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Project

Optimizing Cardio-metabolic Health of People Living with HIV through the use of Bioactive Compounds in Indigenous Food Species in Uganda

Background: An estimated 1.5 million Ugandans are living with HIV, with 85% of 1.5 million are adults enrolled on Antiretroviral Therapy (ART). Although the advent of ART coincided with increased longevity and general quality of life of People Living with HIV (PLWH), altered metabolism among PLWH is widely reported. Sub optimal metabolic health among this population is caused by a cluster of factors such as ART associated factors and other modifiable factors e.g. poor diet, smoking, alcoholism and physical inactivity. Moreover, HIV infection itself chronically activates innate immunity with excessive production of inflammatory cytokines which potentially increase the risk of atherosclerosis and coronary artery inflammation. The prevalence of hypertension and Type 2 Diabetes among PLWH in Uganda is reported to be 20.9% and 10.4% respectively. Currently, management of T2D and hypertension of PLWH in Uganda has been integrated in the routine health care in all governmental health facilities. However, community HIV management mechanisms (Community Drug Distribution Points) have not prioritized metabolic health. Therefore, integrating cardio-metabolic interventions in the community HIV management is recommended for early detection and treatment to avert associated mortalities. This can be strengthened by low cost evidence-based community interventions especially those that target dietary behavior. Therefore, a food based intervention involving such food with nutraceutical potential could provide a low cost community based approach to improving cardio-metabolic health of HIV patients in Uganda. Moreover, Uganda is endowed with a rich diversity of Indigenous Food Species (IFS). A plethora of these IFS have locally been used for medicinal purposes in various regions of the country for centuries. Unfortunately, Uganda is experiencing a worrying shrinkage in the diversity of IFS over time with up to 86.4% of African indigenous vegetables lost since 1989. Therefore, to combat this biodiversity shrinkage, there’s need to map, analyze and increase consumption of IFS through investigating their nutraceutical potential. Hence part of this project will focus on mapping and documenting IFS that have activity on cardio-metabolic health and scientifically quantify the effect size. Objective: To develop an indigenous based food product rich in bioactive compounds and evaluate its efficacy in optimizing cardio-metabolic health of PLWH in Uganda. Methodology: WP1- A baseline study will focus on Dietary patterns and cardio-metabolic profiles of PLWH in Wakiso District Uganda, to elicit data on determinants on cardio-metabolic health. In WP2, IFS that have a positive effect on metabolic health in Uganda will be documented. WP3 will use information generated in WP2 to develop a food product rich in bioactive compounds. WP4- will conduct a single site RCT to assess the efficacy of the formulated food product (WP3) in optimizing the metabolic health of PLWH in Wakiso district, central Uganda. The subjects will be randomly allocated into one of two groups by a 1:1 allocation using a random number generator. The intervention group will receive the developed food product in WP3 on top of their standard HIV care while the control group will maintain their habitual diet and standard HIV care. The two groups will be followed for a period of 3 months. Fasting blood samples will be collected from each volunteer at three time points (0, 6 and 12 weeks) before, during and after the intervention. Primary outcome is cardio-metabolic health assessed by changes in waist circumference, fasting glucose, lipid profile (total cholesterol, HDL cholesterol and triglycerides), body composition and blood pressure. Secondary outcomes include process indicators (reach, dose and fidelity of intervention).

Date:4 Jan 2021 →  Today
Keywords:Cardio-metabolic health, bioactive compounds, HIV patients, Indigenous food species, food diversity, Uganda
Disciplines:Health and community services
Project type:PhD project