Virgin Coconut Oil for HIV - Positive People

Abstract

The objective of the study was to determine effects of 3 x 15 ml/day Virgin Coconut Oil supplementation for 6 weeks in subject to CD4+ T lymphocyte concentration and conducted at Special health center on Dharmais Cancer Hospital, Jakarta. The methods involved experimental study with parallel design on 40 HIV subject with CD4+ T lymphocyte count > 200 cell/µL divided into two groups, VCO group, subject in this group received VCO supplementation 3 x 15 ml/day for 6 weeks and non-VCO Group (without VCO supplementation). Data collected includes demographic characteristic (age and sex), anthropometric (weight, height, and body mass index), daily intakes by food recall 1 x 24 hours and laboratory (CD4+ T lymphocyte count). Statistical analysis was performed with independent t test and Mann-Whitney U test. The results could be summarised as follows. The average BMI were 20.8 ± 2.29 kgs/sqm (VCO group) and 20.7 ± 3.38 kgs/sqm (non-VCO group). Energy and fat intake between VCO group (1459 ± 327.4 Cal/day and 81.8 ± 19.35 gs/day) and non-VCO group (1101 ± 319.8 Cal/day and 37.1 ± 19.35 gs/day). Carbohydrate and protein intake between VCO group (143.8 ± 44.58 gs/day and 41.6 ± 14.04 gs/day) and non-VCO group (151.6 ± 14.04 gs/day and 39.5 ± 18.31gs/day). There were significant differences (p = 0.047) in average of CD4+ T lymphocyte count after 6 weeks intervention between VCO group (481 ± 210.0 cell/µL) and non-VCO group (343 ± 129.1 cell/µL). The conclusion is that Virgin Coconut Oil supplementation 3 x 15 ml/day for 6 weeks increases CD4+ T lymphocyte concentration in HIV patient.

Full text

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Virgin Coconut Oil for HIV - Positive People
Dr. Kadek Dharma Widhiarta
Abstract
The objective of the study was to determine effects of 3 x 15 ml/day Virgin Coconut Oil
supplementation for 6 weeks in subject to CD4+ T lymphocyte concentration and conducted at Special
health center on Dharmais Cancer Hospital, Jakarta. The methods involved experimental study with
parallel design on 40 HIV subject with CD4+ T lymphocyte count > 200 cell/µL divided into two
groups, VCO group, subject in this group received VCO supplementation 3 x 15 ml/day for 6 weeks
and non-VCO Group (without VCO supplementation). Data collected includes demographic
characteristic (age and sex), anthropometric (weight, height, and body mass index), daily intakes by
food recall 1 x 24 hours and laboratory (CD4+ T lymphocyte count). Statistical analysis was performed
with independent t test and Mann-Whitney U test. The results could be summarised as follows. The
average BMI were 20.8 ± 2.29 kgs/sqm (VCO group) and 20.7 ± 3.38 kgs/sqm (non-VCO group).
Energy and fat intake between VCO group (1459 ± 327.4 Cal/day and 81.8 ± 19.35 gs/day) and non-
VCO group (1101 ± 319.8 Cal/day and 37.1 ± 19.35 gs/day). Carbohydrate and protein intake between
VCO group (143.8 ± 44.58 gs/day and 41.6 ± 14.04 gs/day) and non-VCO group (151.6 ± 14.04 gs/day
and 39.5 ± 18.31gs/day). There were significant differences (p = 0.047) in average of CD4+ T
lymphocyte count after 6 weeks intervention between VCO group (481 ± 210.0 cell/µL) and non-VCO
group (343 ± 129.1 cell/µL). The conclusion is that Virgin Coconut Oil supplementation 3 x 15 ml/day
for 6 weeks increases CD4+ T lymphocyte concentration in HIV patient.
Keywords: Virgin Coconut Oil, CD4+ T lymphocyte, Energy intake, and HIV
Introduction
HIV/AIDS is a global crisis, affecting many aspects of life. Social stigma and the economic cost
of HIV/AIDS have been haunting many patients, societies and governments. The cost of treatment and
prevention measures has been a serious burden not only for developing countries, but industrialized
ones as well (Walker, 2003). Since the first report of HIV infection in 1981, more than 40 million
people have been infected and more than 20 million of which have died from AIDS (UNAIDS, 2004).
Prevalence of AIDS varies among countries. The highest reported is the Sub Sahara region of
Africa, which have a 30% rate of infection. It is estimated, with the advancement in early diagnosis,
that the numbers of HIV/AIDS patients will rise significantly (Kamps and Hoffmann, 2005). In
Indonesia, the first case of AIDS was reported on a foreign tourist in Bali in 1987. HIV/AIDS have
now spread to all the provinces of Indonesia. No certain data exist on how many people suffer from
the disease, but experts estimate about 80,000 to 120,000 Indonesian live with HIV (Sujudi, 2002).
____________________________________
Department of Obstretics and Gynaecology, University of Jember, Indonesia.
Email: rintass@gmail.com

