GASTROINTESTINAL TOLERANCE, FAT-ABSORPTION, PLASMA KETONE AND URINARYDICARBOXYLIC-ACID LEVELS IN LOW-BIRTH-WEIGHT INFANTS FED DIFFERENT AMOUNTS OF MEDIUM-CHAIN TRIGLYCERIDES IN FORMULA

This study was conducted to evaluate the effect of medium-chain trigly cerides (MCT) in a formula for low-birth-weight (LBW) infants on gastr ointestinal tolerance, fat absorption, plasma ketone levels, and urina ry dicarboxylic acid (DCA) excretion. At the start of enteral feedings , 64 LBW infants (less-than-or-equal-to 1500 g) were randomly assigned to one of four experimental formulas. The formulas contained either 0 , 17, 34, or 50% of the total fat as MCT oil. The nonfat constituents of all four formulas were the same and identical to Similac Special Ca re 24 (SCF). Infants were studied from the start of enteral feeding un til approximately 7 days after reaching full feeds. Growth and toleran ce were assessed in all infants over the entire feeding period. A 48-h balance study was conducted after enteral intake exceeded 100 kcal/kg /day for 3 days. Stool fat, plasma D-(-)-3-hydroxybutyrate (3HB) and c arnitine, serum glucose, and urinary DCA levels were determined. Group s did not differ in growth, formula intake, fat absorption (76-84%), s erum glucose, or plasma carnitine levels. Gastrointestinal tolerance w as excellent and did not differ among groups. Plasma 3HB was significa ntly different (p < 0.05) only between the 0 and 50% MCT groups, 50 +/ - 10 versus 120 +/- 20 muM, respectively. The excretion of urinary DCA s increased with increasing amounts of MCT in the formula. In conclusi on, fat absorption and gastrointestinal tolerance were not affected by different MCT levels (0 to 50% of the total fat), but higher levels o f plasma 3HB and urinary DCAs were associated with higher levels of MC T in the LBW formulas studied.