The Anti-Lipidemic Effect of Borassus aethiopum „Oman Kube‟ on Individuals with Cardiovascular Disease at the 37 Military Hospital in Accra, Ghana

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AUGUST, 2017
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There is a rise in the prevalence of cardiovascular disease (CVD) globally and it is expected that by 2030, related death associated with CVD will be about 23.6 million mainly from heart disease and stroke. Obesity and lifestyle changes have been attributed as the main causes. Obesity associated with dyslipidemia is one of the factors known to initiate atherogenesis in CVD progression. A single blinded randomized placebo-controlled trail was conducted on 122 CVD patients at the Medical Department of the 37 Military Hospital in Accra, Ghana. The objective of the study was to evaluate the anti-lipidemic effect of Borassus aethiopum among individuals with CVDs. The Borassus aethiopum pulp was used as composite flour for bread. Sensory analysis, phytochemicals present and microbial analysis was conducted on the composite bread. About 150g dough weight of bread was consumed by participants daily for three months. Participants were randomized into two groups. Baseline and post interventional BMI, visceral fat, body fat, waist circumference, blood pressure and serum levels of total cholesterol (TC), triglycerides, high density lipoprotein (HDL-C), low-density lipoproteins (LDL-C) were determined. Data was analysed using IBM SPSS version 23. The Borassus composite bread contained flavonoids, saponins, phenols, alkaloids, glycosides, sterols and steroids with microbes within accepted levels (1.75×103 ±7.07 cfu/g for flour and 2.31×103 ±7.07 cfu/g for the bread). Participants recruited included, 63.9% female and 36.1% male, age ranging from 19 to 70 years. Most (99.2%) were diagnosed of hypertension, dyslipidemia or both. Diabetes mellitus (7.4%), and stroke (1.6%) with 37.7% on lipid lowering medication. Some female 53.3% and some male 7.3% were centrally obese. Baseline systolic blood pressure above normal was 73.8% and diastolic 81.9%, reducing significantly after intervention (p = 0.019, 0.001) respectively. Using the NCEP ATP 111 (2002) guidelines, significant reduction was observed in participants total cholesterol above the normal range and between groups (p=0.002). At baseline, the mean results for LDL-C was 3.4±1.2 for females and 3.3±1.3 for males. These saw some significant reduction among those who were given the composite bread (p=0.0002). Even though 90.1% of participant‟s TG and (female-97.6% and male-94.8%) HDL-C recorded normal levels, reductions in their means were also recorded. Among female participants, strong association existed only between their TC and LDL-C (r-0.930; p=0.000) and TC and HDL-C (r=0.460 p= 0.000). Weaker associations were realised between some other parameters. Similar associations were realised within parameters male participants. Strong correlations existed between Systolic and diastolic (r-0.725 p=0.000), TC and LDL-C (r-0.900 p=0.000) and TC and HDL-C (r-0.526 p=0.000). Among those on medication, significant reductions were realised in systolic (p=0.005), diastolic (p-value=0.0003), LDL-C (p=0.048) and HDL-C (p=0.00039) after intervention. With respect to their anthropometries, with the exception of waist circumference, no significant difference was seen in participant on the various medications. Borassus aethiopum composite bread was seen to reduce appreciably the TC, LDL-C and WC of cardiovascular patients in the study, irrespective of the medication and dosage participant were on.
A thesis submitted to the Department of Biochemistry and Biotechnology in partial fulfilment of the requirements for the award of Master of Philosophy Degree in Human Nutrition and Dietetics