Structured medium and long chain triglycerides show short-term increases in fat oxidation, but no changes in adiposity in men

The impact of medium-chain triglycerides on weight loss and metabolic health in individuals with overweight or obesity: A systematic review and meta-analysis

BACKGROUNDS

The efficacy of medium-chain triglycerides (MCTs) for weight management and mitigating metabolic disorders among individuals with overweight and obesity remains a topic of ongoing discussion. Notably, there is a gap in the distinction between pure MCTs and medium-long-chain triglycerides (MLCTs).

METHODS

This meta-analysis investigates the efficacy of MCTs on weight loss and glucolipid metabolism in these populations, explicitly evaluating the differential effects of pure MCTs and MLCTs. We performed a random-effects meta-analysis on relevant studies examining weight loss and glucolipid parameters, incorporating a subgroup analysis conducted based on intervention types, pure MCTs versus MLCTs.

RESULTS

Our findings revealed diets enriched with MCTs are more effective in achieving weight reduction (WMD: -1.53%; 95% CI: -2.44, -0.63; p < 0.01), particularly those containing pure MCTs (WMD: -1.62%; 95% CI: -2.78, -0.46; p < 0.01), compared to long-chain fatty acids (LCTs) enriched diets. However, our subgroup analysis indicates that an MLCTs-enriched diet did not significantly reduce weight loss. Additionally, MCTs-enriched diets were associated with significant reductions in blood triglyceride levels and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) scores, compared to LCTs-enriched diets.

CONCLUSIONS

Hence, the authors recommend incorporating pure MCTs in dietary interventions for individuals with overweight and obesity, particularly those with comorbidities such as dyslipidemia and impaired glucose metabolism.

Applications of Medium-Chain Triglycerides in Foods

In the 1950s, the production of processed fats and oils from coconut oil was popular in the United States. It became necessary to find uses for the medium-chain fatty acids (MCFAs) that were byproducts of the process, and a production method for medium-chain triglycerides (MCTs) was established. At the time of this development, its use as a non-fattening fat was being studied. In the early days MCFAs included fatty acids ranging from hexanoic acid (C6:0) to dodecanoic acid (C12:0), but today their compositions vary among manufacturers and there seems to be no clear definition. MCFAs are more polar than long-chain fatty acids (LCFAs) because of their shorter chain length, and their hydrolysis and absorption properties differ greatly. These differences in physical properties have led, since the 1960s, to the use of MCTs to improve various lipid absorption disorders and malnutrition. More than half a century has passed since MCTs were first used in the medical field. It has been reported that they not only have properties as an energy source, but also have various physiological effects, such as effects on fat and protein metabolism. The enhancement of fat oxidation through ingestion of MCTs has led to interest in the study of body fat reduction and improvement of endurance during exercise. Recently, MCTs have also been shown to promote protein anabolism and inhibit catabolism, and applied research has been conducted into the prevention of frailty in the elderly. In addition, a relatively large ingestion of MCTs can be partially converted into ketone bodies, which can be used as a component of "ketone diets" in the dietary treatment of patients with intractable epilepsy, or in the nutritional support of terminally ill cancer patients. The possibility of improving cognitive function in dementia patients and mild cognitive impairment is also being studied. Obesity due to over-nutrition and lack of exercise, and frailty due to under-nutrition and aging, are major health issues in today's society. MCTs have been studied in relation to these concerns. In this paper we will introduce the results of applied research into the use of MCTs by healthy subjects.

Beneficial effects of dietary supplementation with olive oil, oleic acid, or hydroxytyrosol in metabolic syndrome: Systematic review and meta-analysis

BACKGROUND AND AIMS

Olive oil and components might have a beneficial effect on Metabolic Syndrome (MetS). The aim of this review and meta-analysis was to assess whether those effects are related to hydroxytyrosol or oleic acid contents, or the combination of them as olive oil, and how powerful is this effect.

