Use of MCT Oil for Enhancement of Weight Loss in Obese Patients

NCT00207272 | Completed

• 1 other identifier: H-24641
• Study Type: interventional
• Target: 24
• Locations: 1 country
• Sites: 1

Brief Summary

Twelve obese patients approved for gastric bypass surgery will be randomized to either receive an MCT-based or LCT-based liquid diet for a 4 week period. These diets will be identical except for the quality of the fat. The intervention will be double-blinded. Six patients will receive a daily diet consisting of 5 liquid meals using the HMR 800 meal replacement product (Health Management Resources, Inc; 160 calories/shake) with 44.5 grams MCT oil (Life Enhancement Products, Inc., Petaluna, CA; 8.3 kcal/gm) added. Six patients will receive the same HMR diet but with 41 grams LCT oil (corn oil; 9 kcal/gm) added. Patients in both groups will be given a list of supplemental foods that are suitable for the study. They may choose to eat up to an additional 700 kcal per day from this list and will be asked to complete food records for monitoring of their caloric intake. Patients will undergo gastric bypass surgery after 4 weeks of being on their diets. Patients in both groups will be seen weekly by a registered dietitian and a physician. Blood pressure and weight will be recorded, and any adverse events will be noted and cared for as is appropriate. Dietary instruction will be reviewed as needed.Both diets will be 1170-1870 kcal/day, consisting of 36% CHO, 26.2% protein, and 37.6% fat. The MCT diet will contain 30.2% of total calories at MCT oil. The percentages given are based on the shake and oil consumption only (1170 kcal/day). The remainder of the diet will vary according to patients' selections from the list of permitted foods, up to an additional 700 kcal/day (for the total 1870 kcal/day). All subjects will receive a multi-vitamin each day. Subjects will also receive two Fibercon capsules per day to prevent possible bowel changes associated with being on a full liquid diet. During surgery, biopsies of visceral and omental adipose tissue, as well as subcutaneous abdominal adipose tissue, will be obtained. Tissue will be analyzed to determine mRNA levels of key enzymes in fatty acid esterification, lipolysis, and oxidative disposition. This preliminary phase will be conducted to determine whether visceral, omental, and subcutaneous abdominal adipose tissue behave similarly when exposed to an MCT-based diet.

Conditions

Obesity; Weight Loss

Keywords

Hypocaloric MCT oil liquid diet; Hypocaloric LCT oil liquid diet; Visceral and omental adipose tissue; Subcutaneous abdominal adipose tissue; Gastric bypass surgery

Outcome Measures

Primary Outcomes (1)

• To determine if the influence that MCFA have on the expression of genes that modulate lipid metabolism in adipose tissue is the same regardless of adipose fat depot

Interventions

1170-1870 kcal/day liquid diet BEHAVIORAL

Gastric bypass surgery PROCEDURE

Biopsy.visceral adipose tissue PROCEDURE

Biopsy.omental adipose tissue PROCEDURE

Biopsy. subcutaneous abdominal adipose tissue PROCEDURE

Blood sample PROCEDURE

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Approved for gastric bypass surgery
• Age: 18-65 years
• Gender: Male and female
• BMI: \>40 kg/m2 or \>35 kg/m2
• Obesity associated co-morbidities
• Race: All

You may not qualify if:

• Those that are a part of the normal standard of care in the pre-selection process for approval of surgery
• Clinically severe lactose intolerance
• Alcohol dependence
• Egg allergy.

Sponsors & Collaborators

• Boston Medical Center: lead

Study Sites (1)

Boston University Medical Center

Boston, Massachusetts, 02118, United States

Location

Related Publications (10)

• Baba N, Bracco EF, Hashim SA. Enhanced thermogenesis and diminished deposition of fat in response to overfeeding with diet containing medium chain triglyceride. Am J Clin Nutr. 1982 Apr;35(4):678-82. doi: 10.1093/ajcn/35.4.678.

  PMID: 7072620 BACKGROUND

• Guo W, Choi JK, Kirkland JL, Corkey BE, Hamilton JA. Esterification of free fatty acids in adipocytes: a comparison between octanoate and oleate. Biochem J. 2000 Jul 15;349(Pt 2):463-71. doi: 10.1042/0264-6021:3490463.

