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Why MCT Oil Causes Stomach Pain
The entry of triglycerides as LCTs from the stomach into the duodenum stimulates the enteric secretion of the hormone cholecystokinin (CCK) and pancreatic enzymes from the pancreas
CCK promotes further release of bile from the gallbladder to help emulsify the triglycerides into smaller fat droplets to maximize its digestion
The chylomicrons are released via exocytosis, enters and travels through the lymphatic system and eventually, drains into the subclavian vein to reach the bloodstream
In the intracellular space, long-chain fatty acids bind to carnitine for transport into the mitochondria for subsequent β-oxidation
Note: In carnitine deficiency states that contribute to severe protein malnutrition (e.g., chronic malabsorption, small bowel obstruction, starvation), these long-chain fatty acids cannot be efficiently utilized and instead lead to accumulation of unoxidized fatty acids and impairment of ureogenesis, ketogenesis, and gluconeogenesis.
By contrast, MCT digestion is rapid and simple - MCTs do not stimulate CCK secretion
MCT absorption occurs via passive diffusion along the gastrointestinal tract into the portal system bound to albumin
No further modification of the MCT molecules is required - moreover, MCTs are not dependent on the carnitine acyltransferase system for transport into the mitochondria for β-oxidation
This provides the ability for more rapid metabolism of MCTs and improved utilization even in states of protein deficiency
Study - The American Journal of Clinical Nutrition
The present study was undertaken to compare the effects of equimolar amounts of long-chain triglycerides (LCT) and medium-chain triglycerides (MCT) on plasma cholecystokinin (CCK) concentrations and gallbladder contraction in man
On separate mornings and in random order six healthy volunteers ingested either 60 mmol LCT or 60 mmol MCT
Plasma CCK concentrations were measured by a sensitive and specific radioimmunoassay and gallbladder contraction by ultrasonography
Ingestion of LCT induced significant increases in plasma CCK and decreases in gallbladder volume
On the other hand, no significant changes in plasma CCK and gallbladder volume were found after MCT
Ingestion of MCT was followed by abdominal cramps and diarrhea, while LCT were without side effects
Concluded that, in contrast to LCT, MCT do not induce CCK release and gallbladder contraction
Cholecystokinin is the principle stimulus for delivery of pancreatic enzymes and bile into the small intestine
Dosage
A tablespoon (15 mL) of MCT oil contains 14 grams of fat and 115 calories
A maximum daily dose of 50-100 grams has been suggested for improved gastrointestinal tolerance; this is equivalent to 4-7 tablespoons (60-100 mL) per day (56-98 grams of fat and 460-805 calories)
The daily dose of MCTs should be increased as tolerated to the maximum daily dose, while equally dividing the dose across all meals
Solutions
Coconut Oil over MCT Oil
Coconut oil is comprised of some LCTs, which stimulate the enteric secretion of the CCK and subsequent pancreatic enzymes from the pancreas
As such, CCK promotes further release of bile from the gallbladder to help emulsify the triglycerides into smaller fat droplets to improve digestion
Watch FODMAP Intake
FODMAP is an acronym that stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols
Your body is unable to completely digest these sugar molecules, they travel through your GI tract and reach your colon undigested, where the bacteria that live in your colon begin to ferment them - the fermentation can produce gas and bloating
Swapping high FODMAP foods for low FODMAP foods (i.e. spinach, zucchini, etc.) and have reduce GI side effects
*Not a direct way to combat digestive issues from MCT oil, but reducing intake can help lessen GI distress and won’t exacerbate the situation*
Cooking vegetables helps break down the fibers they contain, which makes them easier on the digestive system because they’re already partly broken down.
Resources
1) Effect of equimolar amounts of long-chain triglycerides and medium-chain triglycerides on plasma cholecystokinin and gallbladder contraction. (1984, March 1). Retrieved from
2) Halmos EP , et al. (n.d.). A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. - PubMed - NCBI. Retrieved from
3)
4) Cholecystokinin. (n.d.). Retrieved from
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