METHODS

A systematic literature search was performed in MEDLINE via Pubmed, Web of Science (WOS) core collection, and Virtual Health Library (VHL) via LILACS and IBECS (Spain). MeSH terms used were "obesity", "body weight", "body mass index", "adipose tissue", "lipid metabolism", "LDL", "HDL", "VLDL", "insulin resistance", "glucose", "insulin", "hypertension", "arterial pressure", "olive oil", "oleic acid", and other (non-MeSH) terms: "total antioxidant capacity", "total antioxidant status", "hydroxytyrosol" (PROSPERO ID: CRD42021247614). Results of the included studies were meta-analyzed with the RevMan 5.3 program, assuming a random effects model.

RESULTS

76 articles (67 different trials) were identified. Hydroxytyrosol had no effect on MetS [combined standardized mean differences (SMD) = 0.01 (CI 95%: [-0.23, 0.25], I² = 83%; p = 0.920)]. Oleic acid had no significant beneficial effect on MetS [SMD = 0.03 (CI 95%: [-0.01, 0.07], I² = 0%); p = 0.150], but it improved lipid profile [SMD = 0.06 (CI 95%: [-0.00, 0.12], I² = 0%); p = 0. 050]. Olive oil had no effect on MetS [SMD = -0.01 (CI 95%: [-0.05, 0.03]), I² = 55%; p = 0.550)]. The supplementation with hydroxytyrosol, oleic acid or olive oil showed a beneficial effect on antioxidant capacity related to components of MetS [SMD = 0.31 (CI 95%: [-0.34, 0.95], I² = 81%)]; p = 0.35).

CONCLUSION

Most articles compared olive oil and oleic acid with other strategies specially designed for MetS management. Our findings suggest that olive oil or oleic acid consumption are as good as the other strategies to manage MetS.

Investigation of Lipid Metabolism by a New Structured Lipid with Medium- and Long-Chain Triacylglycerols from Cinnamomum camphora Seed Oil in Healthy C57BL/6J Mice

In the present study, a new structured lipid with medium- and long-chain triacylglycerols (MLCTs) was synthesized from camellia oil (CO) and Cinnamomum camphora seed oil (CCSO) by enzymatic interesterification. Meanwhile, the antiobesity effects of structured lipid were investigated through observing the changes of enzymes related to lipid mobilization in healthy C57BL/6J mice. Results showed that after synthesis, the major triacylgeride (TAG) species of intesterificated product changed to LaCC/CLaC (12.6 ± 0.46%), LaCO/LCL (21.7 ± 0.76%), CCO/LaCL (14.2 ± 0.55%), COO/OCO (10.8 ± 0.43%), and OOO (18.6 ± 0.64%). Through second-stage molecular distillation, the purity of interesterified product (MLCT) achieved 95.6%. Later, male C57BL/6J mice were applied to study whether the new structured lipid with MLCT has the efficacy of preventing the formation of obesity or not. After feeding with different diets for 6 weeks, MLCTs could reduce body weight and fat deposition in adipose tissue, lower plasma triacylglycerols (TG) (0.89 ± 0.16 mmol/L), plasma total cholesterol (TC) (4.03 ± 0.08 mmol/L), and hepatic lipids (382 ± 34.2 mg/mice) by 28.8%, 16.0%, and 30.5%, respectively, when compared to the control 2 group. This was also accompanied by increasing fecal lipids (113%) and the level of enzymes including cyclic adenosine monophosphate (cAMP), protein kinase A (PKA), hormone-sensitive lipase (HSL), and adipose triglyceride lipase (ATGL) related to lipid mobilization in MLCT group. From the results, it can be concluded that MLCT reduced body fat deposition probably by modulating enzymes related to lipid mobilization in C57BL/6J mice.

Effects of coconut oil consumption on energy metabolism, cardiometabolic risk markers, and appetitive responses in women with excess body fat

PURPOSE

Virgin coconut oil (VCO) is a medium-chain fatty acid source with popularly attributed benefits on obesity management. However, its role on obesity requires elucidation due to its saturated nature. In the study herein, we investigated acute effects of VCO consumption on energy metabolism, cardiometabolic risk markers, and appetitive responses in women with excess body fat.

