A Diet Rich in Medium-Chain Fatty Acids Improves Systolic Function and Alters the Lipidomic Profile in Patients With Type 2 Diabetes: A Pilot Study

J Clin Endocrinol Metab. 2016 Feb;101(2):504-12. doi: 10.1210/jc.2015-3292. Epub 2015 Dec 10.


Context: Excessive cardiac long-chain fatty acid (LCFA) metabolism/storage causes cardiomyopathy in animal models of type 2 diabetes. Medium-chain fatty acids (MCFAs) are absorbed and oxidized efficiently. Data in animal models of diabetes suggest MCFAs may benefit the heart.

Objective: Our objective was to test the effects of an MCFA-rich diet vs an LCFA-rich diet on plasma lipids, cardiac steatosis, and function in patients with type 2 diabetes.

Design: This was a double-blind, randomized, 2-week matched-feeding study.

Setting: The study included ambulatory patients in the general community.

Patients: Sixteen patients, ages 37-65 years, with type 2 diabetes, an ejection fraction greater than 45%, and no other systemic disease were included.

Intervention: Fourteen days of a diet rich in MCFAs or LCFAs, containing 38% as fat in total, was undertaken.

Main outcome measures: Cardiac steatosis and function were the main outcome measures, with lipidomic changes considered a secondary outcome.

Results: The relatively load-independent measure of cardiac contractility, S', improved in the MCFA group (P < .05). Weight-adjusted stroke volume and cardiac output decreased in the LCFA group (both P < .05). The MCFA, but not the LCFA, diet decreased several plasma sphingolipids, ceramide, and acylcarnitines implicated in diabetic cardiomyopathy, and changes in several sphingolipids correlated with improved fasting insulins.

Conclusions: Although a diet high in MCFAs does not change cardiac steatosis, our findings suggest that the MCFA-rich diet alters the plasma lipidome and may benefit or at least not harm cardiac function and fasting insulin levels in humans with type 2 diabetes. Larger, long-term studies are needed to further evaluate these effects in less-controlled settings.

Trial registration: ClinicalTrials.gov NCT01373814.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Blood Pressure / drug effects*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diet therapy*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetic Cardiomyopathies / blood
  • Diabetic Cardiomyopathies / diet therapy*
  • Diabetic Cardiomyopathies / physiopathology
  • Diet*
  • Double-Blind Method
  • Fatty Acids / therapeutic use*
  • Female
  • Heart Function Tests
  • Humans
  • Lipid Metabolism / drug effects*
  • Male
  • Middle Aged
  • Myocardial Contraction / drug effects
  • Pilot Projects
  • Prospective Studies
  • Stroke Volume / drug effects
  • Systole
  • Treatment Outcome


  • Fatty Acids

Associated data

  • ClinicalTrials.gov/NCT01373814