Dietary Supplements for Cystic Fibrosis

Cystic Fibrosis

Cystic fibrosis is a disorder that is inherited and known to damage the lungs, the digestive system, and other vital organs of the body. Cystic fibrosis causes an impact on the cells that produce mucus, digestive juices, and sweat. These secreted fluids are usually thin and slippery, but in people suffering from cystic fibrosis, these secreted fluids become sticky and thick. Hence, instead of acting as a lubricant, the secretions often plug up the tubes, passageways, and ducts that are situated in the pancreas and lungs.

Nutrition and Calories

Those patients who are suffering from cystic fibrosis and take digestive enzymes have no issues in eating the same food as normal people, but they would also need to eat additional calories each day on an average basis than those who do not have cystic fibrosis. Eating such high caloric content food is very important for increasing and maintaining the weight. This would then provide them with energy. Also, apart from energy, if one has a good intake of food, it would also strengthen and promote the immune system and the muscles that are used for breathing. One can try to consider any of the following options for maintaining weight and getting enough calories and nutrition.

• MCTs: MCT oil is known to provide additional fats and calories. Also, the MCT oil is very much easy to digest without the help of enzymes. One can consult the doctor before consuming this oil.

• Nutritional drinks: These special nutritional drinks are made for those individuals who suffer from chronic illness or those who have nutritional deficiencies. These nutritional drinks are available at any of the grocery stores; hence, they are easily available. Many of these nutritional drinks are high in fats, calories, and proteins. There are also low-fat drinks available. You can check with the doctor on which nutritional drinks can be taken as per the underlying condition.

• Diet high in fat: To convert fat into energy the body uses less oxygen; thus, the impact on the lungs is less when digesting fat than when digesting carbohydrates or protein. Fat is also known to provide more calories than the other macro-nutrients. Those patients who are suffering from cystic fibrosis have to eat more fat than those people who are not suffering from this disease.

• Vitamin supplements: The fat soluble vitamins are vitamins A, D, E, and K. This would mean that they are only absorbed if one is eating and digesting enough fat. Those individuals who are suffering from cystic fibrosis lack the enzymes that are required for digesting and absorbing the fat. Hence, they may not get enough of these vitamins via the diet, for which they would need to consume vitamin supplements.

• Minerals: Since there are large amounts of sodium and chloride that get lost in the sweat, it is recommended to eat foods that have salt in moderate amounts. Salt tablets are usually not prescribed.

• Enzymes: Those people who are suffering from cystic fibrosis can take doses of pancreatic enzymes orally. It helps them to digest food better. The pancreatic enzymes help the body to absorb the nutrients that are available in the food. They help to reduce the amount and number of stools, the flatulence amount, pain in the abdomen, and distension.

It is very much important for a cystic fibrosis patient to keep tabs on the weight. If he or she is losing weight, then it would mean that he or she is not getting enough of all the nutrients that are essential for the body. Also, if the desired vitamins and nutrients are still not available in the body of the person suffering from cystic fibrosis, then it would have an impact on the overall health of the individual. He would need to go in for a feeding tube so that the essential nutrients and vitamins are made available in the body.

Medium-Chain Triglyceride

These are often abbreviated as MCT. By processing coconut and palm kernel oil, the MCT preparation is done. Partially, the fats in it are man-made. The name refers to the arrangement of carbon atoms in a chemical structure. This is done in a laboratory. The usual case of dietary fats is known as long chain triglycerides. MCT are often used by individuals as medicine.

MCT is a very unique form of dietary fat that provides a lot of health related benefits. Individual carbon atoms are linked into a chain that ranges from carbon atoms 2 to 22 in length present in the molecules of dietary fats. The predominant form of fat is the long chain fatty acid, which ranges from carbon atoms 12 to 18 in length. This fat is mostly present in the American fat. In case of MCTs, they are mostly comprised of six to ten carbon links. MCTs are known to have many unique properties due to the shorter length of the chain. This gives them an added advantage over the long chain fatty acids. 

Until the early times of 1980s, majorly MCTs were available as a constituent of butter, natural resources, and coconut oil. MCTs are used along with other medicines for treating disorders related to absorption of food, which include diarrhea, celiac disease, liver disease, and other problems related to digestion. They are also used for milky urine, which is a rare kind of lung disorder. In some cases, athletes also use MCTs for nutrition purposes that would help support their training. In addition to this, it is also used for decreasing the body fat and also increasing the lean muscle mass. MCTs are also used in some cases as a good source of fat.

The technical term for fat is 'triglyceride.' It has two main purposes in our body. The first purpose is to be transported into the cells, and the second one is that they are burned to obtain energy, or they can be stored in the form of fat in the body. Based on their chemical structure, they are named triglyceride, which defines specifically the length of the chain of fatty acids. They consist of glycerol molecules and three types of fatty acids.

