as an additional supplement, as well as used a more higher intensity workload. Again, since these were key differences pointed out in Nosaka it strongly reflects the need for more consistent testing to take place focusing on these factors.

It should be noted that several animal studies support MCTs in controlling weight reduction as well as improving athletic performance it is the human studies that are lacking on evidence. This contrast in results seems to be from lack of proper study design. Perhaps, as an example, if testing were done on a mixture of male and female athletes in one setting as well as recreational athletes in another setting with a dosing period of 6g per day for 2 weeks or longer prior to event and were tested at a lower intensity for several different trials using the MCT as a supplement on it's own reducing insulin release, there could be different results? Thus, is why further investigating and testing is warranted.

**Recommendations **
Based off of studies, reviews, and other literature the low dosage amount is 6g/d and the high dosage amount is 85g/d (Nosaka 2009; NYU Medical 2014). Also, when purchasing supplements the companies suggest 14g-42g/d. Given the possibility of gastric upset it is recommended to start at the low dosage amount of 6g/d taken on a daily basis and one should then work up to a level where no gastric upset is present, since gastric upset is seen with too high an intake in a short amount of time. However, intake should be taken with the caution that more research is warranted and no positive results is guaranteed. At this point in time all the components seem to be there supporting the potential benefit of MCT supplementation, but appropriate protocol is lacking taking away from facts supporting its use. Until more research is grounded supporting MCT supplementation on improving weight and/or athletic performance other means of support in those areas should be utilized. Ingesting MCTs in the form of coconut oil or palm oil as part of a regular healthy diet in replacement of other fats with no intent of supplemental use is okay and potentially beneficial to a healthy lifestyle.

**Sources **
<span style="font-family: 'Comic Sans MS',cursive;"> Dietary Sources include coconut and palm oils. They are also available in supplement form. They can be taken intravenously as well. (NYU Medical 2014)
 * <span style="font-family: 'Comic Sans MS',cursive;">Food sources: *for the food sources look for organic virgin oils, these typically cost more so be weary of cheaply priced oil*
 * <span style="font-family: 'Comic Sans MS',cursive;">Coconut oil and Palm kernel oil
 * Both have about 11 grams of saturated fat in 1 tablespoon of oil. Out of the total saturated fat, you'll get 7.4 grams of MCTs from a tablespoon of palm kernel oil and 7.9 grams from coconut oil. (Busch, 2014)
 * <span style="font-family: 'Comic Sans MS',cursive;">Dairy Products (whole milk, butter, and cheese)
 * <span style="font-family: 'Comic Sans MS',cursive;">Although found here each of these sources contain more of the poor quality fats than the healthy MCTs so the benefit of consuming these as compared to coconut or palm oil is out weighed. (Busch, 2014)

<span style="display: block; font-family: 'Comic Sans MS',cursive; text-align: left;">
 * <span style="font-family: 'Comic Sans MS',cursive; line-height: 1.5;">Recommended Supplements: ***make note that these are GMP (Good Manafacturing Practice) quality assured but are not certified through a 3rd party such as NSF or Informed Choice.***
 * NOW Sports 100% Pure MCT Oil is GMP Quality Assured
 * Cost $17.49 for 32 fluid ounces; 63 servings of 14g cost $0.28 or 126 servings of 7g cost $0.14 per serving.
 * <span style="font-family: arial,helvetica,sans-serif; line-height: 1.5;">PaleoLife MCT Oil is GMP Quality Assured
 * <span style="font-family: arial,helvetica,sans-serif; line-height: 1.5;">Cost $33.94 for 32 fluid ounces; 63 servings of 14g cost $0.54 or 126 servings of 7g cost $0.27 per serving.

**<span style="font-family: 'Comic Sans MS',cursive;">Side Effects **
<span style="font-family: 'Comic Sans MS',cursive;"> When excessive amounts are ingested one may experience gastric upset such as diarrhea, nausea, and vomiting. (NYU Medical, 2014). It is also recommended that people with diabetes avoid supplemental intake because of the potential to aggravate ketone build up; also those with certain liver diseases (unless directed by a doctor) should avoid supplementation since the liver is where they are processed. (WebMD 2015)

**<span style="font-family: 'Comic Sans MS',cursive;">Rankings **
<span style="font-family: 'Comic Sans MS',cursive;"> **Effectiveness:** <span style="font-family: 'Comic Sans MS',cursive;">2/5; less 3 points here because of lacking research in athletic performance, however more information supports weight control and cardiovascular health as part of a daily diet. <span style="font-family: 'Comic Sans MS',cursive;"> **Ease of Use:** <span style="font-family: 'Comic Sans MS',cursive;"> 5/5; Extremely easy to utilize, can either be taken as a capsule or taken in through directly eating off a spoon or by adding it into foods while cooking. <span style="font-family: 'Comic Sans MS',cursive;"> **Cost:** <span style="font-family: 'Comic Sans MS',cursive;">3/5; Not an overly expensive product, however given that research is lacking the cost could be considered a little pricey when taken as a supplement to increase performance. <span style="font-family: 'Comic Sans MS',cursive;"> 4/5; One point off here for the reason of gastric upset if too much is ingested. Concern with diabetes and liver issues not of major concern.
 * <span style="font-family: 'Comic Sans MS',cursive;"> Safety: **

==**<span style="font-family: 'Comic Sans MS',cursive;">Overall Rankings: 14/20 - Good to use as a part of a healthy diet but not enough evidence supporting its use as an ergogenic agent in athletics. **==

**<span style="font-family: 'Comic Sans MS',cursive;">References **
<span style="font-family: 'Comic Sans MS',cursive;">Angus, D. J., Hargreaves, M., Dancey, J., & Febbraio, M. A. (2000). Effect of carbohydrate or <span style="font-family: 'Comic Sans MS',cursive;">carbohydrate plus medium-chain triglyceride ingestion on cycling time trial performance. //Journal of Applied Physiology, 88(1), 113-119.// Retrieved from []

<span style="font-family: 'Comic Sans MS',cursive;">Busch, Sandi. (2014). //List of Foods That Contain Medium Chain Triglycerides//. Retrieved from []

<span style="font-family: 'Comic Sans MS',cursive;">Mayo Clinic Staff. (2012). //Triglycerides: Why do they matter?// - Mayo Clinic. Retrieved from <span style="font-family: 'Comic Sans MS',cursive;">[]

<span style="font-family: 'Comic Sans MS',cursive;">NOSAKA,N., SUZUKI, Y., NAGATOISHI, A., KASAI, M., WU, J., & TAGUCHI, M. (2009) Effect of Ingestion of <span style="font-family: 'Comic Sans MS',cursive;">Medium-Chain Triacylglycerols on Moderate- and High-Intensity Exercise in Recreational Athletes. //Journal of Nutritional Science and Vitaminology Vol. 55 No. 2 P 120-125//. Retrieved from []

<span style="font-family: 'Comic Sans MS',cursive;">NYU Langone Medical Center. (2014). //Medium Chain Triglycerides//. Retrieved from <span style="font-family: 'Comic Sans MS',cursive;">[]

<span style="font-family: 'Comic Sans MS',cursive;">St-Onge, Marie-Pierre & P. J. H. Jones. (2002) Physiological Effects of Medium-Chain Triglycerides: <span style="font-family: 'Comic Sans MS',cursive;">Potential Agents in the Prevention of Obesity. //J. Nutr. vol. 132 no. 3 329-332.// Retrieved from []

<span style="font-family: 'Comic Sans MS',cursive;">WebMD. (2015). //Find a Vitamin or Supplement: Medium Chain Triglycerides (MCTs)//. Retrieved from []