Sains Malaysiana 50(12)(2021): 3683-3691

http://doi.org/10.17576/jsm-2021-5012-18

A Randomized Controlled Trial on the Effect of VCO in Reducing Glucose and Body Weight in Post-Acute Coronary Syndrome Patients: A Pilot Study

(Ujian Terkawal Rawak terhadap Kesan VCO dalam Mengurangkan Glukosa dan Berat Badan pada Pesakit Sindrom Koronari Pascaakut: Suatu Kajian Perintis)

SHARIFAH SHAFINAZ BINTI SH ABDULLAH^1,2, MEI CHAN CHONG¹*, KHATIJAH LIM ABDULLAH², IMRAN ZAINAL ABIDIN³ & BEE WAH YAP⁴

¹Nursing Department, Faculty of Medicine, University of Malaya, Jalan Universiti, 50603 Kuala Lumpur, Wilayah Persekutuan, Malaysia

²Department of Nursing, School of Medical and Life Sciences, Sunway University, Jalan Universiti, Bandar Sunway, 47500 Petaling Jaya, Selangor Darul Ehsan, Malaysia

³Medical Department, Faculty of Medicine, University of Malaya, Jalan Universiti, 50603 Kuala Lumpur, Wilayah Persekutuan, Malaysia

⁴Faculty of Computer and Mathematical Sciences, Universiti Teknologi MARA, 40450 Shah Alam, Selangor Darul Ehsan, Malaysia

Received: 1 May 2020/Accepted: 24 March 2021

ABSTRACT

The aims of this paper were to determine the effect of virgin coconut oil (VCO) on bodyweight and serum glucose level among acute coronary syndrome (ACS) patients. Various clinical trials on animal studies have found that the VCO has many beneficial effects on health. However, there have been limited published human studies on the pharmacological properties of VCO. Investigation on human subjects is extremely required in order to provide more empirical evidence to show the effect of VCO for ACS patients. Randomised single blind study conducted between March 2018 and April 2018. RCT was conducted among 70 ACS patients for 30 days. Participants in group A received their bottles containing 100 pieces of virgin coconut oil soft gels and were required to ingest 10 capsules per day (5 mL/5 gm) and continue routine treatment (diabetic diet and diabetic medication). Group B participants continued receiving routine treatment. Changes in serum fating blood sugar and body weight were identified using a paired t-test and independent t-test. A total of 70 patients participated with ages of 51 years old and older and were mostly male. The serum FBS and body weight of the intervention group that received VCO were reduced about 13.6% on day 30, from the baseline on day 1. They also had body weight reduction of about 2% with p value of less than 0.05. In contrast, the control group that only received routine treatment showed an increment of 12.1% in their serum FBS and had no changes in body weight. These reductions were noted within 30 days of consuming a daily dose of VCO (5 g every day). The properties of lauric acid and antioxidants present in the VCO composition were key players in the reduction of serum glucose levels and body weight. VCO can reduce serum glucose levels and body weight with 5 mL (5 g) of VCO per day for 30 days. Also, VCO may have a positive effect towards the glucose level and other cardiovascular risk factors.

Keywords: Acute coronary syndrome; diabetes mellitus; medium chain triglyceride; virgin coconut oil

ABSTRAK

Kajian ini bertujuan untuk melihat keberkesanan minyak kelapa dara ke atas serum glukosa dan berat badan dalam kalangan pesakit sindrom koronari akut (SKA). Kajian ke atas haiwan mendapati minyak kelapa dara mempunyai beberapa kesan kepada kesihatan. Walau bagaimanapun, kajian keberkesanan minyak kelapa dara ke atas manusia adalah terhad. Penyelidikan keberkesanan minyak kelapa dara terhadap manusia adalah diperlukan untuk menyediakan lebih bukti empirik terhadap kesan minyak kelapa dara kepada pesakit SKA. Ujian terkawal rawak buta tunggal telah dijalankan pada Mac 2018 sehingga April 2018. RCT telah dijalankan ke atas 70 orang pesakit SKA selama 30 hari. Peserta daripada kumpulan A telah diberi satu botol yang mengandungi 100 biji kapsul minyak kelapa dara dan perlu mengambil 10 kapsul sehari (5 mL/5 gm) serta meneruskan rutin perawatan (diet dan ubat diabetik). Peserta daripada kumpulan B pula meneruskan rutin perawatan seperti biasa. Perubahan pada serum glukosa dan berat badan dikenal pasti dengan menggunakan analisis ujian t berpasangan dan ujian t tak bersandar. Seramai 70 peserta kajian kebanyakannya terdiri daripada peserta lelaki dan berusia dalam lingkungan 51 tahun dan lebih. Perbandingan serum glukosa daripada kumpulan intervensi menampakkan penurunan dari hari pertama kajian sehingga hari ke 30 sebanyak 13.6% dan penurunan berat badan adalah sebanyak 2%, dengan kadar signifikasi kurang daripada 0.05. Kumpulan yang menerima penjagaan rutin menunjukkan peningkatan serum FBS sebanyak 12.1% dan tiada perubahan dalam berat badan. Penurunan ini dapat dilihat pada hari ke 30 dengan pengambilan VCO sebanyak 5 g sehari. Kesan penurunan glukosa dan berat badan adalah disebabkan oleh tindakan asid laurik dan antioksida yang terdapat di dalam komposisi VCO. Minyak kelapa dara menunjukkan keupayaan menurunkan serum glukosa dan berat badan dengan dos 5 mL/5 gm sehari selama 30 hari. Minyak kelapa dara mempunyai kesan positif terhadap serum glukosa dan faktor risiko kardiovaskular yang lain.

