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.

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.

Food Insecurity and Perceived Effects of COVID-19 on Livelihoods in Rural Sri Lanka.

BACKGROUND: Little is known about how the COVID-19 pandemic has affected food security and livelihoods in Sri Lanka. OBJECTIVE: This article aims to assess food insecurity, perceived effects of COVID-19, and coping mechanisms among agriculture-based households in rural Sri Lanka. METHODS: We used 2 rounds of panel data from phone surveys (n = 1057 households) conducted in 5 districts. Food insecurity (30-day recall), perceived impacts of COVID-19 (6-month recall), and coping mechanisms (6-month recall) were assessed using a household questionnaire. To assess food insecurity, we used the 8-item Food Insecurity Experience Scale. We tested for differences between T1 (baseline: December 2020-February 2021) and T2 (follow-up: July 2021-September 2021) and explored the association between food insecurity and the perceived effect of COVID-19 on income using a logistic regression model. RESULTS: Food insecurity was highly prevalent (T1: 75%, T2: 80%) but varied across districts. Most respondents were affected by COVID-19 and/or COVID-19-associated mitigation measures (T1: 84%, T2: 89%). Among affected households, commonly reported impacts included those on income (T1: 77%, T2: 76%), food costs (T1: 84%, T2: 83%), and travel (∼90% in both rounds). Agricultural activities were also adversely affected (T1: 64%, T2: 69%). About half of COVID-19-affected households reported selling livestock or assets to meet basic needs. Households whose income was impacted by COVID-19 were more likely to be food insecure (adjusted odds ratio: 2.56, P < .001). CONCLUSIONS: Households in rural Sri Lanka experienced food insecurity and livelihood disturbances during the COVID-19 pandemic. Additional surveys are needed to assess recovery post-COVID-19 and to understand if programs that support livelihoods have been protective.

METHOD: This original article used household level survey data from 2 rounds of phone surveys conducted in 5 districts of Sri Lanka.Using a household-level questionnaire, we recorded experience of food insecurity in the last 30 days, perceived impact of COVID-19, and adopted coping mechanism in the 6 months prior to the survey.We reported statistical means and tested for differences between 2 survey rounds.We also explored association between food insecurity and the perceived effect of COVID-19 on income. RESULTS: Household-level food insecurity was highly prevalent during the pandemic.Households perceived a negative effect of the pandemic on their income and employment sources.Households whose income was impacted by the pandemic were more likely to be food insecure. CONCLUSION: Agriculture-based households in rural Sri Lanka experienced food insecurity and livelihood disturbances during the COVID-19 pandemic.Additional research is needed to assess recovery post COVID-19 and to understand whether livelihood support programs have been protective.

Plain language titleFood Insecurity and Perceived Effects of COVID-19 on Livelihoods in Rural Sri LankaPlain language summaryBackground: Sustained levels of high food insecurity are associated with a range of negative health, nutrition, and well-being effects.The COVID-19 pandemic is expected to aggravate food insecurity and worsen the livelihood situation.Little is known about how the COVID-19 pandemic affected food security and livelihoods of agriculture-based households in rural Sri Lanka.

Factors influencing the food choices of urban Sri Lankan preschool children: Focus groups with parents and caregivers.

Poor diet places children at significant risk of over and under-nutrition including micronutrient deficiencies, which is a public health threat to a middle-income country like Sri Lanka. Understanding factors that influence food choices in early childhood is necessary to promote healthy food choices. As parents are the main gatekeepers of children's food environment, this study aimed to explore parents/caregivers' perspectives on the factors that influence their children's food choices. Thirteen focus groups adopting a partial nominal group technique were conducted with 110 parents/caregivers of children aged 2-6 years living in an urban area, Kurunegala District, Sri Lanka. Parents/caregivers were provided with 22 potential factors and asked to rank six most influential and choose six least influential factors on their child's food decisions. Responses were discussed as a group and audio recorded discussions underwent content analysis. Child food preference was ranked as the core driving factor in food decisions of preschool children. Family income, nutritional knowledge of the family, maternal control of food choices and household food preparation facilities were ranked as the next four most influential. Most frequent choices of least influential factors were: individual characteristics of child including sex and nutritional knowledge; and community (environmental) characteristics including seasonal food availability and community cultural food beliefs. Additional influential factors proposed were having a single child, a supportive family network and healthy menu suggestions by the preschool centres. Findings suggest that modifying the food preference of the child and the family characteristics need to be central for effective eating interventions.

Potential of coconut oil and medium chain triglycerides in the prevention and treatment of Alzheimer's disease.

Alzheimer's disease (AD) is the most common form of dementia. Currently, there is no effective medication for the prevention or treatment of AD. This has led to the search for alternative therapeutic strategies. Coconut oil(CO) has a unique fatty acid composition that is rich in medium chain fatty acids(MCFA), a major portion of which directly reaches the liver via the portal vein, thereby bypassing the lymphatic system. Given that brain glucose hypometabolism is a major early hallmark of AD, detectable well before the onset of symptoms, ketone bodies from MCFA metabolism can potentially serve as an alternative energy source to compensate for lack of glucose utilisation in the brain. Additionally, neuroprotective antioxidant properties of CO have been attributed to its polyphenolic content. This review discusses how the metabolism of CO and MCFA may aid in compensating the glucose hypometabolism observed in the AD brain. Furthermore, we present the current evidence of the neuroprotective properties of CO on cognition, amyloid-ß pathogenicity, inflammation and oxidative stress. The current review addresses the influence of CO/MCFA on other chronic disorders that are risk factors for AD, and addresses existing gaps in the literature regarding the use of CO/MCFA as a potential treatment for AD.

