From the Guidelines
MCT oil can be recommended for patients with exocrine pancreatic insufficiency who have persistent steatorrhoea and inadequate weight gain, despite adequate dietary measures, due to its lipase-independent absorption. The use of MCT oil in this context is supported by the ESPEN guidelines on enteral nutrition: pancreas 1. According to these guidelines, MCTs can be administered if adequate weight gain cannot be achieved and steatorrhoea is persistent, due to their lipase-independent absorption. However, it is essential to note that MCTs have a lower energy density (8.3 kcal/g) and may induce side effects such as abdominal pain, nausea, and diarrhea.
Key points to consider when using MCT oil include:
- Starting with a small amount and gradually increasing to avoid digestive discomfort
- Monitoring for potential side effects such as diarrhea and stomach cramps
- Ensuring that MCT oil replaces other fats in the diet rather than adding to total caloric intake
- Using MCT oil as part of a comprehensive nutritional plan that includes pancreatic enzymes and other necessary supplements. The guidelines suggest that a protein intake of 1.0–1.5 g/kg is sufficient and well tolerated, and that the diet should be rich in carbohydrates and protein, although carbohydrate intake can cause problems with intercurrent diabetes 1.
It is crucial to weigh the potential benefits of MCT oil against its potential drawbacks and to carefully monitor patients for any adverse effects. The guidelines emphasize the importance of nutritional counselling and substitution of pancreatic enzymes as the mainstay of treatment for exocrine pancreatic insufficiency 1.
From the Research
Proposed Benefits of MCT Oil
- MCT oil may have a positive impact on cognition in individuals with Alzheimer's disease, with 80% of subjects showing stabilization or improvement in cognition 2.
- MCT oil supplementation may improve memory in individuals with mild cognitive impairment, with increased serum ketone bodies and improved cognitive assessments 3.
- MCT oil ingestion may enhance cognitive performance in healthy young adults, with improvements in tasks such as Trail Making and Digit Span 4.
- MCT oil supplementation may improve walking balance in healthy older adults, with suppressed glucose metabolism in the right sensorimotor cortex and increased functional connectivity from the ipsilateral cerebellar hemisphere 5.
Effects on Endurance Performance and Substrate Utilization
- MCT oil supplementation may not improve exercise performance in healthy populations, with most studies showing no effect on respiratory exchange ratio, glucose concentration, fat and carbohydrate oxidation, and lactate concentration 6.
- MCT oil may increase ketone production, but the body may not be able to utilize these ketones as a primary energy source during acute endurance exercise 6.
- A dosage of 30g of MCTs may be the safe maximal dosage to minimize adverse reactions during or after exercise 6.
Dosage and Duration of Supplementation
- A dosage of 12g MCT/day may be sufficient to improve cognitive performance in healthy young adults, with minimal difference between 12g and 18g MCT/day groups 4.
- A 3-month supplementation period may be necessary to observe improvements in walking balance in healthy older adults 5.
- A 6-month supplementation period may be necessary to observe improvements in cognition in individuals with Alzheimer's disease, with longer MCT exposure and age > 73 resulting in higher final MMSE and Cognigram scores 2.