ey Goals of Nutritional Therapy

Prevent fasting-induced hypoglycemia

Avoid reliance on long-chain fat metabolism

Provide safe alternative energy sources

Support normal growth and physical activity

Reduce the risk of rhabdomyolysis & metabolic decompensation

1. Frequent Meals & Avoiding Fasting

People with LCAD cannot efficiently use fat stores during fasting, so the blood sugar can drop quickly.

Recommendations

Eat regular meals and snacks every 2–3 hours during the day.

Never skip meals.

Infants may need night feeds, or continuous overnight feeding.

During illness, consider higher-carb intake or emergency regimen to prevent catabolism.

2. High-Carbohydrate, Moderate-Protein Diet

Why?

Carbohydrates provide the safest and easiest fuel source.

Protein supports growth and prevents muscle breakdown.

Examples

Rice, yam, potatoes, pasta, bread

Cereals, oats, porridge

Fruits (banana, mango, apple)

Moderate protein: fish, eggs, chicken, beans

Avoid high-fat options unless prescribed.

People with LCAD cannot process long-chain fatty acids efficiently.

Foods to reduce or avoid

Fatty meats (pork, mutton, skin-on chicken)

Full-fat milk, cheese, butter

Creamy soups/sauces

Deep-fried foods

Pastries high in butter/oils

Palm oil, groundnut oil (use minimal amounts)

4. Medium-Chain Triglyceride (MCT) Supplementation

MCT oil provides rapid, usable energy because it bypasses the blocked LCAD pathway.

Possible forms:

MCT oil mixed into foods

Specialized medical formulas (MCT-based)

Benefits

Prevents muscle breakdown

Supports exercise tolerance

Provides safe energy during fasting or illness

Note: Must be used under the guidance of a metabolic specialist.

5. Essential Fatty Acids Supplementation

Because long-chain fats are restricted, patients may miss key fatty acids like omega-3 and omega-6.

Sources (controlled amounts):

Fortified formulas

Prescribed DHA/EPA supplements

6. Emergency (“Sick Day”) Nutrition Plan

During infections, vomiting, or surgery:

Increase carbohydrate intake (glucose drinks, oral rehydration, juices)

Avoid long fasting

Hospital glucose drip may be needed

Stop physical exertion completely

7. Exercise Guidance

Physical activity is allowed when well-fed, but:

Avoid prolonged, strenuous exercise

Carbohydrate-rich snack before activity

Stop immediately if muscle pain or fatigue occurs

Sample Daily LCAD-Friendly Meal Plan

Breakfast

Oats + banana + small amount of low-fat milk

Bread with jam

Snack

Fruit juice or biscuits

Lunch

Rice with lean chicken

Steamed vegetables (no added oil)

Snack

Crackers + fruit

Dinner

Pasta with tomato sauce

Beans or grilled fish (no frying)

Optional

Doctor-prescribed MCT added in small measured amounts to meals.

Conclusion

Nutritional management of LCAD focuses on:

High carbs, controlled fats

Avoiding fasting

Safe fat replacement with MCT

Protection during illness

Maintaining stable energy levels

With consistent dietary planning, individuals with LCAD can live healthy, active lives while minimizing metabolic risks.