Role of Nutrition in Management of Tuberculosis

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Nutritional status of tuberculosis patient is an important indicator of outcome or prognosis of treatment of tuberculosis. Good and balanced nutrition is very important for good prognosis of tuberculosis patients. Without proper nutrition, administration of antibiotics may not be very useful, hence, management of tuberculosis includes provision of adequate nutrition too. We know, that nutrition plays an important role in tuberculosis, but it is a complex condition and difficult to explain clearly. In absence of adequate nutrition, there may be increased side effects of antibiotics and patients may refuse to continue with treatment.

Following nutritional needs are recommended by experts:

Energy requirement during tuberculosis treatment:

Tuberculosis infection increase need for energy (calorie). Most of the time the patient is under-nourished, which also increase the need for energy. Current recommendation is approximately 35-40 calories (kilo-calories) of per kilo ideal body weight for the age, height and sex of the tuberculosis patient. For example, if a person’s ideal body weight should be 70 kilos, he should consume approximately 2,800 calories a day during treatment of tuberculosis. Additional calories should be added to it, depending on the work done by the patient. If patient is also HIV positive, additional 10% calories need to be added in diet. In presence of AIDS (active HIV), the patient should be provided extra 20%-30% calorie, to be able to maintain body weight.

Protein requirement during tuberculosis treatment:

Tuberculosis increase catabolism in body, which increase protein requirement during tuberculosis treatment, to prevent muscle wasting. The recommendation is to take 1.2 gram to 1.5 grams of protein per kilo body weight (which is approximately 75-100 grams daily) or 15% – 20% of total calorie intake, during tuberculosis treatment. Protein requirement is approximately 0.8 to 1 gram per kilo body weight for normal individuals.

Micronutrients requirement during tuberculosis treatment:

To provide a balanced diet micronutrients such as vitamins, minerals and trace minerals are important. Tuberculosis patients treated with certain anti-tubercular antibiotics require some micronutrients in excess, for example, tuberculosis patients treated with isoniazid, require pyridoxine, folate etc. in excess to prevent serious side effects such as peripheral neuritis. In fact, in countries such as India, Govt. sponsored tuberculosis treatment drugs come along with pyridoxine. Hence, they need to be provided in nutrition or as supplements. It is ideal to provide multivitamin and multi-mineral supplementation to tuberculosis patients during treatment, approximately equivalent to recommended daily allowances of these nutrients.

The importance of nutrition in management of tuberculosis is very much and without providing adequate balanced nutrition, treatment of tuberculosis only with antibiotics may not succeed. The patients need to be managed and not treated alone.


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