Minimal Fat Diet & Chylothorax

Cardiothoracic surgery comes with the potential for many complications, but one specific complication, the chylothorax, requires immediate, strict dietary restriction. A chylothorax is caused when the thoracic duct is injured. This injury causes a milky, lipid filled substance known as chyle to build up in the space around the lungs or pleural space. The recommended diet for treating a chylothorax is a very low fat or non-fat diet.

Chyle

Chyle is made up of cholesterol, triglycerides, protein, lymphocytes, fibrinogen and electrolytes. This milky substance is a product of digestion that travels through your lymphatic system. Due to the high fat content of this substance, a very low or non-fat diet is recommended to help decrease the flow of the lymphatic system.

Very-low Fat or Non-Fat Diet

The American Heart Association defines a very low fat diet as one that contains less than 15 percent of calories from fat sources. This means that if you follow a 2,000 calorie diet, only 33 grams of fat should consumed on a daily basis. Very low fat or non-fat diets can be very challenging to follow due to the large number of foods that contain fat. All meat, fish or poultry sources should be avoided, as well as egg yolks and fat-containing dairy products. It is important that you check the fat content on all food labels in order to maintain this diet restriction. Additional foods that should be avoided include nuts, desserts, breads and baked goods, fat-containing salad dressings and oils. A multivitamin and mineral supplement should be added to your diet. Due to the many foods that are being restricted, a vitamin and mineral supplement will help to ensure that you still consume the appropriate amounts of each micronutrient.

Foods to Include

While following a very low fat or non-fat diet, you should include fruits, vegetables, egg whites and non-fat dairy products such as skim milk. You may need to alter your preparation methods for these foods. Using a non-fat cooking spray to replace butter or oil is a safe cooking alternative. If you have trouble figuring out which foods to include or avoid, contact a registered dietitian for help.

Medium Chain Triglycerides

In addition to following this strict diet, your doctor may advise that you include a source of medium chain triglycerides. Medium chain triglycerides are a source of fat whose structure is short enough to be directly absorbed into portal blood. Although medium chain triglycerides are a source of fat, they bypass the lymphatic system, therefore they will not affect the chylothorax. Medium chain triglycerides can be purchased in a supplemental form known as MCT oil.