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The primary fatty acid of coconut oil is lauric acid, which is present at approximately 45–53 %. The metabolic and physiological properties of lauric acid account for many of the properties of coconut oil. Coconut oil is rapidly metabolized because it is easily absorbed and lauric acid is easily transported. Detailed studies have shown that the majority of ingested lauric acid is transported directly to the liver where it is directly converted to energy and other metabolites rather than being stored as fat. Such metabolites include ketone bodies, which can be used by extrahepatic tissues, such as the brain and heart, as an immediate form of energy. Studies on the effect of lauric acid on serum cholesterol are contradictory. Among saturated fatty acids, lauric acid has been shown to contribute the least to fat accumulation. Lauric acid and monolaurin have demonstrably significant antimicrobial activity against gram positive bacteria and a number of fungi and viruses. Today there are many commercial products that use lauric acid and monolaurin as antimicrobial agents. Because of the significant differences in the properties of lauric acid relative to longer chain fatty acids, they are typically differentiated as medium-chain fatty acids covering C6–C12, and long-chain fatty acids covering C14 and longer.

Non‐alcoholic fatty liver disease (NAFLD) is projected to be the most common chronic liver disease worldwide and is closely linked to obesity, insulin resistance and type 2 diabetes. Currently, no pharmacological treatments are available to treat NAFLD, and lifestyle modification, including dietary interventions, is the only remedy. Therefore, we conducted a study to determine whether supplementation with medium‐chain triglycerides (MCTs), containing a mixture of C8 and C10 (60/40), attenuates NAFLD in obese and insulin‐resistant mice. To achieve that, we fed C57BL/6 male mice a high‐fat diet (HFD) for 12 weeks to induce obesity and hepatic steatosis, after which obese mice were assigned randomly either to remain on the HFD or to transition to an HFD supplemented with MCTs (HFD + MCTs) or a low‐fat diet (LFD) for 6 weeks as another dietary intervention model. Another group of mice was kept on an LFD throughout the study and used as a lean control group. Obese mice that transitioned to HFD + MCTs exhibited improvement in glucose and insulin tolerance tests, and the latter improvement was independent of changes in adiposity when compared with HFD‐fed mice. Additionally, supplementation with MCTs significantly reduced hepatic steatosis, improved liver enzymes and decreased hepatic expression of inflammation‐related genes to levels similar to those observed in obese mice transitioned to an LFD. Importantly, HFD + MCTs markedly lowered hepatic ceramide and diacylglycerol content and prevented protein kinase C‐ε translocation to the plasma membrane. Our study demonstrated that supplementation with MCTs formulated mainly from C8 and C10 effectively ameliorated NAFLD in obese mice. What is the central question of this study? Medium‐chain triglycerides (MCTs) originate from coconut oil. Variations in the types of MCT molecules and their ratios influence their hepatoprotective properties. We aimed to investigate the effects of supplementation with MCTs, consisting primarily of C8 and C10, and not C12 that is abundant in coconut oil, on hepatic steatosis. What is the main finding and its importance? Supplementation with MCTs reduced hepatic steatosis and inflammation while improving liver enzyme levels in obese mice. Moreover, supplementation with MCTs lowered hepatic lipotoxicity and enhanced glucose homeostasis independent of adiposity.

