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Journal of Nutrition Research
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Dietary Intake and Nutritional Status of Patients with Pulmonary Tuberculosis in Puducherry, South India
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Journal of Nutrition Research

DOI: 10.55289/jnutres/v10i1_22.17

Year: 2022, Volume: 10, Issue: 1, Pages: 1-10

Original Article

Dietary Intake and Nutritional Status of Patients with Pulmonary Tuberculosis in Puducherry, South India

Leon Jovita 1 , Sonali Sarkar​ ✉ 2 , Debdatta Basu 3 , Nivedita Nanda 4 , Noyal Mariya Joseph 5 , Sreeja Manghat 1

1 Ph.D. Scholar, Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
2 Professor, Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
3 Professor, Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
4 Additional Professor, Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
5 Additional Professor, Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India

Corresponding author ✉: [email protected]

Received Date:21 October 2022, Accepted Date:10 December 2022, Published Date:26 December 2022

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

A bidirectional relationship exists between tuberculosis (TB) and nutrition. To examine the dietary intakes of tuberculosis (TB) patients and to identify the factors associated with dietary deficiencies. In this cross-sectional study, 173 newly diagnosed sputum smear-positive TB patients, and taking treatment in the National Tuberculosis Elimination Programme (NTEP) were included. Nutrient intakes were evaluated through one day 24-h dietary recall and compared with the Recommended Dietary Allowance (RDA). Data on dietary intake was analyzed using DietSoft software. The mean (SD) age of the study participants was 45.5 (18.7) years with majority male (73.4%). More than one-third (35.3%) didn’t receive any formal education and 28% were unemployed. Nearly half (47%) had diabetes mellitus, 45.1% were alcoholics, 39.3% were smokers, and 36% underweight. The mean (SD) daily intake of energy was 1414.33 (458.45) kcal and the median (Interquartile Range) of protein was 43.15 (30.00-60.26) gms. The daily energy and protein intake were lower than the national guidelines for RDA. The intake of micronutrients was found to be much lower than recommended. The intake of macronutrients and selected micronutrients in TB patients were grossly inadequate. Along with vitamin supplementation, dietary counseling also is needed in this population.

