Effect of chocolate and yerba mate phenolic compounds on inflammatory and oxidative biomarkers in HIV/AIDS individuals: a randomized, double-blind, placebo controlled trial

INTRODUCTION: There has been an increase on cardiovascular diseases occurrence in the HIV/AIDS population. It is know that initial alterations that after evolve to cardiovascular diseases are related with changes in inflammatory and oxidative disorders. Several studies in other populations demonstrated that flavonoids in cocoa (Theobroma cacao) and yerba mate (Ilex paraguaensis) may improve cardiovascular function due to its antioxidant and anti-inflammatory properties. OBJECTIVE: To evaluated the effect of chocolate and yerba mate intake on the inflammatory and oxidative profile of people living with HIV/AIDS in antiretroviral therapy (ART). METHODOLOGY: Randomized, placebo-controlled, blinded cross-over trial involving 92 volunteers ages 28-59 years, in ART for at least six months and with viral load <50 copies/mL. The volunteers consumed 65g chocolate bar (36g dark chocolate containing cocoa or placebo) and 3g of tea (yerba mate soluble and placebo) for 15 day each, followed by 15 days washout period before the subsequent treatment. In addition to the inflammatory and oxidative variables (us-CRP, fibrinogen, TBARS, HDL-c) the following characteristics were evaluated: demographic and socioeconomic profile, anthropometric variables, immunological and physical activity. Statistical analyzes were performed by the cross-over analyzes of variance (ANOVA) using the procedure pkcross in Stata version 11.0. The paired Student`s t-test was also utilized. A p value 0,05 was considered significant. RESULTS: Patients were mostly male (63 per cent ), with a mean age of 45,0 years. The mean time of HIV/AIDS diagnosis was 13,3 (5±), with 10,7 (±5,1) years of ART. There was statistically significant difference when analyzed by ANOVA only for HDL-c (p = 0,05). However, comparing the variables in the baseline x dark chocolate by the paired Student`s t-test, there were increase in the HDL-c (p = 0,01) and decrease in the leukocyte (p = 0,01) and neutrophil (p = 0,02), and when compared the values of the variables between dark chocolate and placebo also there was statistically significant difference for HDL-c (p = 0,05), leukocyte (p = 0,01) and neutrophil (p = 0,03). CONCLUSION: This is the first clinical study that evaluated the effect of chocolate (cocoa) and mate tea (yerba mate) consumption on inflammatory and oxidative profile of individuals with HIV/AIDS on ART. In the present study, daily consumption of neither cocoa nor yerba mate for 15 days was sufficient to improve inflammatory and oxidative profile in this group of individuals, despite the increase in HDL-c and decrease of leukocyte and neutrophil values after consumption of dark chocolate. Such an outcome in this group of individuals can be distinguished due to its metabolism, which is altered not only by the infection, but also by the ART, the amount and bioavailability of flavonoids in supplements and timing of intervention.