Why MCT Oil Causes Stomach Pain by Thomas DeLauer   2 months ago

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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 https://academic.oup.com/ajcn/article-abstract/39/3/356/4691147
2) Halmos EP , et al. (n.d.). A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. - PubMed - NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24076059
3) https://med.virginia.edu/ginutrition/wp-content/uploads/sites/199/2014/06/Parrish-February-17.pdf
4) Cholecystokinin. (n.d.). Retrieved from http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/gi/cck.html

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