MCT fats for fat malabsorption and maldigestion disorders

The special properties of MCT make them useful in a variety of ways for gastroenterological diseases.

Conventionally fats consisting of long-chain fatty acids (LCT) are absorbed as part of the diet. These long chain fatty acids are less water soluble so they must be broken down over several steps in order to ensure their absorption, transport and metabolisation in the body.

Medium-chain fatty acids (MCT) are fats obtained from coconut fat and palm kernal fat. The special composition of MCT result in a much less complicated digestion process compared to LCT fats. The shorter chain lengths ensure high water solubility in MCT. They can be absorbed by cells in the small intestine without bile acid or pancreatic enzymes. MCT do not require chylomicron formation for their absorption and do not stimulate chylomicron secretion. They can move directly to the blood.

While sufficient amounts of bile acid and pancreatic enzymes are necessary for the digestion of LCT fats, MCT fats can be absorbed directly by the blood stream and so provide energy.

Examples for the use of MCT:

For disorders in bile acid metabolism and liver diseases, the property of absorption independent of bile acid is a particular advantage and MCT fats are used as an important energy supply, e.g. cholestatic conditions such as biliary atresia, Alagille syndrome, Progressive familial intrahepatic cholestasis
For fat malabsorption disorders in the gut, the rapid absorption is an advantage for MCT fats and they can be used as a rich energy source and food supplement, e.g.intestinal diseases, short bowel syndrome (surgical short bowel / functional short bowel)
For disorders of fat transport by the lymphatic system, the direct absorption by the blood is an advantage, because the MCT fats do not create pressure on the lymphatic system,e.g. chylothorax, chylaskosis, enteral albumin loss syndrome

Benefits of MCT fats

MCT fats do not require bile salts for digestion.
MCT fats are absorbed by the bowel without pancreatic enzymes.
MCT fats are transported directly by the blood to the liver, independently of the lymphatic system.
MCT fats are used as an energy substrate by the liver and body tissues faster and with fewer complications.

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