Chylous ascites is the pathologic leakage of triglycerides-rich lymphatic fluid into the peritoneal cavity. Chylous ascites is a rare complication in abdominal surgery. This study aimed to find a relatively better method for nutrition support in the treatment of chylous ascites after abdominal surgery. This study was a retrospective study. This study retrospectively reviewed patients who underwent abdominal surgery and developed chylous ascites, from the year 2010 to 2014, at the West China Hospital of Sichuan University and the Affiliated Hospital of Zunyi Medical College. Fifty-eight patients who developed chylous ascites after abdominal surgery were included in the study. The clinical effect of somatostatin was evaluated. The differences in the curative efficacy among a daily diet, a low-fat diet supplemented with medium-chain triglyceride (MCT), and total parenteral nutrition (TPN) were also analyzed in this study. Complete clinical success was reached earlier in patients treated with somatostatin (P<0.001). The tube removal time, the time to resumption of an oral diet, and the length of hospital stay after chylous leakage were significantly different between patients treated with and without somatostatin. The curative efficacies of the enteral nutrition (EN) + MCT plan and the TPN plan were quite similar, with no significant difference, however, were significantly different from the MCT regime, which was the worst. However, using the EN + MCT plan was more cost-effective (P=0.038). In treating chylous ascites, EN + MCT instead of TPN was the best nutrition support. Moreover, somatostatin or its analog octreotide should be used immediately. The treatment with somatostatin in combination with EN + MCT is recommended in the conservative treatment of postoperative chylous ascites.

Ten 1,3-dialkylimidazolium-based ionic liquids (ILs) have been investigated as media for the enzymatic synthesis of tricaprylin, in comparison with the conventional organic solvent hexane. The results suggested that the esterification activity of Novozym 435 was higher than Lypozyme RM IM in all the ILs assayed. Novozym 435 showed higher catalytic activity in ILs with anions Tf₂N⁻ and PF₆ ⁻ than in BF₄ ⁻ and hexane. FTIR analysis of the secondary structure of the lipase indicated that a smaller decrease of the α-helix was observed in [C₄MIM] Tf₂N and [C₄MIM] PF₆ than [C₄MIM] BF₄ and hexane, indicating that the anions of ILs might be a key factor for the activity of lipase in ILs. Process parameters (amount of lipase, caprylic acid/glycerol molar ratio, temperature and their interactive effects) were optimized in 1-butyl-3-methylimidazolium hexafluorophosphate ([C₄MIM]PF₆) using Novozym 435 by response surface methodology. When the reactions were performed with the lipase amount of 6.1 % substrate mass at a caprylic acid/glycerol molar ratio of 4.5:1 and 66.7 °C, a higher yield was reached up to 92.4 %.

Background/Objectives: Dietary supplementation with medium-chain triglycerides (MCTs) improves walking balance and cognitive function in healthy older adults. This study aimed to determine the biological effects of MCTs on gait-related skeletal muscles in healthy older adults by analyzing muscle density and glucose metabolism. Methods: [sup.18]F-FDG-PET/CT imaging data from 63 participants (18 g/day of MCTs and matching placebo in the form of a jelly stick [6 g each, ingested 3 times/day]) in a randomized clinical trial were analyzed. The three-dimensional regions of interest were set as muscles associated with walking balance (bilateral triceps, psoas, and vastus medialis). Each muscle’s mean standardized uptake value (SUV[sub.mean]) and Hounsfield units (HU) were calculated for relative quantitative measurements. Results: MCT supplementation for 3 months decreased the SUV[sub.mean] (p < 0.001) and increased the HU of the psoas (r = −0.61) and vastus medialis muscles (r = −0.59) (p < 0.001); no changes were apparent in participants supplemented with long-chain triglycerides. The changes in the SUV[sub.mean] for each muscle were correlated negatively with those of plasma β-hydroxybutyrate in MCT-supplemented participants (r = −0.57 [psoas] and −0.59 [vastus medialis]; p < 0.001). Conclusion: A 3-month MCT supplementation suppressed glucose metabolism and increased the muscle density in gait-related skeletal muscles, consistent with previous findings that MCT supplementation stabilizes balance functions during walking in healthy older adults.

Medium-chain acyl-CoA dehydrogenase deficiency (MCADD) is identified by newborn screening (NBS). The natural history of MCADD includes metabolic decompensation with hypoglycemia, hyperammonemia, seizures, coma, and death. NBS enables expectant management thus severe symptoms are rare in managed patients. We report premature birth of an MCADD affected infant and resultant management challenges. Nutritional support advanced from parenteral nutrition at 24 hours to enteral feeds. A NBS sample was collected day 2, positive results for MCADD was reported day six, and diagnostic tests were performed day seven. Lab results confirmed MCADD; however, representation of pathologic analytes was so extreme that ingestion of medium chain triglycerides was suspected and subsequently confirmed. Diet was adjusted and reflected in moderation of pathologic analytes. This case emphasizes the need for prompt review NBS results in premature infants. Implementing informatic intervention within electronic medical records, when a disorder requiring special nutritional intervention is identified, will protect premature infants in this vulnerable setting. Standard of care management provided premature infants may be contraindicated in the context of a comorbid inborn error of metabolism.

