Do MCT-fats still have a justification in the nutritional management of CF?

Question

There are manufacturers, who recommend medium-chain trigycerides, MCT, for patients with CF, like it was common practice in the 80ties of the last century for CF patients, before the micro-encapsuled digestive enzymes came on the market. From a medical point of view, is there still an indication for patients with CF to use of MCT-fats or should this generally be dehorted?

Answer

Hello,

Nowadays MCT-fats hardly play a role in the daily nutrition thanks to the micro-encapsuled enzyme preparations. In case of cholestatic liver disease however, the replacement of long-chain triglycerides by medium-chain triglycerides could be considered, as the latter neither need pancreatic lipase nor bile fluid in order to be absorbed. However, it has to be paid attention to a sufficient uptake of essential fatty acids.
Furthermore, the intractable steatorrhea could be a further indication. Since MCT-fats are more expensive, have a striking taste and are more difficult to handle than commercial nutritional fats and oils, the reason for the persisting steatorrhea should be checked in detail.
Possible would also be the application of MCT-fats in case of increased calprotectin due to the tendency of malabsorption and the decreased release of CCK, that in turn, leads to a decreased release of bile acid.

I hope to have answered your question.

Best regards, Suzanne van Dullemen

02.06.2014