Changes

Introduction/Summary.{{Skeleton}}* A type The MCT diet is a modification of the [[Ketogenic Ratio Diet]] for the [[Ketogenic Diets for Epilepsy| treatment of epilepsy]]* Introduce . This diet uses Medium Chain Triglycerides ([[MCT]]** Digestive differences* History** Introduced 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 early 1970s by Huttenlocher MCTs tend to allow more carbohydrate** cause digestive problems such as diarrhea, vomiting, bloating, and cramps. (Huttenlocher et alThe MCT diet must not be used by those taking [http://en., 1971)wikipedia.*** Medium-chain triglycerides as a therapy for intractable child epilepsyorg/wiki/Sodium_valproate Valproate]. Neurology)* Formation of =The MCT dietDiet=** 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% Proteinprotein, 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]]. =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<ref name="Liu-2012"/>:* Digestive The MCT Diet is more palatable due to less carbohydrate restriction. This includes more fruit and vegetables.* Children have better growth and need less [[Ketogenic Diet Supplements| supplements]]. * There are fewer problemswith [[Health Risks of the Ketogenic Diet| kidney stones, hypoglycemia, ketoacidosis, constipation, low bone density, and growth retardation]].* Concerns about saturated fatThere are no problems with acidosis or reduction in serum alanine.* Digestive Adaptation and Phased introduction Lipid levels are better with a lower total cholesterol/high density lipoprotein (HDL) ratio.=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 [http://en.wikipedia.org/wiki/Sodium_valproate Valproate] (5an 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-10 days)2008"/>. * =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<ref name="Liu-2012"/>.=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|}