Kata kunci: Diabetes mellitus; minyak kelapa dara; sindrom koronari akut; trigliserida rantai sederhana

REFERENCES

Abadal, A.C. & Flores, J.S. 2008. The significance of hyperglycemia in acute coronary. Revista Española de Cardiología 61(5): 447-450.

Ahmad, W.A.W. 2016. Annual Report of the NCVD-PCI Registry Year 2015-2016. Malaysia: National Cardiovascular Disease Database.

Barstow, C., Rice, M.S. & McDivitt, J.D. 2017. Acute coronary syndrome: Diagnostic evaluation. American Family Physician 95(3): 170-177.

Braun, M.M., William, A.S. & Craig, H.B. 2018. Stable coronary artery disease: Treatment. American Family Physician 97(6): 376-384.

Cardoso, D.A., Moreira, A.S., de Oliveira, G.M., Luiz, R.R. & Rosa, G. 2015. A coconut extra virgin oil-rich diet increases HDL cholesterol and decreases waist circumference and body mass in coronary artery disease patients. Nutricion Hospitalaria 32(5): 2144-2152.

Chapman, J.M. & Massey Jr., F.J. 1964. The interrelationship of serum cholesterol, hypertension, body weight, and risk of coronary disease: results of the first ten years' follow-up in the Los Angeles heart study. Journal of Chronic Diseases 17(10): 933-949.

Chinwong, S., Chinwong, D. & Mangklabruks, A. 2017. Daily consumption of virgin coconut oil increases high-density lipoprotein cholesterol levels in healthy volunteers: A randomized crossover trial. Evidence-Based Complementary and Alternative Medicine 2017: 7251562.

Dayrit, F.M. 2015. The properties of lauric acid and their significance in coconut oil. Journal of the American Oil Chemists' Society 92(1): 1-15.

Deedwania, P., Kosiborod, M., Barrett, E., Ceriello, A., Isley, W., Mazzone, T. & Raskin, P. 2008. Hyperglycemia and acute coronary syndrome: A scientific statement from the American Heart Association Diabetes committee of the council on nutrition, physical activity, and metabolism. Circulation 117(12): 1610-1619.

dela Paz, C., Jimeno, C., Sy, R., Eduardo, F., Punzalan, M.D. & dela Pena, P. 2010. The effect of virgin coconut oil on lipid profile and fasting blood sugar: A phase I clinical trial. Philippine Journal of Internal Medicine 48(2). doi.org/10.3860/PJIM.V48I2.2632.

Ford, I., Murray, H., McCowan, C. & Packard, C.J. 2016. Long-term safety and efficacy of lowering low-density lipoprotein cholesterol with statin therapy: 20-year follow-up of west of Scotland coronary prevention study. Circulation 133(11): 1073-1080.

Gasiorek, J. 2016. The “dark side” of CAT. In Communication Accommodation Theory: Negotiating Personal Relationships and Social Identities Across Contexts, edited by Giles, H. Cambridge: Cambridge University Press. pp. 85-104.

Garfinkel, M., Lee, S., Opara, E.C. & Akwari, O.E. 1992. Insulinotropic potency of lauric acid: A metabolic rationale for medium chain fatty acids (MCF) in TPN formulation. Journal of Surgical Research 52(4): 328-333.

Harris, M., Hutchins, A. & Fryda, L. 2017. The impact of virgin coconut oil and high-oleic safflower oil on body composition, lipids, and inflammatory markers in postmenopausal women. Journal of Medicinal Food 20(4): 345-351.

Hewins, K. 2016. 2014 NSTE-ACS Guidelines Overview. In Acute Coronary Syndrome Summit.

Jensen, R.G. 1999. Lipids in human milk. Lipids 34(12): 1243-1271.

