Difference between revisions of "MCT Diet"

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Introduction/Summary.
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The MCT diet is a modification of the [[Ketogenic Ratio Diet]] for the [[Ketogenic Diets for Epilepsy| treatment of epilepsy]]. This diet uses Medium Chain Triglycerides ([[MCT]]s) to allow more carbohydrates while maintaining Ketone levels. It allows far greater flexibility in food choices with similar effectiveness in seizure reduction, but the MCTs tend to cause digestive problems such as diarrhea, vomiting, bloating, and cramps. (The MCT diet must not be used by those taking [http://en.wikipedia.org/wiki/Sodium_valproate Valproate].)
−
{{Skeleton}}
+
=The MCT Diet=
−
* A type of [[Ketogenic Diets for Epilepsy]]
+
Originally the MCT provided 60% of calories from MCT, but this causes digestive problems<ref name="Kossoff-2011-106"/>. The other 40% were from 10% protein, 15-19% carbohydrate and 11-15% long chain fats<ref name="Kossoff-2011-"/>. Because of the digestive problems, which include stomach cramps, diarrhea, and vomiting, the diet was changed to 30% from MCT and 30% from long chain fats, though often the MCT level needs to be increase to 40-50%<ref name="Kossoff-2011-3169"/>. The MCT needs to be introduced slowly than the other ketogenic diets, normally over 5-10 days<ref name="Kossoff-2011-3204"/>. (This suggests to me that there is an adaptation that occurs that improves the absorption of the MCT. Personally I've experience some type of adaptation, and I've also found that my ability to digest MCT depends on what other foods it is taken with.) The digestive problems seen with MCT means it can be used with other ketogenic diets to reduce constipation<ref name="Kossoff-2011-3213"/>. The MCT Diet should be initiated under medical supervision in a hospital<ref name="Liu-2012"/>. The MCT should be taken as an [[MCT#MCT Shake| MCT Shake]].
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* Introduce [[MCT]]
+
=Comparison with the Ratio Ketogenic Diet=
−
** Digestive differences
+
There have been a number of studies comparing the MCD Diet with the [[Ketogenic Ratio Diet]] (also called the Classic Ketogenic Diet) that founds<ref name="Liu-2012"/>:
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* History
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* The MCT Diet is more palatable due to less carbohydrate restriction. This includes more fruit and vegetables.
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** Introduced in the early 1970s by Huttenlocher to allow more carbohydrate
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* Children have better growth and need less [[Ketogenic Diet Supplements| supplements]].
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** (Huttenlocher et al., 1971).
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* There are fewer problems with [[Health Risks of the Ketogenic Diet| kidney stones, hypoglycemia, ketoacidosis, constipation, low bone density, and growth retardation]].
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*** Medium-chain triglycerides as a therapy for intractable child epilepsy. Neurology
+
* There are no problems with acidosis or reduction in serum alanine.
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* Formation of MCT diet
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* Lipid levels are better with a lower total cholesterol/high density lipoprotein (HDL) ratio.
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** 60% [[MCT]], 10% Protein, 15-19% carbohydrate and 11-15% long chain fats.
+
=Problems with the MCT Diet=
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* Digestive problems
+
In addition to the noted digestive issues, there are reports of liver failure when the MCT diet is used with [http://en.wikipedia.org/wiki/Sodium_valproate Valproate] (an anticonvulsant)<ref name="Liu-2008"/>. In addition, the MCT diet takes longer to achieve seizure control as the diet requires longer to introduce in order to minimize digestive problems<ref name="Liu-2008"/>.
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* Concerns about saturated fat
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=Relative success for epilepsy=
−
* Digestive Adaptation and Phased introduction (5-10 days)
+
Studies have shown that the MCT Diet is as effective as other Ketogenic Diets, with more than 50% of the children achieving >50% reduction in seizures<ref name="Liu-2012"/>.
−
* Relative success for epilepsy
+
=MCT Intake for MCT Diet=
 +
The amount of MCT required for different percentages of calorie intake and different daily calorie requirements is shown below. The values are in Tablespoons and the calculation assumes 0.945 grams/ml and 6.72 Calories/gram.
 +
{| class="wikitable"
 +
! Daily Calories
 +
! 10%
 +
! 15.0%
 +
! 20.0%
 +
! 25.0%
 +
! 30.0%
 +
! 35.0%
 +
! 40.0%
 +
! 45.0%
 +
! 50.0%
 +
! 55.0%
 +
! 60.0%
 +
|-
 +
| 1500
 +
| 1.6
 +
| 2.4
 +
| 3.1
 +
| 3.9
 +
| 4.7
 +
| 5.5
 +
| 6.3
 +
| 7.1
 +
| 7.9
 +
| 8.7
 +
| 9.4
 +
|-
 +
| 1600
 +
| 1.7
 +
| 2.5
 +
| 3.4
 +
| 4.2
 +
| 5.0
 +
| 5.9
 +
| 6.7
 +
| 7.6
 +
| 8.4
 +
| 9.2
 +
| 10.1
 +
|-
 +
| 1700
 +
| 1.8
 +
| 2.7
 +
| 3.6
 +
| 4.5
 +
| 5.4
 +
| 6.2
 +
| 7.1
 +
| 8.0
 +
| 8.9
 +
| 9.8
 +
| 10.7
 +
|-
 +
| 1800
 +
| 1.9
 +
| 2.8
 +
| 3.8
 +
| 4.7
 +
| 5.7
 +
| 6.6
 +
| 7.6
 +
| 8.5
 +
| 9.4
 +
| 10.4
 +
| 11.3
 +
|-
 +
| 1900
 +
| 2.0
 +
| 3.0
 +
| 4.0
 +
| 5.0
 +
| 6.0
 +
| 7.0
 +
| 8.0
 +
| 9.0
 +
| 10.0
 +
| 11.0
 +
| 12.0
 +
|-
 +
| 2000
 +
| 2.1
 +
| 3.1
 +
| 4.2
 +
| 5.2
 +
| 6.3
 +
| 7.3
 +
| 8.4
 +
| 9.4
 +
| 10.5
 +
| 11.5
 +
| 12.6
 +
|-
 +
| 2100
 +
| 2.2
 +
| 3.3
 +
| 4.4
 +
| 5.5
 +
| 6.6
 +
| 7.7
 +
| 8.8
 +
| 9.9
 +
| 11.0
 +
| 12.1
 +
| 13.2
 +
|-
 +
| 2200
 +
| 2.3
 +
| 3.5
 +
| 4.6
 +
| 5.8
 +
| 6.9
 +
| 8.1
 +
| 9.2
 +
| 10.4
 +
| 11.5
 +
| 12.7
 +
| 13.9
 +
|-
 +
| 2300
 +
| 2.4
 +
| 3.6
 +
| 4.8
 +
| 6.0
 +
| 7.2
 +
| 8.5
 +
| 9.7
 +
| 10.9
 +
| 12.1
 +
| 13.3
 +
| 14.5
 +
|-
 +
| 2400
 +
| 2.5
 +
| 3.8
 +
| 5.0
 +
| 6.3
 +
| 7.6
 +
| 8.8
 +
| 10.1
 +
| 11.3
 +
| 12.6
 +
| 13.9
 +
| 15.1
 +
|-
 +
| 2500
 +
| 2.6
 +
| 3.9
 +
| 5.2
 +
| 6.6
 +
| 7.9
 +
| 9.2
 +
| 10.5
 +
| 11.8
 +
| 13.1
 +
| 14.4
 +
| 15.7
 +
|-
 +
| 2600
 +
| 2.7
 +
| 4.1
 +
| 5.5
 +
| 6.8
 +
| 8.2
 +
| 9.6
 +
| 10.9
 +
| 12.3
 +
| 13.6
 +
| 15.0
 +
| 16.4
 +
|-
 +
| 2700
 +
| 2.8
 +
| 4.3
 +
| 5.7
 +
| 7.1
 +
| 8.5
 +
| 9.9
 +
| 11.3
 +
| 12.8
 +
| 14.2
 +
| 15.6
 +
| 17.0
 +
|-
 +
| 2800
 +
| 2.9
 +
| 4.4
 +
| 5.9
 +
| 7.3
 +
| 8.8
 +
| 10.3
 +
| 11.8
 +
| 13.2
 +
| 14.7
 +
| 16.2
 +
| 17.6
 +
|-
 +
| 2900
 +
| 3.0
 +
| 4.6
 +
| 6.1
 +
| 7.6
 +
| 9.1
 +
| 10.7
 +
| 12.2
 +
| 13.7
 +
| 15.2
 +
| 16.7
 +
| 18.3
 +
|-
 +
| 3000
 +
| 3.1
 +
| 4.7
 +
| 6.3
 +
| 7.9
 +
| 9.4
 +
| 11.0
 +
| 12.6
 +
| 14.2
 +
| 15.7
 +
| 17.3
 +
| 18.9
 +
|}
 