  PMID: 10880345 BACKGROUND

• Geliebter A, Torbay N, Bracco EF, Hashim SA, Van Itallie TB. Overfeeding with medium-chain triglyceride diet results in diminished deposition of fat. Am J Clin Nutr. 1983 Jan;37(1):1-4. doi: 10.1093/ajcn/37.1.1.

  PMID: 6849272 BACKGROUND

• Bray GA, Lee M, Bray TL. Weight gain of rats fed medium-chain triglycerides is less than rats fed long-chain triglycerides. Int J Obes. 1980;4(1):27-32.

  PMID: 7390698 BACKGROUND

• Han J, Farmer SR, Kirkland JL, Corkey BE, Yoon R, Pirtskhalava T, Ido Y, Guo W. Octanoate attenuates adipogenesis in 3T3-L1 preadipocytes. J Nutr. 2002 May;132(5):904-10. doi: 10.1093/jn/132.5.904.

  PMID: 11983812 BACKGROUND

• Krotkiewski M. Value of VLCD supplementation with medium chain triglycerides. Int J Obes Relat Metab Disord. 2001 Sep;25(9):1393-400. doi: 10.1038/sj.ijo.0801682.

  PMID: 11571605 BACKGROUND

• Tsuji H, Kasai M, Takeuchi H, Nakamura M, Okazaki M, Kondo K. Dietary medium-chain triacylglycerols suppress accumulation of body fat in a double-blind, controlled trial in healthy men and women. J Nutr. 2001 Nov;131(11):2853-9. doi: 10.1093/jn/131.11.2853.

  PMID: 11694608 BACKGROUND

• Bendixen H, Flint A, Raben A, Hoy CE, Mu H, Xu X, Bartels EM, Astrup A. Effect of 3 modified fats and a conventional fat on appetite, energy intake, energy expenditure, and substrate oxidation in healthy men. Am J Clin Nutr. 2002 Jan;75(1):47-56. doi: 10.1093/ajcn/75.1.47.

  PMID: 11756059 BACKGROUND

• Papamandjaris AA, White MD, Raeini-Sarjaz M, Jones PJ. Endogenous fat oxidation during medium chain versus long chain triglyceride feeding in healthy women. Int J Obes Relat Metab Disord. 2000 Sep;24(9):1158-66. doi: 10.1038/sj.ijo.0801350.

  PMID: 11033985 BACKGROUND

• St-Onge MP, Jones PJ. Physiological effects of medium-chain triglycerides: potential agents in the prevention of obesity. J Nutr. 2002 Mar;132(3):329-32. doi: 10.1093/jn/132.3.329.

  PMID: 11880549 BACKGROUND

MeSH Terms

Conditions

Obesity; Weight Loss

Interventions

Blood Specimen Collection

Condition Hierarchy (Ancestors)

Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Body Weight Changes

Intervention Hierarchy (Ancestors)

Specimen Handling; Clinical Laboratory Techniques; Diagnostic Techniques and Procedures; Diagnosis; Punctures; Surgical Procedures, Operative; Investigative Techniques

Study Officials

• Caroline Apovian, MD

  Boston University Medical Cneter

  PRINCIPAL INVESTIGATOR

• Sherman Bigornia

  Boston University

  STUDY CHAIR

• James Kirkland, MD,PhD

  Boston University

  STUDY CHAIR

• Peter Burke, MD

  Boston University

  STUDY CHAIR

• Wen Guo, PhD

  Boston University

  STUDY CHAIR

• Robert Forse, MD

  Boston University

  STUDY CHAIR

• Diana Cullum-Dugan, RD,LD

  Boston University

  STUDY CHAIR

• Donald Hess

  Boston University

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: September 13, 2005
• First Posted: September 21, 2005
• Study Start: July 1, 2003
• Primary Completion: February 1, 2008
• Study Completion: February 1, 2008
• Last Updated: May 26, 2008

Record last verified: 2008-03

Locations

US (1)