BACKGROUND: Nutritional support is often recommended as part of the treatment of tuberculosis, but it has never been properly tested. OBJECTIVE: We assessed the effects of early nutritional intervention on lean mass and physical function in patients with tuberculosis and wasting. DESIGN:Patients who started antituberculous therapy within the previous 2 wk were randomly assigned to receive standard nutritional counseling (control group) or nutritional counseling to increase their intake through diet and high-energy supplements (nutritional supplement group) for 6 wk. Body composition was measured by dual-energy X-ray absorptiometry, and physical function was assessed by maximum grip strength. RESULTS: Patients in the nutritional supplement group (n = 19) had a significantly greater increase in body weight (2.57 +/- 1.78 compared with 0.84 +/- 0.89 kg, P = 0.001), total lean mass (1.17 +/- 0.93 compared with 0.04 +/- 1.26 kg, P = 0.006), and grip strength (2.79 +/- 3.11 compared with -0.65 +/- 4.48 kg, P = 0.016) than did the control subjects (n = 17) at week 6. During subsequent follow-up, the increase in body weight remained greater in the nutritional supplement group, but this increase was due mainly to a greater gain in fat mass in the nutritional supplement group than in the control group. CONCLUSIONS: Early intervention to increase nutritional intake increases lean mass and physical function. This adjunct to tuberculosis therapy could confer socioeconomic and survival benefits that deserve investigation in large-scale trials. Nutritional intervention after the initial phase of treatment could be less beneficial because it mainly increases fat.
RCT Entities:
BACKGROUND: Nutritional support is often recommended as part of the treatment of tuberculosis, but it has never been properly tested. OBJECTIVE: We assessed the effects of early nutritional intervention on lean mass and physical function in patients with tuberculosis and wasting. DESIGN:Patients who started antituberculous therapy within the previous 2 wk were randomly assigned to receive standard nutritional counseling (control group) or nutritional counseling to increase their intake through diet and high-energy supplements (nutritional supplement group) for 6 wk. Body composition was measured by dual-energy X-ray absorptiometry, and physical function was assessed by maximum grip strength. RESULTS:Patients in the nutritional supplement group (n = 19) had a significantly greater increase in body weight (2.57 +/- 1.78 compared with 0.84 +/- 0.89 kg, P = 0.001), total lean mass (1.17 +/- 0.93 compared with 0.04 +/- 1.26 kg, P = 0.006), and grip strength (2.79 +/- 3.11 compared with -0.65 +/- 4.48 kg, P = 0.016) than did the control subjects (n = 17) at week 6. During subsequent follow-up, the increase in body weight remained greater in the nutritional supplement group, but this increase was due mainly to a greater gain in fat mass in the nutritional supplement group than in the control group. CONCLUSIONS: Early intervention to increase nutritional intake increases lean mass and physical function. This adjunct to tuberculosis therapy could confer socioeconomic and survival benefits that deserve investigation in large-scale trials. Nutritional intervention after the initial phase of treatment could be less beneficial because it mainly increases fat.
Authors: M Bakari; J Wamsele; T MacKenzie; I Maro; J Kimario; S Ali; S Dowla; K Hendricks; Z Lukmanji; N M Neke; R Waddell; M Matee; K Pallangyo; C F von Reyn Journal: Public Health Action Date: 2013-09-21
Authors: Jennifer K Frediani; Nestani Tukvadze; Ekaterina Sanikidze; Maia Kipiani; Gautam Hebbar; Kirk A Easley; Neeta Shenvi; Usha Ramakrishnan; Vin Tangpricha; Henry M Blumberg; Thomas R Ziegler Journal: Clin Nutr Date: 2013-03-05 Impact factor: 7.324
Authors: T D Sudarsanam; J John; G Kang; V Mahendri; J Gerrior; M Franciosa; S Gopal; K R John; C A Wanke; J Muliyil Journal: Trop Med Int Health Date: 2011-03-21 Impact factor: 2.622