METHODS

Fifteen adult women with excess body fat (37.43 ± 0.83%) participated in this randomized, crossover, controlled study. Two isocaloric mixed breakfasts containing 25 mL of VCO or control (extra-virgin olive oil-C) were evaluated. Resting energy expenditure (REE), fat oxidation rate (FOR), diet induced thermogenesis (DIT) and appetitive subjective responses were assessed at fasting and postprandial periods (up to 240 min). Cardiometabolic risk markers were assessed at fasting and up to 180 min postprandially.

RESULTS

VCO did not affect REE, FOR, and DIT compared to C. In addition, VCO did not cause deleterious change in triglycerides, total cholesterol, HDL-c, LDL-c, triglycerides/HDL-c ratio, uric acid, glucose and Homeostasis Model Assessment of Insulin Resistance Index (HOMA-IR) (P _{time×treatment} > 0.05). However, VCO suppressed less hunger (P _{time×treatment} = 0.003), total satiety (P _iAUC = 0.021) and total fullness (P _iAUC = 0.035) responses than C.

CONCLUSIONS

VCO consumption did not acutely change energy metabolism and cardiometabolic risk markers when added to a mixed breakfast but promoted less appetitive responses.

The diverse nature of saturated fats and the case of medium-chain triglycerides: how one recommendation may not fit all

PURPOSE OF REVIEW

The adverse cardiovascular health effects of saturated fats have been debated recently since the publication of studies reporting no increase in cardiovascular risk with saturated fat intakes. We purport that this may be because of the varied nature of saturated fats, which range in length from 2 to over 20 carbon atoms, and review evidence surrounding the cardiovascular health effects of medium-chain triglycerides (MCT).

RECENT FINDINGS

MCTs are saturated fats of shorter chain length than other, more readily consumed saturated fats. Studies have reported that consumption of MCT may lead to improvements in body composition without adversely affecting cardio-metabolic risk factors. There may also be synergistic actions between MCT and n-3 polyunsaturated fats that may lead to improvements in cardiovascular health.

SUMMARY

It is clinically relevant to distinguish between sources of saturated fats for cardiovascular health. Medium, and possibly shorter chain, saturated fats behave differently than long-chain saturated fats and should not be judged similarly when it comes to their cardio-metabolic health effects. Given their neutral, and potentially beneficial cardiovascular health effects, they should not be categorized together.

Effects of medium-chain triglycerides on weight loss and body composition: a meta-analysis of randomized controlled trials

BACKGROUND

Medium-chain triglycerides (MCTs) may result in negative energy balance and weight loss through increased energy expenditure and lipid oxidation. However, results from human intervention studies investigating the weight reducing potential of MCTs, have been mixed.

OBJECTIVE

To conduct a systematic review and meta-analysis of randomized controlled trials comparing the effects of MCTs, specifically C8:0 and C10:0, to long-chain triglycerides (LCTs) on weight loss and body composition in adults. Changes in blood lipid levels were secondary outcomes.

METHODS

Randomized controlled trials >3 weeks' duration conducted in healthy adults were identified searching Web of Knowledge, Discover, PubMed, Scopus, New Zealand Science, and Cochrane CENTRAL until March 2014 with no language restriction. Identified trials were assessed for bias. Mean differences were pooled and analyzed using inverse variance models with fixed effects. Heterogeneity between studies was calculated using I(2) statistic. An I(2)>50% or P<0.10 indicated heterogeneity.

RESULTS

Thirteen trials (n=749) were identified. Compared with LCTs, MCTs decreased body weight (-0.51 kg [95% CI-0.80 to -0.23 kg]; P<0.001; I(2)=35%); waist circumference (-1.46 cm [95% CI -2.04 to -0.87 cm]; P<0.001; I(2)=0%), hip circumference (-0.79 cm [95% CI -1.27 to -0.30 cm]; P=0.002; I(2)=0%), total body fat (standard mean difference -0.39 [95% CI -0.57 to -0.22]; P<0.001; I(2)=0%), total subcutaneous fat (standard mean difference -0.46 [95% CI -0.64 to -0.27]; P<0.001; I(2)=20%), and visceral fat (standard mean difference -0.55 [95% CI -0.75 to -0.34]; P<0.001; I(2)=0%). No differences were seen in blood lipid levels. Many trials lacked sufficient information for a complete quality assessment, and commercial bias was detected. Although heterogeneity was absent, study designs varied with regard to duration, dose, and control of energy intake.