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HIV mainly destroys the immune system,
causing decreased quantity and quality of
lymphocyte T cells, especially CD4.
Progressives of the disease will depend mainly
on the host immune response, which is measure
by the amount of CD4 in the body (CD4 count).
Therefore, CD4 count is the base of HIV
infection classification (Kamps and Hoffmann,
2005). Nutrition is well known for its immune
response stimulation effects. Malnutrition can
aggravate the disease by up regulating viral
replication (Scrimshaw and San Giovanni,
1997). On the other hand, achievement of
optimal nutritional intake will ensure adequate
immune response of HIV patients (Kotler, 1992).
Coconut oil has long been used not only as
food, but also as traditional remedies.
Indigenous population of the Asia Pacific, which
consumes coconut and coconut oil has long been
known to have healthy and long lives. Despite
the many benefits, many publications have
focused on the negative effects of coconut oil.
Their focus is on the high content of saturated
fatty acids (SAFA). Saturated fatty acid is
believed to be the main cause of arterial
coronary diseases. This belief has caused people
to turn to other sources of plant oil, which sure
low in SAFA, in their daily food consumption.
This notorious belief is not entirely true, because
SAFA in coconut oil, consist mainly of medium
chain triglyceride/MCT, which have many
beneficial health effects.
Coconut oil has unique features, where it
is not only a source medium chain fatty acids,
which are easier to absorb and utilize by cells, it
also contain lauric acid and capric acid, which
have anti microbial effects (Odle, 1997; Klein et
al, 1999). These substances can destroy bacteria
and virus which have lipid layer on their cell
membrane (Enig, 1998). Because of its fatty
acids and other nutrient contents, coconut oil is
thought to be beneficial to HIV patients.
Methods
This trial was an experimental study
conducted at Dharmais Cancer Hospital Special
Clinic, Jakarta for six weeks (between June until
August 2006). Written informed consent was
obtained from subjects or legal guardians. Age
between 18 – 59 years, HIV positive with CD4+
count > 200 cell/µL and without antiretroviral
(ARV) treatment were considered as inclusion
criteria for this study. Exclusion criteria included
chronic protein energy malnutrition (body mass
index < 17 kg/sqm), history of cardiovascular
disease and diabetes mellitus (from anamnesis),
pregnant and breast feeding. Subject removed
from the study if subject death, refused to
continue the trial and difficulty to follow
protocol.
Forty subjects who met inclusion criteria
were admitted to this study. The subjects were
selected using block-randomized method into
two groups designated as VCO and non-VCO,
20 subjects in each group. The main different
treatment was on the VCO group, all the subjects
received VCO 3 x 15 ml/day for six weeks but
not in the non-VCO group.
Population demographics data (age and
sex), anthropometric measurements included
height and weight to determine body mass index
(BMI), assessment of nutritional intake with
food recall 1 x 24 hours was used to establish
daily energy and macronutrient intake and
laboratory assessment (CD4+ count) will be done
on subjects. Statistical Analysis used
independent t test for group difference if normal
distribution otherwise the Mann-Whitney test.
Results
In the VCO group, 57% subjects were
between 18 – 29 years old and in the non-VCO
group 71% subject were between 18 – 29 years
old. Women were the greatest number in the
VCO group (71%); on the contrary man was the
most number in the non-VCO group (64%). 12
subjects (6 from each group) had dropped out
from the study. Eight subjects had dropped out
because they had difficulty to follow up (loss of
contact), 3 subjects have moved outside Jakarta
and 1 subject was tag on other trial. 92%
subjects had HIV from intravenous drug use
(IDU), 5% from heterosexual intercourse, and
2% from homosexual intercourse. There was no
significant difference on anthropometric
measurement before and after treatment (Table
1).

