Triglycerides medium chain

MCT fats (MCT is the acronym for "medium chain triglycerides") are triglycerides that consist mainly of medium chain saturated fatty acids. Fatty acids with 6 - 10 carbon atoms (C6-C10) are described as "medium chain".

Medium-chain triglycerides occur in nature, e.g. as caprylic acid, capric acid and lauric acid in butter, coconut fat and palm kernel fat. Due to their smaller molecular size compared to long-chain fatty acids (C14-C24), their melting point is lower than that of long-chain fatty acids.

Industrially, medium-chain triglycerides are obtained by hydrolysis of coconut fat and palm kernel oil, fractionation of the medium-chain fatty acids and subsequent esterification with glycerine. A pure MCT oil is colourless to yellowish, neutral in smell and taste and of very low viscosity. MCT oil is insoluble in water, miscible with dichloromethane, ether, ethanol and fatty oils. It is declared as vegetable oil (oleum neutral) and according to DAB 10 it consists of 50-80 % caprylic acid (C8), 20-50 % capric acid (C10), max. 3 % lauric acid, max. 2 % caproic acid and max. 1 % myristic acid (v. Bruchhausen F et al.)

Medium-chain triglycerides are carriers for pharmaceutical forms (e.g. suspensions, juices, drops, soft capsules, etc.). They are components of lotions, creams and ointments. They are characterized by a very good skin tolerance, stability and high solubility.

Medium chain triglycerides are used in clinical nutrition for dietary management of enteral diseases associated with malabsorption syndrome. Thus with:

• Whipple's disease (K90.8)
• Enteral protein loss syndrome (K 90.4)
• Bile acid loss syndrome (K90.8)
• Short bowel syndrome: If the colon is preserved, medium-chain fatty acids can be sufficiently absorbed and can be a suitable alternative to conventional fats (Jeppese PB (1998).
• Defects in the β oxidation of long chain (LCHAD) and very long chain (VLCAD) fatty acids, medium chain fatty acids are an essential source of energy.
• MCT fats are also used in artificial nutrition (enteral and parenteral) for various diseases, mainly of the gastrointestinal tract.
• In premature births, MCTs are used to increase weight because the digestive system is not yet fully developed.

In dietetics, the behaviour of medium-chain fatty acids is of particular importance. Special fats with medium-chain triglycerides have advantages in fat digestion, fat absorption and fat transport compared to conventional dietary fats with mostly long-chain fatty acids. They do not require bile acids for their metabolism. Furthermore, MCTs can be metabolized independently of pancreatic enzymes. Their use is indicated in the case of an existing exocrine pancreatic insufficiency with pronounced steatorrhea (fatty stool), if enzyme supplementation does not have the desired effect. Furthermore, MCTs can pass directly and unaltered through the cells of the intestinal mucosa and enter the blood without any detour via lymph vessels.

1. Ammon H et al (2014). Hunnius Pharmaceutical Dictionary. Walter de Gruyter GmbH Berlin/Boston S 1815-1816
2. v. Bruchhausen F et al (eds.): Hager's Handbook of Pharmaceutical Practice. 5th edition p. 1059
3. Heepe F. Dietary Indications 3rd Edition. Springer-Verlag Berlin Heidelberg New York
4. Jeppese PB (1998) The influence of a preserved colon on the absorption of medium chain fat in patients with small bowl resection. All right, 43/478-483.
5. Ohnuma T et al (2016) Benefits of use, and tolerance of, medium-chain triglyceride medical food in the management of Japanese patients with Alzheimer's disease: a prospective, open-label pilot study. Clin Interv Aging 11:29-36.
6. Papavassilis C et al (1999) Medium-chain triglycerides inhibit growth of Malassezia: implications for prevention of systemic infection. Crit Care Med 27:1781-1786.
7. Wu GH et al (2017) Structured triglycerides versus physical mixtures of medium- and long-chain triglycerides for parenteral nutrition in surgical or critically ill adult patients: Systematic review and meta-analysis. Clin Nutr 36:150-161.