MSc

The study entitled 'Impact of spirulina (Spirulina fusiform is) food
supplement on premalignant conditions in women' was undertaken with an
objective to formulate food supplements incorporating spirulina and to
assess its impact on premalignant conditions of the oral cavity of selected
subjects.
The study was undertaken among two fishermen communities VIZ.,
Puthukuruchy and Maryanad in Thiruvananthapuram district.
Clinical assistance from Regional Cancer Centre aided m
conducting medical camp to screen 60 fisherwomen in the age group of
40-55 years with oral precancerous symptoms who were habituated with
betel quid chewing. The 60 women were divided into experimental and
control groups of 30 members each.
Personal profile of the respondents indicated that majority were
above 50 years of age, illiterate and engaged in fish vending.
Most of the families were of nuclear type and their monthly income
ranged between Rs.l 000 to 3000.
Dietary surveys revealed an absolutely ill balanced but uniform
pattern comprising rice and fish. All the respondents were non-
vegetarians and fish' was the .main non-vegetarian food in their diet.
However consumption of vegetables, green leafy vegetables, pulses, egg
and milk and milk products was less. The diet of the women were
deficient in all the nutrients except calcium when compared to RDA.
An enquiry on the personal habits revealed that all the women were
tobacco chewers with 50.00 per cent chewing for more than 30 years.
Majority of them chewed 5 to 9 quids a day for a duration of 5 to 10
minutes each time.


Clinical examination of the oral cavity of the respondents indicated
that 85.00 per cent suffered from leukoplakia and the remaining showed
submucous fibrosis (SMF) as the precancerous condition.
Majority of the respondents suffered from homogenous type of
leukoplakia with size less than 2 cm and generalized type of SMF with an
interlabial diameter (ILD) between 1 to 3 cm. Most of them complained
an intolerance to spices and a few were prone to problem associated with
taste perception and appetite.
Nutritional status revealed that all the women were below the
normal height and weight standards. Body mass Index of the women
showed that 45.00 per cent suffered from energy deficiency. Among
86.70 per cent the blood haemoglobin and among 40.00 per cent the serum
~-carotene levels were below the acceptable values.
For the feeding trial six spirulina based supplements incorporating
one gram spray dried spirulina per portion were standardized in the
laboratory. The six supplements were lemon-ginger squash, rava laddu,
rice balls, bengal gram balls, coconut chutney powder and green gram
chutney powder. Three highly preferred supplements (lemon-ginger
squash, rava laddu and rice balls) were selected for the feeding trial of six
months duration.
Assessment of the impact of spirulina supplementation on the
precancerous condition of the oral cavity revealed that among the 86.70
percent suffering from leukoplakia, there was complete remission among
13.40 per cent and regression: was seen in 40.00 per cent. Mean while in
the control group the condition was found to aggravate. It was also noted
that in the experimental group the number of subjects having ulcerated
type (moderate) of leukoplakia had been reduced as they were shifted to
the mild form (homogenous type). With regard to submucous fibrosis
(SMF) among the 13.30 per cent cases there was regression in 10.00 per
cent. Almost all the subjects in the experimental group regained their


tolerance to spices which can be considered as a positive impact of
feeding spirulina over a period of six months.
Changes in serum ~-carotene levels of the respondents in the
experimental group revealed that there was an average increase of 0.385
ug/ml after six months of supplementation. At the same time a decrease
was noted in the ~-carotene level of the control women. There was an
average increase of 1.17 g/dl on the haemoglobin level of the experimental
group as a result of spirulina supplementation.
Supplementary feeding with spirulina also indicated improvement
in general appetite and taste perception among the experimental women.
Nutrition and health education imparted to the experimental women
revealed an excellent gain in knowledge from the post-test scores.
Due to the education programme 23.30 per cent respondents
stopped the habit of chewing and 56.70 per cent excluded tobacco while
chewing. There oral hygiene could also be improved.
Acceptable spirulina food supplements could be formulated and the
present trial evidenced that these supplements imposed a positive role III
reversing the precancerous symptoms of the oral cavity in fisherwomen.