Browsing by Author "Fernando, M.G."

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Effect of virgin coconut oil supplementation on cognition of individuals with mild-to-moderate alzheimer's disease in Sri Lanka (VCO-AD study): A randomized placebo-controlled trial
(IOS Press, 2023) Fernando, M.G.; Silva, R.; Fernando, W.M.A.D.B.; de Silva, H.A.; Wickremasinghe, A.R.; Dissanayake, A.S.; Sohrabi, H.R.; Martins, R.N.; Williams, S.S.
BACKGROUND: Virgin coconut oil (VCO) is a potential therapeutic approach to improve cognition in Alzheimer’s disease (AD) due to its properties as a ketogenic agent and antioxidative characteristics. OBJECTIVE: This study aimed to investigate the effect of VCO on cognition in people with AD and to determine the impact of apolipoprotein E (APOE) ɛ4 genotype on cognitive outcomes. METHODS: Participants of this double-blind placebo-controlled trial (SLCTR/2015/018, 15.09.2015) were 120 Sri Lankan individuals with mild-to-moderate AD (MMSE = 15-25), aged > 65 years, and they were randomly allocated to treatment or control groups. The treatment group was given 30 mL/day of VCO orally and the control group, received similar amount of canola oil, for 24 weeks. The Mini-Mental Sate Examination (MMSE) and Clock drawing test were performed to assess cognition at baseline and at the end of the intervention. Blood samples were collected and analyzed for lipid profile and glycated hemoglobin (HbA1 C) levels.∥ RESULTS: There were no significant difference in cognitive scores, lipid profile, and HbA1 C levels between VCO and control groups post-intervention. The MMSE scores, however, improved among APOE ɛ4 carriers who had VCO, compared to non-carriers (2.37, p = 0.021). APOE ɛ4 status did not influence the cognitive scores in the control group. The attrition rate was 30%.∥ CONCLUSION: Overall, VCO did not improve cognition in individuals with mild-to-moderate AD following a 24-week intervention, compared to canola oil. However, it improved the MMSE scores in APOE ɛ4 carriers. Besides, VCO did not compromise lipid profile and HbA1 C levels and is thus safe to consume.
Nutrition of patients with mild-to-moderate Alzheimers disease using the Mini Nutritional Assessment (MNA)
(Sri Lanka Medical Association., 2019) Fernando, M.G.; Silva, K.D.R.R.; de Silva, M.P.; Obadaarachchi, L.N.; Yalegama, L.L.W.C.; Dissanayake, A.S.; Williams, S.S.
INTRODUCTION & OBJECTIVES: Focus on the nutrition of patients with Alzheimer's disease is limited despite the need for optimization of overall patient health to improve well being and outcome. The objective of this study was to look at the nutrition and energy intake of patients with mild to moderate dementia. METHODS: Sixty patients with mild-to-moderate AD (Mini Mental State Examination score: 12-25; male:28; female: 32; age >65 years) were recruited from the clinics at the North Colombo Teaching Hospital, Ragama and Lanka Alzheimer's Foundation as part of the VCO-AD study, after informed consent. Baseline nutritional status was assessed by a Mini Nutritional Assessment (MNA) tool and dietary intake via a 24-hour dietary recall. RESULTS: The total energy intake of the study population (men: 1822±645 kcal/day, women: 1380±346 kcal/day) was lower than recommended standards. The percentage energy from fat, protein and carbohydrates (30.7±7.6%, 12.7±2.7%, and 56.8±8.7%, respectively) met recommendations. The energy intake from saturated fat (19.7±6.9%) however was higher than the recommendation. Vitamin C, D, E, folate, calcium, potassium, selenium and iodine intake (37.4±30.4 mg/day, 2.2±3.1 µg/day, 2.4±1.4 mg/day, 219±125 µ/day, 483.8±230.8 mg/day, 1853.9±590.8 mg/day, 38.1±22.7 µg/day, and 59.8±35.4 µg/day respectively) was lower than the estimated average requirements (EAR). MNA results showed that 20% were at risk of malnutrition. CONCLUSION: A higher saturated fat intake and lower vitamin intake were concerns in this population of patients with mild to moderate dementia.
The role of virgin coconut oil in the treatment of alzheimer's disease
(University of Kelaniya, 2021) Fernando, M.G.
Alzheimer disease (AD) is the most common cause of dementia and one of the leading causes of morbidity and mortality in aging population. Virgin coconut oil (VCO) is an emerging approach to improve cognition of AD patients. This double-blind placebo- controlled trial was designed to investigate the effect of VCO on memory and cognition of mild-to-moderate AD patients and to investigate the association of Apolipoprotein E (APOE) genotypes on the outcome. Subjects were 120 Sri Lankan mild-to-moderate AD patients aged >65 years and were randomly allocated to the treatment and control groups. Treatment group was fed 30 mL/ day of VCO and control group with a same amount of canola oil for 24 weeks. Memory and cognition were assessed by Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MOCA), and executive clock drawing task (CLOX) at the baseline and at the end of the intervention. Blood samples were collected and lipid profile and HbAlC at the baseline and at the post- intervention were analyzed. APOE genotype tests were performed. There was no significant difference in changes of memory scores, lipid profile and HbAlC between the treatment and control groups. However, MMSE scores were improved among A POE-4 carriers compared to the non-carriers (2.37, p=0.021) who had VCO, whereas APOE-4 status did not influence the memory scores of patients who had canola oil. In conclusion, oral supplementation with VCO for 24 weeks did not result an improvement in MMSE and MOCA scores in patients with mild-moderate AD compared to canola oil. However, intervention with VCO improved MMSE scores in patients who had APOE-4 allele compared to those did not have it. VCO supplementation did not compromise fasting lipid profile and HbAlC.