Impact of peanut supplementation on cardiovascular disease markers in HIV-infected adults with dyslipidemia attending Nyeri level- 5 -hospital, Kenya
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Date
2016-04
Authors
Wangui, Kamuhu Regina
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Cardiovascular diseases (CVD) is currently second, after cancer, as the most frequent
cause of death among HIV-positive subjects in areas of the world where Highly active
anti-retroviral therapy (HAART) is widely available. Dyslipidemia is an important
adaptable cardiovascular risk factor that is a widespread clinical feature of HIV-infected
patients in the present era of HAART. Peanuts are a rich source of magnesium, folate,
fibre, α- tocopherol, copper, arginine and resveratrol. These compounds have been shown
to reduce the CVD risk in various ways and this suggests that peanut consumption might
benefit those at risk of CVD. The purpose of this study was to investigate the effect of
peanut supplementation on cardiovascular disease markers in HIV-infected adults with
normal and hyperlipidemia attending comprehensive care clinic in Nyeri Level- 5-
Hospital. The study design was a randomized cross-over clinical trial. The study duration
was 22 weeks. The eligible participants were randomly assigned to a two arm study. In
treatment I, the participants consumed their regular diet supplemented with 80g of
peanuts; while in treatment II, the participants were counseled on healthy diet and
supplemented it with 80g of peanut. The participants then crossed over to respective
treatments. Each treatment took 8 weeks, with a six weeks washout period between
treatments. Descriptive statistics were used to analyze all study variables. Relationships
between all and individual CVD risk factors were analyzed using Spearman’s correlation
coefficient, single line linkage and ward’s cluster method. A paired T- test was used to
compare subject differences in markers at baseline and at the end of each treatment.
Multiple regression analysis was used to determine the effect of peanut supplementation
on CVD markers. Criterion for statistical significance was at p < 0.05 and 90% power of
test. The sample comprised of 18 (21.2%) males and 67 (78.8%) females. Peanut
supplementation significantly increased intake of total fat (p < 0.05), poly unsaturated
fatty acid (p < 0.05), Vitamin E (p < 0.05) and mono unsaturated fatty acids (p < 0.05)
while carbohydrate intake decreased significantly (p < 0.05) between baseline and the
two treatments. There was no significant change in weight, BMI, waist circumference,
hip circumference, body fat, body muscle, systolic and diastolic blood pressure and
fasting blood glucose after consumption of peanut with regular diet and consumption of
peanut combined with nutritional counseling on healthy diet. There was a significant
decrease (p < 0.05) in total cholesterol, triglycerides and Low density lipoprotein in both
treatments while High density lipoprotein increased significantly (p < 0.05). Also reduced
significantly, was the estimated 10-year risk of coronary heart disease between baseline
and end of study (p =0.03). Peanut consumption was found to lower cardiovascular risk
significantly due to reduction in total cholesterol, triglyceride and Low Density
Lipoprotein Cholesterol. The policy makers should promote the incorporation of this
food-based supplement in order to lower the economic burden cardiovascular diseases are
imposing on the economy.
Description
A research thesis submitted in partial fulfillment of the requirements for the award of the degree of doctor of philosophy (food, nutrition and dietetics) in the school of applied human sciences of Kenyatta University. April, 2016