Influence of Carbohydrate Intake on Caprylic Acid (C8:0)-Induced Ketogenesis-A Systematic Review and Meta-Analysis

Area of Science:

• Nutritional Science
• Metabolic Research
• Biochemistry

Background:

• The ketogenic diet, particularly using medium-chain triglycerides (MCTs) like caprylic acid (C8), is vital for managing conditions such as drug-resistant epilepsies.
• Caprylic acid (C8) is a key compound in MCTs that effectively promotes ketogenesis, the metabolic process of ketone body production.

Purpose of the Study:

• To systematically review and analyze the impact of concurrent carbohydrate intake on caprylic acid (C8)-induced ketogenesis.
• To investigate the relationship between C8 dosage, carbohydrate consumption, and subsequent ketone production.

Main Methods:

• A systematic literature search was conducted on PubMed and Web of Science, adhering to PRISMA guidelines.
• Included studies focused on metabolic responses to C8-containing MCT interventions with carbohydrate intake, excluding full ketogenic diets.
• Data from 7 trials (4 RCTs) were assessed for quality (RoB II) and meta-analyzed using Cochrane RevMan software.

Main Results:

• Ketone production was significantly lower when caprylic acid (C8) was administered with carbohydrates compared to C8 alone.
• Analysis indicated a heterogeneous dataset, suggesting a non-linear relationship between C8, carbohydrate intake, and ketone levels.
• No significant difference in ketogenic effect was observed between lower (11 g) and higher (19 g) C8 doses.

Conclusions:

• Concurrent carbohydrate intake attenuates C8-induced ketogenesis.
• The interaction between caprylic acid and carbohydrates on ketone production is complex and non-linear.
• Further research is necessary to elucidate the effects of various carbohydrates on C8-mediated ketogenesis, considering limitations like intervention heterogeneity.