Xu Q, Zhang Y, Zhang X, et al. - In this double-blind, randomized, placebo-controlled crossover study, researchers examined the impacts of medium-chain triglycerides (MCT) on cognitive ability in mild to moderate Alzheimer disease (AD) patients (n = 53) and analyzed the changes in peripheral blood metabolomics. Participants in the study were randomized between two sequences (placebo followed by MCT or MCT followed by placebo) and received MCT jelly or placebo jelly (canola oil) three times daily by mouth (total daily fat dose: 17.3 g MCT, or 19.7g canola oil) for 30 days per phase. The data presented in this work showed a significant decline in ADAC-Cog-C scores between the MCT (2.62 points below baseline) and placebo interventions (2.57 points above baseline). They analyzed data from 46 (86.8%) APOE4^-/- individuals who finished the entire study. In mild to moderate AD patients with APOE4^-/-, MCT had positive effects on cognitive ability. In addition to the ketogenic effect, these impacts of MCT may be related to the metabolism of LysoPC, oleic acid, linoleic acid and palmitic acid.