Medium-Chain Triglyceride (MCT) Content of Adult Enteral Tube Feeding Formulas and Clinical Outcomes. A Systematic Review

Overview

Journal Front Nutr

Specialty Nutritional Sciences

Date 2021 Aug 19

PMID 34409063

Citations 3

Authors

Maurizio Muscaritoli

Lorenzo Pradelli

Affiliations

Soon will be listed here.

Abstract

Available data on the effect of lipid composition of enteral formulas on clinical outcomes are controversial. The present systematic review was performed in order to verify whether the presence of specific lipidic substrates, namely medium-chain triglycerides (MCT), in enteral tube feeding formulas is associated to measurable clinical benefits in patients receiving enteral nutrition in different clinical settings, including home enteral nutrition (HEN). The results of this systematic review highlight a lack of robust evidence supporting the use of specific types of lipids in standard or disease-specific formulas. Evidence exists, however, that MCT-containing formulas are safe and well-tolerated. Further, well-designed, adequately powered, randomized controlled trials would be needed in order to assess the superiority of MCT- containing enteral formulas over other standard or disease-specific commercially available enteral products.

Citing Articles

Tolerance, adherence, and acceptability of a ketogenic 2.5:1 ratio, nutritionally complete, medium chain triglyceride-containing liquid feed in children and adults with drug-resistant epilepsy following a ketogenic diet.

Griffen C, Schoeler N, Browne R, Cameron T, Kirkpatrick M, Thowfeek S Epilepsia Open. 2024; 9(2):727-738.

PMID: 38411329 PMC: 10984290. DOI: 10.1002/epi4.12910.

Impact of critical illness on cholesterol and fatty acids: insights into pathophysiology and therapeutic targets.

Lauwers C, De Bruyn L, Langouche L Intensive Care Med Exp. 2023; 11(1):84.

PMID: 38015312 PMC: 10684846. DOI: 10.1186/s40635-023-00570-y.

Postprandial lipemic response in dairy-avoiding females following an equal volume of sheep milk relative to cow milk: A randomized controlled trial.

Teng F, Samuelsson L, Milan A, Subbaraj A, Agnew M, Shrestha A Front Nutr. 2023; 9:1029813.

PMID: 36687710 PMC: 9846784. DOI: 10.3389/fnut.2022.1029813.

References

Pan W, Cai S, Luo H, Ouyang S, Zhang W, Wei Z . The application of nutrition support in conservative treatment of chylous ascites after abdominal surgery. Ther Clin Risk Manag. 2016; 12:607-12. PMC: 4841117. DOI: 10.2147/TCRM.S100266. View

Cederholm T, Barazzoni R, Austin P, Ballmer P, Biolo G, Bischoff S . ESPEN guidelines on definitions and terminology of clinical nutrition. Clin Nutr. 2016; 36(1):49-64. DOI: 10.1016/j.clnu.2016.09.004. View

Kawai K, Nakashima M, Kojima M, Yamashita S, Takakura S, Shimizu M . Ghrelin activation and neuropeptide Y elevation in response to medium chain triglyceride administration in anorexia nervosa patients. Clin Nutr ESPEN. 2017; 17:100-104. DOI: 10.1016/j.clnesp.2016.10.001. View

McCarthy M, Martindale R . Immunonutrition in Critical Illness: What Is the Role?. Nutr Clin Pract. 2018; 33(3):348-358. DOI: 10.1002/ncp.10102. View

Lochs H, Allison S, Meier R, Pirlich M, Kondrup J, Schneider S . Introductory to the ESPEN Guidelines on Enteral Nutrition: Terminology, definitions and general topics. Clin Nutr. 2006; 25(2):180-6. DOI: 10.1016/j.clnu.2006.02.007. View

Wang X, Pan L, Zhang P, Liu X, Wu G, Wang Y . Enteral nutrition improves clinical outcome and shortens hospital stay after cancer surgery. J Invest Surg. 2011; 23(6):309-13. DOI: 10.3109/08941939.2010.519428. View

Singer P, Reintam Blaser A, Berger M, Alhazzani W, Calder P, Casaer M . ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2018; 38(1):48-79. DOI: 10.1016/j.clnu.2018.08.037. View

Sakurai T, Matsui T, Yao T, Takagi Y, Hirai F, Aoyagi K . Short-term efficacy of enteral nutrition in the treatment of active Crohn's disease: a randomized, controlled trial comparing nutrient formulas. JPEN J Parenter Enteral Nutr. 2002; 26(2):98-103. DOI: 10.1177/014860710202600298. View

Jakob S, Butikofer L, Berger D, Coslovsky M, Takala J . A randomized controlled pilot study to evaluate the effect of an enteral formulation designed to improve gastrointestinal tolerance in the critically ill patient-the SPIRIT trial. Crit Care. 2017; 21(1):140. PMC: 5466775. DOI: 10.1186/s13054-017-1730-1. View

10.

Kozeniecki M, Fritzshall R . Enteral Nutrition for Adults in the Hospital Setting. Nutr Clin Pract. 2015; 30(5):634-51. DOI: 10.1177/0884533615594012. View

11.

Calder P, Adolph M, Deutz N, Grau T, Innes J, Klek S . Lipids in the intensive care unit: Recommendations from the ESPEN Expert Group. Clin Nutr. 2017; 37(1):1-18. DOI: 10.1016/j.clnu.2017.08.032. View

12.

Viall C, Porcelli K, Teran J, Varma R, Steffee W . A double-blind clinical trial comparing the gastrointestinal side effects of two enteral feeding formulas. JPEN J Parenter Enteral Nutr. 1990; 14(3):265-9. DOI: 10.1177/0148607190014003265. View

13.

McClave S, Taylor B, Martindale R, Warren M, Johnson D, Braunschweig C . Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2016; 40(2):159-211. DOI: 10.1177/0148607115621863. View

14.

Brown B, Roehl K, Betz M . Enteral nutrition formula selection: current evidence and implications for practice. Nutr Clin Pract. 2014; 30(1):72-85. DOI: 10.1177/0884533614561791. View

15.

Abu Hilal M, Layfield D, Di Fabio F, Arregui-Fresneda I, Panagiotopoulou I, Armstrong T . Postoperative chyle leak after major pancreatic resections in patients who receive enteral feed: risk factors and management options. World J Surg. 2013; 37(12):2918-26. DOI: 10.1007/s00268-013-2171-x. View

16.

Qiu C, Chen C, Zhang W, Kou Q, Wu S, Zhou L . Fat-Modified Enteral Formula Improves Feeding Tolerance in Critically Ill Patients: A Multicenter, Single-Blind, Randomized Controlled Trial. JPEN J Parenter Enteral Nutr. 2015; 41(5):785-795. DOI: 10.1177/0148607115601858. View

17.

Bernini A, Masoodi M, Solari D, Miroz J, Carteron L, Christinat N . Modulation of cerebral ketone metabolism following traumatic brain injury in humans. J Cereb Blood Flow Metab. 2018; 40(1):177-186. PMC: 6928557. DOI: 10.1177/0271678X18808947. View

18.

Ajabnoor S, Forbes A . Effect of fat composition in enteral nutrition for Crohn's disease in adults: A systematic review. Clin Nutr. 2018; 38(1):90-99. DOI: 10.1016/j.clnu.2017.12.018. View