Tuberculosis and Nutrition

WHAT IS TB?

TB is an infectious disease caused by the bacteria known as Mycobacterium tuberculosis. Most often TB affects the lungs but can also affect other parts of the body. TB is spread through the air from person to person in droplets formed when a sick person coughs, speaks, sneezes, spits, laughs or even sings. The germ gets into the air, ready to be inhaled by the next person that passes by.

Tuberculosis has the second disease highest mortality rate after HIV/Aids infection. People with compromised immune systems such as babies, the elderly, malnourished individuals and people living with HIV or diabetes, have a greater risk of contracting TB. Although contagious, you are more likely to get TB from a person you live or work with than from a stranger1.

SIGNS AND SYMPTOMS OF TB

There are two forms of TB infection, latent and active. Latent TB occurs when you are infected with the bacteria but your immune system can fight it and you do not show symptoms. The bacteria can stay in the body but cannot be spread. This form of TB is far more common than you would expect, affecting a third of the world’s population2. Active TB is when the infection eventually shows symptoms, making you sick. This is the stage that you can spread the disease to others. Active TB presents as a persistent chest infection that includes coughing3. The most common signs of TB are4:

  • Persistent cough that last more than three weeks
  • Coughing up blood
  • High fever
  • Night sweats
  • Unexplained weight loss
  • Lack of energy

When a person develops active TB (disease), the symptoms may be mild for many months. This can lead to people putting off seeking medical help. This delay often results in the spread of the bacteria to others. People with active TB that do not receive adequate treatment can infect up to 10-15 people in a year1.

TB can be treated and healed but, without adequate treatment it can lead to complications from the spread of the bacteria through the body and can eventually be fatal. Some complications of TB include3:

  • Spinal pain
  • Joint damage
  • Meningitis- swelling in the brain
  • Liver or kidney problems
  • Heart disorders

TB AND NUTRITION

A vicious cycle

There is a huge link between TB and nutrition. Forms of under-nutrition such as protein and energy malnutrition can lower your immune system and thus make you more susceptible to infection with the disease. Poor nutrition also increases the risk for complications in those that are infected. Infection with the disease itself can also affect the use of nutrients within the body and thus the nutritional status of patient5.

It’s a cycle, bad nutrition leads to increased infection which leads to worse nutrition as shown in image below.

tb

Active TB, like other infectious diseases, causes an in increase energy requirements. Studies show that patients who receive nutritional supplementation during TB treatment tend to have better outcomes compared to those who do not5.

Increased requirements

Increased energy requirements are experienced because the body is in a catabolic state (breaking down muscle). If energy intake is not sufficient in the diet, this can lead to weight loss. Energy requirements are recommended at 147-168 kilojoules (KJ) per kilogramme of ideal body weight. So for instant a person with a healthy weight of 50kg will require 7350-8400kJ of energy per day.

Protein needs are also increased and intake is recommended at 15% of total energy intake. This equates to approximately 75g to 100g of protein per day.

There is little evidence as to the exact micronutrient requirements incurred by the disease. A micronutrient supplementation that provide 50-150% of recommended daily allowance (RDA) of vitamin and minerals is recommended7.

Practical recommendations include:

  • Ensure that meals not only provide enough energy and protein but are appetising in appearance and taste.
  • High energy and protein drinks or porridges such as FUTURELIFE® HIGH ENERGY Smart Food™ and FUTURELIFE® HIGH PROTEIN Smart Food™ can be used to meet these increased requirements.
  • Household foods such as sugar, vegetable oil, peanut butter, eggs and non-fat dry milk powder can be added to porridge, soups, gravies, casseroles or milk based drinks to increase the protein and energy.
  • Ensure adequate intake of fruits and vegetables. At least 5-6 portions of fruit and vegetables are recommended per day.
  • Alcohol intake should be avoided.
  • Adequate fluid intake is important due to increased fluid losses.
  • Safe food handling and personal hygiene is very important. Wash hands and utensils regularly and thoroughly7.

WHERE DOES FUTURELIFE® FIT IN?

FUTURELIFE® HIGH ENERGY Smart Food™ and FUTURELIFE® HIGH PROTEIN Smart Food™ are both high in energy and protein containing 1510KJ, 18g protein and 1460KJ, 30g protein per 100g respectively. Not only are they energy and protein-dense but also low GI and contain 21-23 vitamins and minerals, 19 amino acids, Omega-3, Moducare®(daily immune supplement), Inulin (prebiotic) and Lecithin.

The medication used to treat TB, Isoniazid, depletes your body’s vitamin B6 stores and it interferes with vitamin D metabolism which in turn can decrease absorption of calcium and phosphorus. Individuals with TB therefore require increased vitamin, especially B6 and D, and mineral intake from food and supplements. FUTURELIFE® HIGH ENERGY Smart Food™ and FUTURELIFE® HIGH PROTEIN Smart Food™ are excellent sources of vitamins and minerals where in every 100g (2 servings) you get 100% of all the vitamins and most of the minerals that a healthy person needs per day. FUTURELIFE® HIGH ENERGY Smart Food™ and HIGH PROTEIN Smart Food™ also contain the specific vitamins and minerals that are of importance in TB:

  • Vitamin B6 – 1.7 mg
  • Vitamin D – 15 µg
  • Calcium – 337 mg
  • Phosphorus – 247 mg

FUTURELIFE® HIGH ENERGY Smart Food™ and FUTURELIFE® HIGH PROTEIN Smart Food™ can be enjoyed as a meal, shake or smoothie require no cooking or preparation. The versatility, convenience and nutritional value of these products make them a suitable and affordable meal or supplement that can be consumed by individuals with TB. FUTURELIFE® SmartBars and FUTURELIFE® Smart Drink are also great supplement options to increase energy, protein and micronutrient intake8.

Conclusion

TB is a very treatable disease and maintaining nutrition is one of many important factors involved in treatment. It important to provide nutrient and energy dense foods to reach increased requirements. Be aware of how the disease presents in order to help prevent it or get treatment as soon as possible. Together we can beat TB.

References

  1. http://www.who.int/features/qa/08/en/
  2. http://www.who.int/trade/distance_learning/gpgh/gpgh3/en/index4.html
  3. http://www.mayoclinic.org/diseases-conditions/tuberculosis/symptoms-causes/dxc-20188557
  4. http://www.thetruthabouttb.org/do-i-have-tb/
  5. http://www.fantaproject.org/news-and-events/why-good-nutrition-important-treatment-tb
  6. https://www.ncbi.nlm.nih.gov/books/NBK189860/#ch2.s2
  7. http://www.sun.ac.za/english/faculty/healthsciences/nicus/Documents/Files/Files/Fact_sheets/TB%20and%20Nutrition.pdf
  8. Krause’s Food & the Nutrition Care Process 13th Edition, L. Kathleen Mahan, Sylvia Escott-Stump, et al
  9. FUTURELIFE® website

Images:

www.fantaproject.org