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Table 1. Weight, height, and body mass index
Variable
VCO
(n=14)
Non-VCO
(n=14)
p
Weight (kg)
Before treatment
After treatment
Height (m)
Before treatment
After treatment
Body mass index (kg/sqm)
Before treatment
After treatment
53.7 ± 7.78
54.0 ± 7.46
160.5 ± 7.03
160.5 ± 7.12
20.8 ± 2.29
20.9 ± 2.06
56.0 ± 7.96
55.8 ± 7.64
164.6 ± 4.83
164.6 ± 4.83
20.7 ± 3.38
20.7 ± 3.21
0.291m
0.358m
0.082t
0.09t
0.55m
0.811t
m = Mann-Whitney U
t = independent t test
Figure 1. Energy intake before and after treatment between VCO and non-VCO
0
200
400
600
800
1000
1200
1400
1600
1800
Before Treatment After Treatment
Energy Intake (Cal/day)
VCO
Non-VCO
1120 ± 346.0
1001 ± 319.8
1000 ± 344.1
1459 ± 327.4
p = 0.007 t
p = 0.37t

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Figure 2. Carbohydrate intake before and after treatment between VCO and non-VCO
Figure 3. Protein intake before and after treatment between VCO and non-VCO
0
20
40
60
80
100
120
140
160
180
200
Before Treatment After Treatment
Carbohydrate Intake (g/day)
VCO
Non-VCO
155.0 ± 42.9
143.8 ± 44.58
145.5 ± 53.37
151.6 ± 14.04
p = 0.671 t
p = 0.61t
0
20
40
60
80
100
120
140
160
180
200
Before Treatment After Treatment
Protein Intake (g/day)
VCO
Non-VCO
155.0 ± 42.9
143.8 ± 44.58
145.5 ± 53.37
151.6 ± 14.04
p = 0.29 m
p = 0.86t

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Figure 4. Fat intake before and after treatment between VCO and non-VCO
Table 2. Energy requirement, energy intake, and energy intake proportion
Energy
VCO
Non VCO
p
Requirement (Cal/day)
Intake (Cal/day)
Energy Intake Proportion (%)
2608.57 ± 309.41
1459.35 ± 327.37
56.07 ± 11.7
2820.71 ± 321.74
1101.01 ± 319.82
39.43 ± 13.03
0.084m
0.007t
0.004m
m = Mann-Whitney U test
t = Independent t test
Significant at p < 0.05
0
20
40
60
80
100
Before Treatment After Treatment
Fat Intake (g/day)
VCO
Non-VCO
35.9 ± 17.20
37.1 ± 19.35
27.4 ± 14.10
81.8 ± 19.35
p < 0.001 t
p = 0.17t

