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Impairment of intestinal fat digestion and absorption constitutes one of the principal manifestations of cystic fibrosis of the pancreas (1, 2). It has been reported that in these patients, triglycer-ides of shorter chain fatty acids appear to be more completely absorbed than those containing fatty acids with chain lengths longer than 12 carbon atoms (3, 4). After medium chain triglyceride preparations (MCT), which contain principally caprylic (C8: 0) and capric (C10: 0) acids with less than 5% of C12 and longer chain acids,' became available , several investigators found them useful in the management of various types of steatorrhea (5-7). This paper reports on the effect of MCT feeding upon 1) the plasma lipid levels, 2) the fatty acid compositions of the major plasma lipid fractions and the depot fat, and 3) the fecal fat loss and the nutritional status of children with cystic fibrosis of the pancreas. Methods Subjects. Two groups of children who presented typical clinical and laboratory findings of cystic fibrosis of * the pancreas were used in this study. Group 1 consisted of ten children ranging in age from 1 to 11 years. Group 2 contained four young infants from 1i to 5 months of age. Pancreatic insufficiency in these children was established by tryptic activity of the duodenal juice and stool fat determinations. For comparison with patients in group 1, we studied blood and depot fat lipids of ten other age-matched children who showed no clinical or laboratory evidence of disturbance in fat digestion and absorption but were convalescing in the hospital from various medical and surgical conditions and consuming a regular mixed diet. Diet, MCT feedings, and blood, depot fat, and stool samples. During the control period, older children with cystic fibrosis of the pancreas (group 1) and children in the control group received a regular hospital diet consisting of three meals supplemented with 8 ounces of milk with each meal and an extra 8 ounces at 8 p.m. Four cystic fibrosis infants in group 2, 11 to 5 months old, were fed five times a day with a standard cow's milk formula diet and three supplements of mixed baby food. Two or three blood samples (after a 10-to 12-hour fast) and subcutaneous fat aspirations were taken from each child during this initial period. A 72-hour stool collection was also obtained from each patient. In the MCT feeding period, cow's milk supplement and the …

The effect of medium chain triglyceride upon fat absorption and plasma lipid and depot fat of children with cystic fibrosis of the pancreas.