Randomized controlled trial of nutritional supplementation in patients with newly diagnosed tuberculosis and wasting.
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.


METHODS
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.
Department of Infectious Diseases, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 309973. nick_paton2003@hotmail.com
Nicholas I
NI
Paton
Yueh-Khim
YK
Chua
Arul
A
Earnest
Cynthia B E
CB
Chee
D015502:Absorptiometry, Photon; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001823:Body Composition; D003376:Counseling; D019587:Dietary Supplements; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018529:Nutritional Support / Q000379:methods*; D011788:Quality of Life; D014376:Tuberculosis / Q000188:drug therapy / Q000628:therapy*; D019282:Wasting Syndrome / Q000628:therapy*
D000995:Antitubercular Agents