Human plasma dynamically quenches the fluorescein at the initial point of oxygen radical absorption capacity (ORAC) assay.

OBJECTIVE: Oxygen radical absorbance capacity (ORAC) assay measures the quenching of fluorescent probe by peroxyl radicals. Antioxidants present in biological systems block the quenching of fluorescence probe. We experienced the dynamic quenching of fluorescein, the fluorescence probe used in ORAC assay by the human plasma while plasma ORAC assay was optimized. Therefore, for the first time, we report the quenching of fluorescein by human plasma at the initial point of ORAC assay. RESULTS: Aqueous whole and non-protein fractions of plasma were used in the analysis. Since the both fractions showed a similar pattern of quenching at the initial stage, quenched percentage of fluorescein was calculated and added to each sample in subsequent analysis. Addition of extra 20% fluorescein allowed plasma samples to quench the required amount of fluorescein and follow the normal decay curves afterwards. Further, change of fluorescein quenching (ΔF/F0) disclosed a dose dependent linear relationship with plasma (R2 = 0.8). It can be speculated that dynamic quenching exhibited by human plasma biomolecule/s at the initial stage would be of non-protein aqueous phase molecule/s. We suggest initiating further studies to detect, identify and quantify the fluorescein quenching biomolecules present in human plasma for further improvements in plasma ORAC assay.

Poor Glycaemic Control Is Associated with Increased Lipid Peroxidation and Glutathione Peroxidase Activity in Type 2 Diabetes Patients.

Glycaemic control is the main focus of managing diabetes and its complications. Hyperglycaemia induces oxidative stress favouring cellular damage and subsequent diabetic complications. The present study was conducted to compare the plasma total antioxidant capacity (TAC) and individual antioxidant marker antioxidant status of type 2 diabetics (T2D) with good ((+) GC) and poor ((-) GC) glycaemic control with prediabetic (PDM) and normoglycaemic (NG) individuals. T2D (n = 147), PDM (n = 47), and NGC (n = 106) were recruited as subjects. T2D and PDM had lower plasma TAG than NG subjects. T2D and PDM had significantly higher GPx activity and plasma MDA concentrations than NG. PDM showed the highest SOD activity. T2D (-) GC showed significantly elevated GPx activity and higher MDA level and significantly lower SOD activity among all study groups. Lower plasma TAC and higher plasma MDA indicate the presence of oxidative stress in T2D and PDM. Elevated GPx activity in T2D, PDM, and particularly in T2D (-) GC suggests a compensatory response to counteract excess lipid peroxidation in the hyperglycaemic state. Decline in SOD activity advocates the presence of glycation and excess lipid peroxidation in T2D.

Metformin in the Management of Childhood Obesity: A Randomized Control Trial.

BACKGROUND: Childhood obesity-related metabolic derangements are increasing among South Asian populations. Dietary and physical activity plans have limited effect. This study aims to assess the effectiveness of metformin in the management of obesity among 8- to 16-year-old children in Gampaha District of Sri Lanka. MATERIALS AND METHODS: A triple-blinded controlled trial was conducted on 150 obese school children. After 12-hour overnight fast, blood was drawn for fasting blood glucose (FBG) and lipid profile. Anthropometry, fat mass (FM), and blood pressure were measured. BMI and insulin resistance were calculated. Children randomly received either metformin (8-10 years-500 mg 12 hourly; 11-16 years-1 g 12 hourly) or placebo. Anthropometry and blood investigations were repeated at 6 and 12 months. Mean difference in outcome measures, adjusted for baseline values, was compared using ANCOVA. RESULTS: There were 84/150 boys. Metabolic syndrome was present in 25 (16.7%). A statistically significant adjusted mean reduction was observed in the metformin group compared with placebo, in weight (-0.991 vs. 1.394, p = 0.000), BMI/Age-standard deviation score (SDS; -0.287 vs. -0.116, p = 0.000), %FM/Age-SDS (-0.092 vs. 0.016, p = 0.04), systolic blood pressure (SBP; -0.415 vs. 0.015, p = 0.015), total cholesterol (-0.95 vs. -0.7, p = 0.001), low-density lipoprotein (-0.67 vs. -0.45, p = 0.001), and highly sensitive C-reactive protein (-1.36 vs. 0.08, p = 0.013) at 6 months, and in BMI/Age-SDS (-370 vs. -0.222, p = 0.001), WC/Age-SDS (-0.473 vs. -0.337, p = 0.018), SBP (-0.834 vs. -0.477, p = 0.023), and triglycerides (-0.33 vs. -0.14, p = 0.019) at 12 months. CONCLUSIONS: Metformin compared with placebo has beneficial effects on anthropometric and metabolic indicators in the management of childhood obesity.

A homogeneous chemiluminescent immunoassay method.

A new homogeneous chemiluminescent immunoassay method featuring the use of specific binding members separately labeled with an acridan-based chemiluminescent compound and a peroxidase is reported. Formation of an immunocomplex brings the chemiluminescent compound and the peroxidase into close proximity. Without any separation steps, a chemiluminescent signal is generated upon addition of a trigger solution, and the intensity is directly correlated to the quantity of the analyte.