Pancreatic Cancer and Pancreatic Exocrine Insufficiency Mary Phillips

What are Medium‐Chain Triglycerides (MCT) ?

Medium‐chain triglycerides (MCT) are a type of fat which contain medium chain fatty acids. Medium‐chain fatty acids contain between 8 to 12 carbon atoms in their fatty acid chains and are typically saturated1. They are usually very limited in western diets with coconut and palm being the only rich sources. The predominant form of fat in western diets is long‐chain triglyceride (LCT) which contain at least 14 carbon atoms in their fatty acid chains and can be saturated, polyunsaturated or monounsaturated2.

How MCT works:

MCT has many different clinical applications which relate to it being a useful source of energy when LCT needs to be restricted. Due to having a shorter chain length, MCT is digested and transported differently to LCT: it does not require bile acids/salts to emulsify it; it is more easily hydrolysed than LCT; it is absorbed directly into the portal venous circulation3. MCT does not need to be packaged into chylomicrons and therefore does not use the lymphatic system for transportation unlike LCT.

Where is MCT used:

The different clinical applications include liver and gallbladder disease, pancreatic enzyme insufficiency, pancreatitis, chylothorax, intestinal lymphangiectasia and type 1 hyperlipidaemia. All require the manipulation of dietary fat for successful dietetic management4. MCT can be a useful source of energy when LCT is restricted due to its energy density and how it is absorbed and transported differently.

1. Enig M. Know Your Fats: The Complete Primer for Understanding the Nutrition of Fats, Oils, and Cholesterol. 1st ed. Maryland: Bethesda Press; 2000.
2. Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, et al. Origins and evolution of the Western diet: health implications for the 21st century. The American journal of clinical nutrition. 2005;81(2):341‐54.
3. Marten B, Pfeuffer M, Schrezenmeir J. Medium‐chain triglycerides. International Dairy Journal. 2006;16(11):1374‐82.
4. Lomer M. Advanced Nutrition and dietetics in Gastroenterology: John Wiley & Sons; 2014.

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