How does MCT work?

For patients unable to tolerate other types of fats, MCTs are basically a source of fat for them. It has been revealed through studies that MCTs produce chemicals in the body that help to fight against Alzheimer's disease. Due to the shorter length of the chain of fatty acids, the MCTs are broken down rapidly and absorbed into the body. MCTs are known to go straight to the liver, unlike the longer chain fatty acids. They can be served as an instant source of energy in the liver or be served as ketones. Unlike the regular fatty acids, ketones cross through the blood and then enter the brain. This would help to provide an alternative source of energy to the brain, which would ordinarily use glucose for fuel. There are likely chances that MCTs would be stored as fat, since the calories present in MCTs are converted efficiently into energy used by the body.

MCT should be taken as directed by the physician. One should not increase or decrease the dosage limit unless recommended to do so. MCTs can be mixed in juice, salad, or veggies that are used in cooking, blending, or baking. If one is having MCT liquid supplement, then shake it well before the use of the product. MCT should be stored at room temperature away from heat and moisture. The usual adult dose of MCT is 15ml orally at least three to four times in a day.

Sources

MCTs are those saturated fats that contain 8 to 12 carbons. Usually, the fatty acids go through a special digestive process. This enables them to travel through the bloodstream and reach the tissues that would metabolize them or use them as fat. In such instance, MCTs are different. They get easily absorbed, after which they are metabolized in the liver for the purpose of energy.

Caprylic acid, capric acid, and lauric acid are the three types of MCTs. They are available in a variety of vegetable and animal fats. They are easily obtained. A few of the sources may contain higher amounts of MCTs.

Whole food sources - These would contain coconut oil, dairy products, and palm kernel oil. These foods are the richest source of MCTs.

• Coconut Oil and Palm Kernel Oil: These are rich in MCTs. In about one table spoon of oil, 11 grams of saturated fat are present. From one tablespoon of palm kernel oil, one can get 7.4 grams of MCTs out of the total saturated fat and somewhere around 7.9 grams from the coconut oil. Both these oils are commonly used in cooking various foods or snack items. They are also used in preparing sweets, baked items, or non-dairy products. Check the label of ingredients to see whether MCTs are present when you purchase food from stores.

• Dairy products: Milk is known to be a natural source of MCTs. However, the question here is how much MCT is present. This would rather depend on whether the milk is low fat or whole. A cup of whole milk contains 0.55 grams of MCT. The skimmed milk or low fat milk barely contains any traces of MCT. One slice of cheddar cheese contains 0.4 grams of MCT, whereas one tablespoon of butter would contain one gram of MCT. Milk, butter, and cheese all contain five to seven grams of saturated fat, so the artery clogging fats exceed in comparison with the MCTs.

Prepared food vs home cooked food: The foods that are prepared commercially or those that are not prepared at home tend to contain more MCTs than home cooked meals. If the amount of total fats and saturated fats is higher, then the amount of MCTs is also higher.

MCT Oil: One of the highly concentrated sources of medium chain triglycerides is the MTC oil. It is prepared through a process called fractionation; hence it is something made by man. Extraction and isolation of MCTS from coconut or palm kernel oil are the two main processes involved in the fractionation process. MCT oil can either contain 100 percent caprylic, capric acid 100 percent, or a combination of both. Due to the unpleasant smell and taste, caproic acid is not included during the preparation of MCT oil. Lauric acid is either present in smaller quantities or it is not present at all. Since the coconut oil has the main component as lauric acid, one should be wary of those manufacturers who try to market MCT oil saying it’s a liquid coconut oil. This can often be very misleading. The effect of lauric acid on the quality of MCT oil is still being argued. It is still not clear whether lauric acid enhances or reduces the quality of MCT. Since MCT oil consists of capric acid and caprylic acid, and because it quickly gets absorbed and processed for energy production as compared to lauric acid, many experts feel that MCT oil is far better than the traditional coconut oil. The debate continues. 

The choice of the best source of MCT would depend upon the goal and the amount of medium chain triglycerides one would need to consume. It is still not clear as to how much is required to obtain the absolute benefits of MCT. Certain studies suggest that the doses can range from 5 to 70 grams of daily MCT. MCT oil does not have any peculiar taste or smell of its own; hence, it can be directly mixed on salad as dressing or in any food or drinks, or it can be directly consumed from the jar. By using coconut oil or palm kernel oil, the ultimate aim of maintaining overall good health can be achieved.

Side effects

If there are any allergy signs, such as swelling of the face, tongue, lips, or throat, irregular breathing, or hives, then get emergency treatment.

One should not consume MCT or inform the doctor about any of the conditions before consuming products or supplements containing MCT:

• Liver disease or cirrhosis
• High blood pressure, which can happen inside the liver
• Complications in the brain or nervous system that could be caused by damage to the liver