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Nutritional supplements for people being treated for active tuberculosis: A technical summary.
L Grobler1, S Durao, S M Van der Merwe
1Centre for Evidence-Based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa. liesl.nicol@gmail.com.
South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
|December 22, 2017
Summary
Oral nutritional supplements likely improve weight gain in tuberculosis patients but offer no proven clinical benefits for treatment outcomes. More research is needed to confirm the effectiveness of these interventions for tuberculosis recovery.
Area of Science:
- Nutrition and Dietetics
- Infectious Diseases
- Public Health
Background:
- Tuberculosis (TB) and malnutrition share a complex, bidirectional relationship.
- Undernutrition can exacerbate TB progression and impede recovery.
- Oral nutritional supplements are often considered as an adjunct therapy for TB patients.
Purpose of the Study:
- To assess the effects of oral nutritional supplements on treatment outcomes in patients with active tuberculosis.
- To evaluate the impact of various supplementation types (food, high-energy, multi- and single-micronutrients) on TB recovery.
Main Methods:
- An updated Cochrane review of randomized controlled trials (RCTs) was conducted.
- Searched for trials comparing oral nutritional supplements (≥4 weeks) with no intervention, placebo, or dietary advice in TB patients on drug therapy.
- Included 35 trials with 8,283 participants, analyzing different types of nutritional interventions.
Main Results:
- Free food or high-energy supplements probably improve weight gain but lack evidence for improved TB treatment outcomes (death, cure rates).
- Micronutrient supplementation (multi-, single-, dual-) may improve plasma levels of certain nutrients (zinc, vitamin D, E, selenium) but shows no reliable clinical benefits for TB treatment.
- Current evidence is insufficient to support routine supplementation above recommended daily intake for clinical benefits in TB patients.
Conclusions:
- While oral nutritional supplements may aid weight gain in some TB patients, robust evidence for improved clinical outcomes like reduced mortality or increased cure rates is lacking.
- Supplementation with specific micronutrients may improve biochemical markers but does not translate to demonstrable clinical benefits in TB treatment.
- Current supplementation protocols, like those in South Africa, often rely on nutritional assessment rather than solely on disease diagnosis or treatment status.
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