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Figure 5. CD4+ T lymphocyte count before and after treatment between VCO and non-VCO
Nutritional assessment
There was no significant difference on
energy intake before treatment (p = 0.37) on the
contrary, there was significant difference on
energy intake after treatment (p = 0.007)
between VCO and non-VCO (figure 1). There
were no significant difference on carbohydrate
(figure 2) and protein intake (figure 3) not only
before treatment but also after treatment. There
was significant difference on fat intake after
treatment (p < 0.001) between VCO and non-
VCO (figure 4).
Energy Intake Proportion
There was no significant difference on
energy requirement (p = 0.084) between VCO
and non-VCO. However there was significant
difference on energy intake proportion (energy
intake per energy requirement) (p = 0.004)
between VCO and non-VCO (table 2).
CD4+ T Lymphocyte Count
There was no significant difference on
CD4+ T lymphocyte count (p = 0.37) before
treatment between VCO and non-VCO.
However there was significant difference on
CD4+ T lymphocyte count (p = 0.047) after
treatment (figure 5).
Discussion
30% subjects drop out in this study
resulted declining on research power from 80%
to 60 – 70%. High number of drop out in this
study resulted from most of the subject (92%) in
this study were drug or narcotic user (junkies).
We know that junkies have high incline to use
drug/narcotics again because of emotional factor
or peer pressure. This condition made difficult to
obtain subject to follow the protocol.
92% subject had HIV from IDU. In
developing country, HIV spread mostly through
IDU (WHO, 2005). Badan Narkotika Nasional
(BNN), 2004 conducted a study in ten big cities
in Indonesia (Medan, Jakarta, Bandung,
Semarang, Yogyakarta, Surabaya, Makasar,
Denpasar, Manado and Batam) found that 56%
from 572 thousand people are intravenous
drug/narcotic user and 40% or 229 thousand are
HIV positive. This different data show to us that
HIV cases rise very high in past four year.
Body mass index is not significantly
different between VCO and non-VCO not only
before treatment but also after treatment. Short
period of treatment and not lower proportion of
energy intake were main reason from that result.
There was interesting data from this study,
0
100
200
300
400
500
600
700
Before Treatment
After Treatment
CD4+ T lymphocyte count (cell/µL)
VCO
Non-VCO

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although all the subject had lower energy intake
proportion but all of them had normal BMI.
There are several explanation. First, possible
occurred inaccuracy or bias in food recall
interview. Second, reference for energy
requirement from AKG (Angka Kebutuhan Gizi)
or Indonesian RDA is not suitable for the subject
(too high). There were several study had the
same result using AKG for energy requirement
reference (Muhilal et all, 1998; Hatma, 2001;
dan Nugraha, 2005). If we calculated basal
energy requirement with Harris-Benedict
equation, the entire subject had 75% (minimum)
fulfilled basal energy requirement. But there is
no data to show us that how long if someone had
energy intake only for basal requirement have
affected BMI. McCallan et all, 1985 show that
BMI will decline if there is opportunistic
infection on HIV subject.
CD4+ T lymphocyte count is used to
indicate HIV disease progression, because HIV
bind to this receptor in human body resulted
destruction and decline of CD4+ T lymphocyte
count. In this study show that there was
significant difference on CD4+ T lymphocyte
count between VCO and non-VCO. This result
indicates that VCO supplementation had positive
influence to CD4+ T lymphocyte. The same
result was obtained by Dayrit (2000). One of the
reason of positive influence VCO
supplementation on CD4+ T lymphocyte is high
content of lauric and capric acid in VCO. As we
know that lauric and capric acid are fatty acid
with antiviral and bacterial capability. Takatsuki
et all (1969) showed that fatty acid had toxic on
viral cultivated and the more carbon chain on
fatty acid made the more weaker toxicity
characteristic. Thormar et all (1987) showed that
lauric and capric have the antiviral ability, it can
destruct lipid capsule layer virus at ten times
more on lower concentration compare to long
chain fatty acid like oleat and linoleat
It can be concluded that Virgin Coconut
Oil supplementation 3 x 15 ml/day for 6 weeks
significantly increases CD4+ T Lymphocyte
concentration in HIV patient.
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