MCT Diet
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.)
Contents
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]:
- The MCT Diet is more palatable due to less carbohydrate restriction. This includes more fruit and vegetables.
- Children have better growth and need less supplements.
- There are fewer problems with kidney stones, hypoglycemia, ketoacidosis, constipation, low bone density, and growth retardation.
- There are no problems with acidosis or reduction in serum alanine.
- Lipid levels are better with a lower total cholesterol/high density lipoprotein (HDL) ratio.
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
- The classifications and types of Low Carbohydrate Diet.
- An introduction to the Ketogenic Diet.
- My experiences with ultrarunning on the Ketogenic Diet
- My Ketogenic Recipes
- Non-Ketogenic Low Carbohydrate Diets
7 References
- ↑ 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
- ↑ 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
- ↑ 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
- ↑ 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
- ↑ 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
- ↑ 6.0 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
- ↑ 7.0 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