Clinical studies on spirulina
Many studies, one tendency
In 1999, at the World Nutrition Congress, Antenna and the Medical College of Madurai presented the results of the clinical trials which they had conducted in southern India. They announced the finding that a daily dose of 1 to 3 grams of spirulina, over a period of 4 to 6 weeks, could be sufficient to cure young children of 5 years or younger of their mild and moderate malnutrition.
Many other studies have been undertaken but, as we recognise in our 2011 review ‘Spirulina in the fight against malnutrition: Assessment and prospects , “ … one has to admit that most of the clinical trials carried out with spirulina are questionable in some respects. Of course, it would be desirable for future studies to provide more conclusive results, but one must keep in mind the difficulty of conducting such studies in developing countries where malnutrition is rife”. The large-scale clinical tests which are still needed to secure the development of spirulina in fact await the necessary resources and the political will.
The doctor will see you now, spirulina
Current perceptions of spirulina will surely change as more scientific data is gathered, and with the growth of initiatives in the field. The volume of evidence of its potential has become sizeable, and yet its nutritional virtues are only gaining recognition of international organisations and the WHO at a very cautious pace indeed. One would have thought that by now the accumulation of positive results, added to the growing mass of first-hand accounts by health professionals, would suffice for the decision makers of the fight against malnutrition to take some positive steps. In our 2011 review, we add that “it should also be noted that almost all nutritional supplements recommended by intergovernmental organizations have never been subjected to irrefutable scientific validation, such as required for spirulina”.
Key points of field trials
The following text, until the end of this section, is a survey of some of the most recent clinical studies on malnutrition conducted with spirulina, in particular with children and vulnerable populations (HIV-positive). It is reproduced from our 2011 review.
- “In Bangui (Central African Republic), the ‘Nutrition Santé Bangui’ association (Nutrition and Health Bangui), which manages a child nutrition centre, has been producing and using spirulina for almost two decades. In 1993, more than 300 children had already benefited from a nutritional treatment based on a sardine-spirulina combination. The centre’s manager, Mrs. Picard (Pharm. D.), wrote: “These first results reveal the benefits of spirulina to tackle malnutrition problems, even in severe cases. This product is easy to use and well accepted by mothers when it is properly explained.” (Picard, 1993). This study was later extended and made comparative by observing a group of 592 children aged from 0 to 5 years old fed with the sardine-spirulina combination, in comparison with a group of 182 children receiving only sardine to supplement the staple diet. The treatment duration varied between 94 and 145 days and the dose of spirulina was 5 g/day. Data analysis showed a significantly better improvement for children treated with spirulina, in terms of both average body weight gain and speed of recovery (Dupire, 1998).
- In the Democratic Republic of the Congo, a study on 28 children suffering from protein-energy malnutrition was carried out from January to November 1989 (Bucaille, 1990). The parameters measured during this work show the global positive effect of spirulina on the patients’ nutritional status, in spite of the inevitable problems inherent in field research.
- New studies have been undertaken in recent years. Unfortunately, some of them mainly bring out the difficulty of designing and following a research protocol that is both adequate and rigorous. For instance, a research carried out in Burkina Faso and concluding that spirulina is of no interest in fighting child malnutrition (Branger, 2003) is the perfect example of what should be avoided. The absurdity of the applied protocol, as well as the gravity of the conclusions that the authors still published, have been denounced several times (Darcas, 2004; Falquet, 2004; Fox, 2004). (This point is developed further in Appendix 1 of the review)
- In India, a randomized clinical trial on 60 schoolgirls addressed not only the purely nutritional effects of a small intake of spirulina (1 g/day), but also possible indirect effects on their intellectual performance (Sachdeva, 2004). This study led to positive and statistically significant results on both the haematological status of the pupils and on their intellectual performance. It ends with a recommendation to the Indian government about the supply of free spirulina in schools, particularly in deprived regions.
- In Burkina Faso, a comparative study on the nutritional recovery of 170 children (84 HIV-positive and 86 HIV-negative) demonstrates the benefits of spirulina in the treatment of child malnutrition, as well as its particularly positive impact on the nutritional rehabilitation of HIV-infected children (Simpore, 2005). This work was carried out in Ouagadougou, using spirulina that was produced locally and with simple facilities.
- Another work by the same authors compared the nutritional benefits of diets composed of spirulina grown in Burkina Faso and/or of Misola  (Simpore, 2006). The study was on 550 malnourished children under 5 in Ouagadougou. An improvement in body weight as a function of height and age is observed for all children, especially those whose diet was made of spirulina and Misola. The authors conclude that Misola, spirulina added to traditional food or Misola with spirulina are good diets for severely malnourished children. The diet with spirulina and Misola yields the best results, because it combines Misola’s large caloric intake with spirulina’s high protein content.
- In Central African Republic, a 6-month prospective randomized trial was carried out with people infected and affected by the HIV (Yamani, 2009). 160 patients were divided into two groups.
- Patients in the first group received 10 grams of spirulina per day, while patients in the second group received a placebo. This study showed a significant improvement in the main follow-up criteria (weight, arm girth, number of infectious episodes, CD4 count, protidemia) that is similar for both groups. However, no clear conclusions could be drawn from a clinical standpoint because of methodological problems reported by the authors.
- On the other hand, a similar study on 52 HIV-positive patients compared a group supplemented with spirulina and a group supplemented with soya beans. (Azabji, 2010). This work showed a comparable efficacy for spirulina and soya beans as regards weight gain, but also a significant increase in immunological markers for the group treated with spirulina, and not with the group treated with soya beans.”
 ‘Spirulina in the fight against malnutrition: Assessment and prospects’ by Christophe Hug & Denis von der Weid. Antenna Technologies Foundation, Geneva, February 2011, from http://www.antenna.ch/en/research/malnutrition/spirulina-assessment-prospects
 Misola is a mixture of millet (60%), soy (20%), peanuts (10%), sugar (9%) and salt (1%).