Potential of as a Nutritional Supplement in Malnourished HIV-Infected Adults in Sub-Saharan Africa: A Randomised, Single-Blind Study

Background Malnutrition is a major global public health issue and its impact on communities and individuals is more dramatic in Sub-Saharan Africa, where it is compounded by widespread poverty and generalized high prevalence of human immunodeficiency virus (HIV). Therefore, malnutrition should be ad...

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Main Authors: M. Azabji-Kenfack, S. Edie Dikosso, E.G. Loni, E.A. Onana, E. Sobngwi, E. Gbaguidi, A.L. Ngougni Kana, G. Nguefack-Tsague, D. Von der Weid, O. Njoya, J. Ngogang
Format: Article
Language:English
Published: SAGE Publishing 2011-01-01
Series:Nutrition and Metabolic Insights
Online Access:https://doi.org/10.4137/NMI.S5862
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author M. Azabji-Kenfack
S. Edie Dikosso
E.G. Loni
E.A. Onana
E. Sobngwi
E. Gbaguidi
A.L. Ngougni Kana
G. Nguefack-Tsague
D. Von der Weid
O. Njoya
J. Ngogang
spellingShingle M. Azabji-Kenfack
S. Edie Dikosso
E.G. Loni
E.A. Onana
E. Sobngwi
E. Gbaguidi
A.L. Ngougni Kana
G. Nguefack-Tsague
D. Von der Weid
O. Njoya
J. Ngogang
Potential of as a Nutritional Supplement in Malnourished HIV-Infected Adults in Sub-Saharan Africa: A Randomised, Single-Blind Study
Nutrition and Metabolic Insights
author_facet M. Azabji-Kenfack
S. Edie Dikosso
E.G. Loni
E.A. Onana
E. Sobngwi
E. Gbaguidi
A.L. Ngougni Kana
G. Nguefack-Tsague
D. Von der Weid
O. Njoya
J. Ngogang
author_sort M. Azabji-Kenfack
title Potential of as a Nutritional Supplement in Malnourished HIV-Infected Adults in Sub-Saharan Africa: A Randomised, Single-Blind Study
title_short Potential of as a Nutritional Supplement in Malnourished HIV-Infected Adults in Sub-Saharan Africa: A Randomised, Single-Blind Study
title_full Potential of as a Nutritional Supplement in Malnourished HIV-Infected Adults in Sub-Saharan Africa: A Randomised, Single-Blind Study
title_fullStr Potential of as a Nutritional Supplement in Malnourished HIV-Infected Adults in Sub-Saharan Africa: A Randomised, Single-Blind Study
title_full_unstemmed Potential of as a Nutritional Supplement in Malnourished HIV-Infected Adults in Sub-Saharan Africa: A Randomised, Single-Blind Study
title_sort potential of as a nutritional supplement in malnourished hiv-infected adults in sub-saharan africa: a randomised, single-blind study
publisher SAGE Publishing
series Nutrition and Metabolic Insights
issn 1178-6388
publishDate 2011-01-01
description Background Malnutrition is a major global public health issue and its impact on communities and individuals is more dramatic in Sub-Saharan Africa, where it is compounded by widespread poverty and generalized high prevalence of human immunodeficiency virus (HIV). Therefore, malnutrition should be addressed through a multisectorial approach, and malnourished individuals should have access to nutritional rehabilitation molecules that are affordable, accessible, rich in nutrient and efficient. We thus assessed the efficacy of two affordable and accessible nutritional supplements, spirulina platensis versus soya beans among malnourished HIV-infected adults. Methods Undernourished patients, naïve of, but eligible to antiretroviral treatment (ART), aged 18 to 35 years were enrolled and randomly assigned to two groups. The first group received spirulina (Group A) as food supplement and the second received soya beans (Group B). Patients were initiated ART simultaneously with supplements. Food supplements were auto-administered daily, the quantity being calculated according to weight to provide 1.5 g/kg body weight of proteins with 25% from supplements (spirulina and soya beans). Patients were monitored at baseline and followed-up during twelve weeks for anthropometric parameters, body composition, haemoglobin and serum albumin, CD4 count and viral load. Results Fifty-two patients were enrolled (Group A: 26 and Group B: 26). The mean age was 26.4 ± 4.9 years (Group A) and 28.7 ± 4.8 (Group B) with no significant difference between groups ( P = 0.10). After 12 weeks, weight and BMI significantly improved in both groups ( P < 0.001 within each group). The mean gain in weight and BMI in Group A and B were 4.8 vs. 6.5 kg, ( P = 0.68) and 1.3 vs. 1.90 Kg/m 2 , ( P = 0.82) respectively. In terms of body composition, fat free mass (FFM) did not significantly increase within each group (40.5 vs. 42.2 Kg, P = 0.56 for Group A; 39.2 vs. 39.0 Kg, P = 0.22 for Group B). But when compared between the two groups at the end of the trial, FFM was significantly higher in the spirulina group (42.2 vs. 39.0 Kg, P = 0.01). The haemoglobin level rose significantly within groups ( P < 0.001 for each group) with no difference between groups ( P = 0.77). Serum albumin level did not increase significantly within groups ( P < 0.90 vs. P < 0.82) with no difference between groups ( P = 0.39). The increase in CD4 cell count within groups was significant ( P < 0.01 in both groups), with a significantly higher CD4 count in the spirulina group compared to subjects on soya beans at the end of the study ( P = 0.02). Within each group, HIV viral load significantly reduced at the end of the study ( P < 0.001 and P = 0.04 for spirulina and soya beans groups respectively). Between the groups, the viral load was similar at baseline but significantly reduced in the spirulina group at the end of the study ( P = 0.02). Conclusion We therefore conclude in this preliminary study, firstly, that both spirulina and soja improve on nutritional status of malnourished HIV-infected patients but in terms of quality of nutritional improvement, subjects on spirulina were better off than subjects on soya beans. Secondly, nutritional rehabilitation improves on immune status with a consequent drop in viral load but further investigations on the antiviral effects of this alga and its clinical implications are strongly needed.
