Energy Expenditure in Preterm Infants Supplemented With Canola Oil Versus Medium-Chain Triglyceride Oil

Objective. To test the hypothesis that intestinal fat losses and energy expenditure (EE) are lower in preterm infants (PTIs) supplemented with medium-chain triglyceride (MCT) oil than in those supplemented with canola oil (CO). Design/Methods. A total of 6 PTIs were studied in a randomized, crossover design. Gestational age was 28 to 34 weeks, and birth weight was 920 to 1269 g. Infants were randomized to supplementation with either 34 kcal (4 g) CO per kg per day or 34 kcal (4.4 g) MCT oil per kg per day for 3 days followed by 3 days of the other oil. EE was measured at baseline, after 3 days of the first oil supplementation, and after 3 days of the alternate oil supplementation based on indirect calorimetry. Also, 72-hour stool samples were collected. Results. The coefficient of added fat absorption was 99.5% ± 0.9% of the MCT oil versus 90.0% ± 16.2% of the CO (P = .056). EE increased after CO supplementation by 4.33 ± 5.96 kcal/kg/d and by 4.17 ± 3.97 kcal/kg/d after MCT (nonsignificant). Thus, after correction for net additional energy intake, energy retained from 34 kcal/kg of added fat was 26.1 ± 6.9 kcal/kg/d after CO and 30.1 ± 5.0 kcal/kg/d after MCT (P = .09). Conclusions. MCT oil may be better absorbed than CO in growing PTIs. The metabolic cost of absorption of MCT oil and CO are similar.