title: 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.
abstract: BACKGROUND
  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.
  
  
  METHODS
  This was a double-blind, randomized, 2-week matched-feeding study.
  
  
  METHODS
  The study included ambulatory patients in the general community.
  
  
  METHODS
  Sixteen patients, ages 37-65 years, with type 2 diabetes, an ejection fraction greater than 45%, and no other systemic disease were included.
  
  
  METHODS
  Fourteen days of a diet rich in MCFAs or LCFAs, containing 38% as fat in total, was undertaken.
  
  
  METHODS
  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.
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Sophia
authors.initials: S
authors.lastname: Airhart
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: W Todd
authors.initials: WT
authors.lastname: Cade
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Hui
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Coggan
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Racette
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Kevin
authors.initials: K
authors.lastname: Korenblat
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Catherine Anderson
authors.initials: CA
authors.lastname: Spearie
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Waller
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Robert
authors.initials: R
authors.lastname: O'Connor
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Adil
authors.initials: A
authors.lastname: Bashir
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Ory
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Jean E
authors.initials: JE
authors.lastname: Schaffer
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Eric
authors.initials: E
authors.lastname: Novak
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Marsha
authors.initials: M
authors.lastname: Farmer
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Alan D
authors.initials: AD
authors.lastname: Waggoner
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Víctor G
authors.initials: VG
authors.lastname: Dávila-Román
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Cylen
authors.initials: C
authors.lastname: Javidan-Nejad
authors.affiliation: Department of Medicine (S.A.), Program in Physical Therapy (W.T.C., S.B.R.), Diabetic Cardiovascular Disease Center (H.J., D.S.O., J.E.S., M.F.), Mallinckrodt Institute of Radiology (A.R.C., R.O'C., A.B., C.J.-N.), Gastroenterology Division (K.K., C.A.S., S.W.), Lifestyle Intervention Research Core, Cardiology Division (A.D.W., V.G.D.-R., L.R.P.), Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Linda R
authors.initials: LR
authors.lastname: Peterson
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000178:diet therapy* / Q000503:physiopathology; D058065:Diabetic Cardiomyopathies / Q000097:blood / Q000178:diet therapy* / Q000503:physiopathology; D004032:Diet; D004311:Double-Blind Method; D005227:Fatty Acids / Q000627:therapeutic use*; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects; D010865:Pilot Projects; D011446:Prospective Studies; D013318:Stroke Volume / Q000187:drug effects; D013599:Systole; D016896:Treatment Outcome
chemical_list: D005227:Fatty Acids