Khaw, K.T., Sharp, S.J., Finikarides, L., Afzal, I., Lentjes, M., Luben, R. & Forouhi, N.G. 2018. Randomised trial of coconut oil, olive oil or butter on blood lipids and other cardiovascular risk factors in healthy men and women. BMJ Open 8(3): p.e020167.

Koshizaka, M., Ishikawa, K., Ishibashi, R., Maezawa, Y., Sakamoto, K., Uchida, D., Nakamura, S., Yamaga, M., Yokoh, H., Kobayashi, A. & Onishi, S. 2019. Comparing the effects of ipragliflozin versus metformin on visceral fat reduction and metabolic dysfunction in Japanese patients with type 2 diabetes treated with sitagliptin: A prospective, multicentre, open‐label, blinded‐endpoint, randomized controlled study (PRIME‐V study). Diabetes, Obesity and Metabolism 21(8): 1990-1995.

Landgraf, K., Rockstroh, D., Wagner, I.V., Weise, S., Tauscher, R., Schwartze, J.T., Löffler, D., Bühligen, U., Wojan, M., Till, H. & Kratzsch, J. 2015. Evidence of early alterations in adipose tissue biology and function and its association with obesity-related inflammation and insulin resistance in children. Diabetes 64(4): 1249-1261.

Li, H., Liu, Y., Zhang, X., Xu, Q., Zhang, Y., Xue, C. & Guo, C. 2018. Medium-chain fatty acids decrease serum cholesterol via reduction of intestinal bile acid reabsorption in C57BL/6J mice. Nutrition & Metabolism 15(1): 1-12.

Liau, K.M., Lee, Y.Y., Chen, C.K. & Rasool, A.H.G. 2011. An open-label pilot study to assess the efficacy and safety of virgin coconut oil in reducing visceral adiposity. ISRN Pharmacology 2011: 949686.

Longo, M., Zatterale, F., Naderi, J., Parrillo, L., Formisano, P., Raciti, G.A., Beguinot, F. & Miele, C. 2019. Adipose tissue dysfunction as determinant of obesity-associated metabolic complications. International Journal of Molecular Sciences 20(9): 2358.

Mach, F., Ray, K.K., Wiklund, O., Corsini, A., Catapano, A.L., Bruckert, E., De Backer, G., Hegele, R.A., Hovingh, G.K., Jacobson, T.A. & Krauss, R.M. 2018. Adverse effects of statin therapy: perception vs. the evidence-focus on glucose homeostasis, cognitive, renal and hepatic function, haemorrhagic stroke and cataract. European Heart Journal 39(27): 2526-2539.

MOH. 2015. Health Facts 2015. Malaysia: Ministry of Health Malaysia (MOH).

MOH. 2017. Primary & Secondary Prevention of Cardiovascular Disease 2017. Malaysia: Ministry of Health Malaysia (MOH).

Nevin, K.G. & Rajamohan, T. 2004. Beneficial effects of virgin coconut oil on lipid parameters and in vitro LDL oxidation. Clinical Biochemistry 37(9): 830-835.

Stehbens, W.E. 1990. The epidemiological relationship of hypercholesterolemia, hypertension, diabetes mellitus and obesity to coronary heart disease and atherogenesis. Journal of Clinical Epidemiology 43(8): 733-741.

Tholstrup, T., Ehnholm, C., Jauhiainen, M., Petersen, M., Høy, C.E., Lund, P. & Sandström, B. 2004. Effects of medium-chain fatty acids and oleic acid on blood lipids, lipoproteins, glucose, insulin, and lipid transfer protein activities. The American Journal of Clinical Nutrition 79(4): 564-569.

Vallejo-Vaz, A.J., Robertson, M., Catapano, A.L., Watts, G.F., Kastelein, J.J., Packard, C.J., Ford, I. & Ray, K.K. 2017. Low-density lipoprotein cholesterol lowering for the primary prevention of cardiovascular disease among men with primary elevations of low-density lipoprotein cholesterol levels of 190 mg/dL or above: Analyses from the WOSCOPS (West of Scotland coronary prevention study) 5-year randomized trial and 20-year observational follow-up. Circulation 136(20): 1878-1891.

Varghese, T.P. & Kumar, A.V. 2019. Predisposing risk factors of acute coronary syndrome (ACS): A mini review. Journal of Pharmaceutical Sciences and Research 11(5): 1999-2002.

Wei, C.H. & Litwin, S.E. 2014. Hyperglycemia and adverse outcomes in acute coronary syndromes: Is serum glucose the provocateur or innocent bystander? Diabetes 63(7): 2209-2212.

Wilson, P.W., D'Agostino, R.B., Sullivan, L., Parise, H. & Kannel, W.B. 2002. Overweight and obesity as determinants of cardiovascular risk: The Framingham experience. Archives of Internal Medicine 162(16): 1867-1872.

*Corresponding author; email: mcchong@um.edu.my