{{KetoSeeAlso}}
 
{{KetoSeeAlso}}
 +
=References=
 +
<references>
 +
<ref name="Liu-2012">YM. Liu, HS. Wang, Medium-chain triglyceride ketogenic diet, an effective treatment for drug-resistant epilepsy and a comparison with other ketogenic diets., Biomed J, volume 36, issue 1, pages 9-15, doi [http://dx.doi.org/10.4103/2319-4170.107154 10.4103/2319-4170.107154], PMID [http://www.ncbi.nlm.nih.gov/pubmed/23515148 23515148]</ref>
 +
<ref name="Liu-2008">YM. Liu, Medium-chain triglyceride (MCT) ketogenic therapy., Epilepsia, volume 49 Suppl 8, pages 33-6, Nov 2008, doi [http://dx.doi.org/10.1111/j.1528-1167.2008.01830.x 10.1111/j.1528-1167.2008.01830.x], PMID [http://www.ncbi.nlm.nih.gov/pubmed/19049583 19049583]</ref>
 +
<ref name="Kossoff-2011-3213">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 3213</ref>
 +
<ref name="Kossoff-2011-3204">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 3204</ref>
 +
<ref name="Kossoff-2011-3169">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 3169</ref>
 +
<ref name="Kossoff-2011-">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset </ref>
 +
<ref name="Kossoff-2011-106">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 106</ref>
 +
</references>

Latest revision as of 06:11, 18 October 2014

The MCT diet is a modification of the Ketogenic Ratio Diet for the treatment of epilepsy. This diet uses Medium Chain Triglycerides (MCTs) to allow more carbohydrates while maintaining Ketone levels. It allows far greater flexibility in food choices with similar effectiveness in seizure reduction, but the MCTs tend to cause digestive problems such as diarrhea, vomiting, bloating, and cramps. (The MCT diet must not be used by those taking Valproate.)