Post-traumatic stress disorder (PTSD) is characterized by neuroinflammatory and neurotrophic dysregulation, and effective interventions remain limited. Medium-chain triglyceride (MCT) oil, a dietary source of ketone bodies, may offer a practical means to elevate circulating β-hydroxybutyrate (BHB), a molecule with reported anti-inflammatory and neuroprotective properties. This study investigated whether oral administration of MCT oil modulates behavioral and molecular stress responses in a single prolonged stress (SPS) rat model of PTSD. Repeated oral MCT administration significantly increased circulating BHB levels and reduced anxiety-like behavior in the elevated plus maze, without affecting locomotor activity. Under acute restraint stress, serum brain-derived neurotrophic factor (BDNF) levels were significantly lower in MCT-treated rats than in long-chain triglyceride (LCT)-treated controls. Inflammatory cytokine expression remained unchanged in serum and brain tissue. These findings suggest that oral MCT oil attenuates anxiety-like behavior under SPS conditions and is associated with differences in serum BDNF responses during acute stress. Therefore, MCT oil may represent a feasible dietary approach for influencing stress-related behavioral responses.

Chylous leakage is a relevant clinical problem after major abdominal surgery leading to an increased length of stay. A systematic search of MEDLINE/PubMed and the Cochrane Library was performed according to the PRISMA statement. The search for the MeSH terms “chylous ascites” and/or “lymphatic fistula” retrieved a total of 2,348 articles, of which 36 full-text articles were reviewed by 2 independent investigators. Chylous ascites is described with an incidence of up to 11%, especially after pancreatic surgery. The incidence is increasing with the number of lymph nodes harvested. In patients treated with total parenteral nutrition, conservative treatment is demonstrated to be effective in up to 100% of cases. The extent of abdominal surgery mainly predicts the risk of chylous ascites. Conservative treatment has been shown to be effective in almost all cases and is the treatment of choice. •Postoperative chylous ascites represents a relevant economic problem, especially in oncologic surgery.•Extensive lymphadenectomies and lymphatic tissue dissections increase the risk.•Conservative treatment is highly effective in resolving chylous ascites.

Medium-chain triglycerides (MCTs, C6–C12 fatty acids) exhibit rapid absorption, preferential portal transport, efficient mitochondrial β-oxidation, promoting acetyl-CoA formation and ketogenesis. Under high lipid flux or impaired β-oxidation, MCTs undergo ω-oxidation, producing dicarboxylic acids further metabolized peroxisomally, preventing fatty acid accumulation. Industrially, MCTs are synthesized via chemical or enzymatic esterification of caprylic (C8) and capric (C10) acids, yielding high-purity triglycerides used in food and medical nutrition. In Germany and across the European Union, they are primarily used in Foods for Special Medical Purposes (FSMPs) for conditions such as fat malabsorption, ketogenic dietary therapy for refractory epilepsy, and inherited disorders of long-chain fatty-acid oxidation. In Japan, MCTs are additionally incorporated into functional food systems, including Foods for Specified Health Uses (FOSHU) and Foods with Function Claims (FFC), targeting generally healthy adults and older populations. In the United States, MCTs are widely marketed as food ingredients, dietary supplements, clinical nutrition products, and medical foods, reflecting their status as generally recognized as safe (GRAS). This review integrates knowledge on MCT metabolism, industrial production, clinical applications, and regulatory frameworks in Germany, Japan, and the United States, highlighting how regulatory environments influence the translation of MCTs from clinical nutrition toward broader preventive health strategies.