CONCLUSIONS

Replacement of LCTs with MCTs in the diet could potentially induce modest reductions in body weight and composition without adversely affecting lipid profiles. However, further research is required by independent research groups using large, well-designed studies to confirm the efficacy of MCT and to determine the dosage needed for the management of a healthy body weight and composition.

Effect of dietary fatty acid composition on substrate utilization and body weight maintenance in humans

BACKGROUND/PURPOSE

Dietary fat content is a primary factor associated with the increase in global obesity rates. There is a delay in achieving fat balance following exposure to a high-fat (HF) diet (≥ 40% of total energy from fat) and fat balance is closely linked to energy balance. Exercise has been shown to improve this rate of adaptation to a HF diet. Recently, however, the role of dietary fatty acid composition on energy and macronutrient balance has come into question.

METHODS

We chose studies that compared monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), and saturated fatty acids (SFA). We have reviewed studies that measured diet-induced thermogenesis (DIT), energy expenditure (EE), or fat oxidation (FOx) in response to a HF meal challenge, or long-term dietary intervention comparing these fatty acids.

RESULTS

While single-meal studies show that SFA induce lower DIT and FOx compared to unsaturated fats, the effect of the degree of unsaturation (MUFA vs. PUFA) appears to yet be determined. Long-term dietary interventions also support the notion that unsaturated fats induce greater EE, DIT, and/or FOx versus SFA and that a high MUFA diet induces more weight loss compared to a high SFA diet. Sex and BMI status also affect the metabolic responses to different fatty acids; however, more research in these areas is warranted.

CONCLUSION

SFA are likely more obesigenic than MUFA, and PUFA. The unsaturated fats appear to be more metabolically beneficial, specifically MUFA ≥ PUFA > SFA, as evidenced by the higher DIT and FOx following HF meals or diets.

Medium-chain fatty acid nanoliposomes suppress body fat accumulation in mice

Medium-chain fatty acids (MCFA) are widely used in diets for patients with obesity. To develop a delivery system for suppressing dietary fat accumulation into adipose tissue, MCFA were encapsulated in nanoliposomes (NL), which can overcome the drawbacks of MCFA and keep their properties unchanged. In the present study, crude liposomes were first produced by the thin-layer dispersion method, and then dynamic high-pressure microfluidisation (DHPM) and DHPM combined with freeze-thawing methods were used to prepare MCFA NL (NL-1 and NL-2, respectively). NL-1 exhibited smaller average size (77.6 (SD 4.3) nm), higher zeta potential (- 40.8 (SD 1.7) mV) and entrapment efficiency (73.3 (SD 16.1) %) and better stability, while NL-2 showed narrower distribution (polydispersion index 0.193 (SD 0.016)). The body fat reduction property of NL-1 and NL-2 were evaluated by short-term (2 weeks) and long-term (6 weeks) experiments of mice. In contrast to the MCFA group, the NL groups had overcome the poor palatability of MCFA because the normal diet of mice was maintained. The body fat and total cholesterol (TCH) of NL-1 (1.54 (SD 0.30) g, P = 0.039 and 2.33 (SD 0.44) mmol/l, P = 0.021, respectively) and NL-2 (1.58 (SD 0.69) g, P = 0.041 and 2.29 (SD 0.38) mmol/l, P = 0.015, respectively) significantly decreased when compared with the control group (2.11 (SD 0.82) g and 2.99 (SD 0.48) mmol/l, respectively). The TAG concentration of the NL-1 group (0.55 (SD 0.14) mmol/l) was remarkably lower (P = 0.045) than the control group (0.94 (SD 0.37) mmol/l). No significant difference in weight and fat gain, TCH and TAG was detected between the MCFA NL and MCFA groups. Therefore, MCFA NL could be potential nutritional candidates for obesity to suppress body fat accumulation.