1 The MCT Diet

Originally the MCT provided 60% of calories from MCT, but this causes digestive problems[1]. The other 40% were from 10% protein, 15-19% carbohydrate and 11-15% long chain fats[2]. Because of the digestive problems, which include stomach cramps, diarrhea, and vomiting, the diet was changed to 30% from MCT and 30% from long chain fats, though often the MCT level needs to be increase to 40-50%[3]. The MCT needs to be introduced slowly than the other ketogenic diets, normally over 5-10 days[4]. (This suggests to me that there is an adaptation that occurs that improves the absorption of the MCT. Personally I've experience some type of adaptation, and I've also found that my ability to digest MCT depends on what other foods it is taken with.) The digestive problems seen with MCT means it can be used with other ketogenic diets to reduce constipation[5]. The MCT Diet should be initiated under medical supervision in a hospital[6]. The MCT should be taken as an MCT Shake.

2 Comparison with the Ratio Ketogenic Diet

There have been a number of studies comparing the MCD Diet with the Ketogenic Ratio Diet (also called the Classic Ketogenic Diet) that founds[6]:

3 Problems with the MCT Diet

In addition to the noted digestive issues, there are reports of liver failure when the MCT diet is used with Valproate (an anticonvulsant)[7]. In addition, the MCT diet takes longer to achieve seizure control as the diet requires longer to introduce in order to minimize digestive problems[7].

4 Relative success for epilepsy

Studies have shown that the MCT Diet is as effective as other Ketogenic Diets, with more than 50% of the children achieving >50% reduction in seizures[6].

5 MCT Intake for MCT Diet

The amount of MCT required for different percentages of calorie intake and different daily calorie requirements is shown below. The values are in Tablespoons and the calculation assumes 0.945 grams/ml and 6.72 Calories/gram.

Daily Calories 10% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0% 50.0% 55.0% 60.0%
1500 1.6 2.4 3.1 3.9 4.7 5.5 6.3 7.1 7.9 8.7 9.4
1600 1.7 2.5 3.4 4.2 5.0 5.9 6.7 7.6 8.4 9.2 10.1
1700 1.8 2.7 3.6 4.5 5.4 6.2 7.1 8.0 8.9 9.8 10.7
1800 1.9 2.8 3.8 4.7 5.7 6.6 7.6 8.5 9.4 10.4 11.3
1900 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0 10.0 11.0 12.0
2000 2.1 3.1 4.2 5.2 6.3 7.3 8.4 9.4 10.5 11.5 12.6
2100 2.2 3.3 4.4 5.5 6.6 7.7 8.8 9.9 11.0 12.1 13.2
2200 2.3 3.5 4.6 5.8 6.9 8.1 9.2 10.4 11.5 12.7 13.9
2300 2.4 3.6 4.8 6.0 7.2 8.5 9.7 10.9 12.1 13.3 14.5
2400 2.5 3.8 5.0 6.3 7.6 8.8 10.1 11.3 12.6 13.9 15.1
2500 2.6 3.9 5.2 6.6 7.9 9.2 10.5 11.8 13.1 14.4 15.7
2600 2.7 4.1 5.5 6.8 8.2 9.6 10.9 12.3 13.6 15.0 16.4
2700 2.8 4.3 5.7 7.1 8.5 9.9 11.3 12.8 14.2 15.6 17.0
2800 2.9 4.4 5.9 7.3 8.8 10.3 11.8 13.2 14.7 16.2 17.6
2900 3.0 4.6 6.1 7.6 9.1 10.7 12.2 13.7 15.2 16.7 18.3
3000 3.1 4.7 6.3 7.9 9.4 11.0 12.6 14.2 15.7 17.3 18.9

6 See Also

7 References

  1. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 106
  2. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset
  3. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 3169
  4. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 3204
  5. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 3213
  6. ↑ 6.0 6.1 6.2 YM. Liu, HS. Wang, Medium-chain triglyceride ketogenic diet, an effective treatment for drug-resistant epilepsy and a comparison with other ketogenic diets., Biomed J, volume 36, issue 1, pages 9-15, doi 10.4103/2319-4170.107154, PMID 23515148
  7. ↑ 7.0 7.1 YM. Liu, Medium-chain triglyceride (MCT) ketogenic therapy., Epilepsia, volume 49 Suppl 8, pages 33-6, Nov 2008, doi 10.1111/j.1528-1167.2008.01830.x, PMID 19049583
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