url https://doi.org/10.4137/NMI.S5862
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spelling doaj-08fd63271c194177af9a408d1afcc7712020-11-25T03:24:17ZengSAGE PublishingNutrition and Metabolic Insights1178-63882011-01-01410.4137/NMI.S5862Potential of as a Nutritional Supplement in Malnourished HIV-Infected Adults in Sub-Saharan Africa: A Randomised, Single-Blind StudyM. Azabji-Kenfack0S. Edie Dikosso1E.G. Loni2E.A. Onana3E. Sobngwi4E. Gbaguidi5A.L. Ngougni Kana6G. Nguefack-Tsague7D. Von der Weid8O. Njoya9J. Ngogang10Department of Physiological Sciences and Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Cameroon.Department of Physiological Sciences and Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Cameroon.Department of Physiological Sciences and Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Cameroon.Department of Physiological Sciences and Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Cameroon.University of Newcastle upon Tyne, UK.PPSAC/KfW/OCEAC, Yaounde, Cameroon.Department of Psychology, University of Yaounde 1, Cameroon.Public Health Department, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Cameroon.Fondation Antenna, Geneva, Switzerland.Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Cameroon.Department of Physiological Sciences and Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Cameroon.Background Malnutrition is a major global public health issue and its impact on communities and individuals is more dramatic in Sub-Saharan Africa, where it is compounded by widespread poverty and generalized high prevalence of human immunodeficiency virus (HIV). Therefore, malnutrition should be addressed through a multisectorial approach, and malnourished individuals should have access to nutritional rehabilitation molecules that are affordable, accessible, rich in nutrient and efficient. We thus assessed the efficacy of two affordable and accessible nutritional supplements, spirulina platensis versus soya beans among malnourished HIV-infected adults. Methods Undernourished patients, naïve of, but eligible to antiretroviral treatment (ART), aged 18 to 35 years were enrolled and randomly assigned to two groups. The first group received spirulina (Group A) as food supplement and the second received soya beans (Group B). Patients were initiated ART simultaneously with supplements. Food supplements were auto-administered daily, the quantity being calculated according to weight to provide 1.5 g/kg body weight of proteins with 25% from supplements (spirulina and soya beans). Patients were monitored at baseline and followed-up during twelve weeks for anthropometric parameters, body composition, haemoglobin and serum albumin, CD4 count and viral load. Results Fifty-two patients were enrolled (Group A: 26 and Group B: 26). The mean age was 26.4 ± 4.9 years (Group A) and 28.7 ± 4.8 (Group B) with no significant difference between groups ( P = 0.10). After 12 weeks, weight and BMI significantly improved in both groups ( P < 0.001 within each group). The mean gain in weight and BMI in Group A and B were 4.8 vs. 6.5 kg, ( P = 0.68) and 1.3 vs. 1.90 Kg/m 2 , ( P = 0.82) respectively. In terms of body composition, fat free mass (FFM) did not significantly increase within each group (40.5 vs. 42.2 Kg, P = 0.56 for Group A; 39.2 vs. 39.0 Kg, P = 0.22 for Group B). But when compared between the two groups at the end of the trial, FFM was significantly higher in the spirulina group (42.2 vs. 39.0 Kg, P = 0.01). The haemoglobin level rose significantly within groups ( P < 0.001 for each group) with no difference between groups ( P = 0.77). Serum albumin level did not increase significantly within groups ( P < 0.90 vs. P < 0.82) with no difference between groups ( P = 0.39). The increase in CD4 cell count within groups was significant ( P < 0.01 in both groups), with a significantly higher CD4 count in the spirulina group compared to subjects on soya beans at the end of the study ( P = 0.02). Within each group, HIV viral load significantly reduced at the end of the study ( P < 0.001 and P = 0.04 for spirulina and soya beans groups respectively). Between the groups, the viral load was similar at baseline but significantly reduced in the spirulina group at the end of the study ( P = 0.02). Conclusion We therefore conclude in this preliminary study, firstly, that both spirulina and soja improve on nutritional status of malnourished HIV-infected patients but in terms of quality of nutritional improvement, subjects on spirulina were better off than subjects on soya beans. Secondly, nutritional rehabilitation improves on immune status with a consequent drop in viral load but further investigations on the antiviral effects of this alga and its clinical implications are strongly needed.https://doi.org/10.4137/NMI.S5862