Impact Of Peanut Supplementation On Cardiovascular Disease Markers In Hiv-Infected Adults With Dyslipidemia Attending Nyeri Level- 5 -Hospital, Kenya

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