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

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 rel...