Keywords: Dietary intake, Nutritional status, Risk behaviors, Tuberculosis

References

  2. Pakasi TA, Karyadi E, Dolmans WMV, Meer JWMVD, Der V, Velden K. Malnutrition and socio-demographic factors associated with pulmonary tuberculosis in Timor and Rote Islands, Indonesia. Int J Tuberc Lung Dis. 2009;13(6):755–759. Available from: https://pubmed.ncbi.nlm.nih.gov/19460253/
  3. Kumar A, Kakkar R, Kandpal SD, Sindhwani G. Nutritional status in multi-drug resistance-pulmonary tuberculosis patients. Indian J Community Med. 2015;26(5):204–208. Available from: https://www.iapsmupuk.org/journal/index.php/IJCH/article/view/495
  4. Zachariah R, Spielmann MP, Harries AD, Salaniponi FML. Moderate to severe malnutrition in patients with tuberculosis is a risk factor associated with early death. Trans R Soc Trop Med Hyg. 2002;96(3):90103–90106. Available from: https://doi.org/10.1016/S0035-9203(02)90103-3
  5. Lettow MV, Harries AD, Kumwenda JJ, Zijlstra EE, Clark TD, Taha TE, et al. Micronutrient malnutrition and wasting in adults with pulmonary tuberculosis with and without HIV co-infection in Malawi. BMC Infectious Diseases. 2004;4(1):1–8. Available from: https://doi.org/10.1186/1471-2334-4-61
  6. Friis H, Range N, Pedersen ML, Mølgaard C, Changalucha J, Krarup H, et al. Hypovitaminosis D Is Common among Pulmonary Tuberculosis Patients in Tanzania but Is Not Explained by the Acute Phase Response. The Journal of Nutrition. 2008;138(12):2474–2480. Available from: https://doi.org/10.3945/jn.108.094979
  9. Kotecha P. Micronutrient malnutrition in India: Let us say "no" to it now. Indian Journal of Community Medicine. 2008;33(1):9. Available from: https://doi.org/10.4103/0970-0218.39235
  10. Gil-Santana L, Cruz LAB, Arriaga MB, Miranda PFC, Fukutani KF, Silveira-Mattos PS, et al. Tuberculosis-associated anemia is linked to a distinct inflammatory profile that persists after initiation of antitubercular therapy. Scientific Reports. 2019;9(1):1–8. Available from: https://doi.org/10.1038/s41598-018-37860-5
  11. Lee SW, Kang YA, Yoon YS, Um SW, Lee SM, Yoo CG, et al. The Prevalence and Evolution of Anemia Associated with Tuberculosis. Journal of Korean Medical Science. 2006;21(6):1028–1032. Available from: https://doi.org/10.3346/jkms.2006.21.6.1028
  12. Semba RD, Darnton-Hill I, Pee SD. Addressing Tuberculosis in the Context of Malnutrition and HIV Coinfection. Food and Nutrition Bulletin. 2010;31(4_suppl4):S345–S364. Available from: https://doi.org/10.1177/15648265100314s404
  13. Williams BG, Cegielski P, Dye C. A consistent log-linear relationship between tuberculosis incidence and body mass index. Int J Epidemiol. 2010;39(1):149–155. Available from: https://doi.org/10.1093/ije/dyp308
  14. Putri FA, Burhan E, Nawas A, Soepandi PZ, Sutoyo DK, Agustin H, et al. Body mass index predictive of sputum culture conversion among MDR-TB patients in Indonesia. The International Journal of Tuberculosis and Lung Disease. 2014;18(5):564–570. Available from: https://doi.org/10.5588/ijtld.13.0602
  15. Satyaraddi A, Velpandian T, Sharma SK, Vishnubhatla S, Sharma AK, Sirohiwal A, et al. Correlation of plasma anti-tuberculosis drug levels with subsequent development of hepatotoxicity. The International Journal of Tuberculosis and Lung Disease. 2014;18(2):188–195. Available from: https://doi.org/10.5588/ijtld.13.0128
  16. Ramachandran G, Kumar AKH, Bhavani PK, Gangadevi NP, Sekar L, Vijayasekaran D, et al. Age, nutritional status and INH acetylator status affect pharmacokinetics of anti-tuberculosis drugs in children. The International Journal of Tuberculosis and Lung Disease. 2013;17(6):800–806. Available from: https://doi.org/10.5588/ijtld.12.0628
  17. Polasa K, Murthy KJ, Krishnaswamy K. Rifampicin kinetics in undernutrition. British Journal of Clinical Pharmacology. 1984;17(4):481–484. Available from: https://doi.org/10.1111/j.1365-2125.1984.tb02377.x
  18. Bhargava A, Chatterjee M, Jain Y, Chatterjee B, Kataria A, Bhargava M, et al. Nutritional Status of Adult Patients with Pulmonary Tuberculosis in Rural Central India and Its Association with Mortality. PLoS ONE. 2013;8(10):e77979. Available from: https://doi.org/10.1371/journal.pone.0077979
  19. Waitt CJ, Squire SB. A systematic review of risk factors for death in adults during and after tuberculosis treatment [Review article] The International Journal of Tuberculosis and Lung Disease. 2011;15(7):871–885. Available from: https://doi.org/10.5588/ijtld.10.0352
  20. Podewils LJ, Holtz T, Riekstina V, Skripconoka V, Zarovska E, Kirvelaite G, et al. Impact of malnutrition on clinical presentation, clinical course, and mortality in MDR-TB patients. Epidemiology and Infection. 2011;139(1):113–120. Available from: https://doi.org/10.1017/S0950268810000907
  21. Mitnick C, Bayona J, Palacios E, Shin S, Furin J, Alcántara F, et al. Community-Based Therapy for Multidrug-Resistant Tuberculosis in. N Engl J Med. 2003;348(2):119–128. Available from: https://doi.org/10.1056/nejmoa022928
  23. Koethe JR, Reyn CFV. Protein-calorie malnutrition, macronutrient supplements, and tuberculosis. The International Journal of Tuberculosis and Lung Disease. 2016;20(7):857–863. Available from: https://doi.org/10.5588/ijtld.15.0936
  24. Karyadi E, Schultink W, Nelwan RHH, Gross R, Amin Z, Dolmans WMV, et al. Poor Micronutrient Status of Active Pulmonary Tuberculosis Patients in Indonesia. The Journal of Nutrition. 2000;130(12):2953–2958. Available from: https://doi.org/10.1093/jn/130.12.2953
  25. Ray ML, Kumar RP. Plasma zinc status in Indian childhood TB: Impact of ATT. In Int J Tuberc Lung Dis. 1998;2(9):719–725. Available from: https://pubmed.ncbi.nlm.nih.gov/9755925/
  26. 1 TKIK, Haruta H, Maeda M, Kubota TN. Cerebral hemorrhage associated with vitamin K deficiency in congenital tuberculosis treated with isoniazid and rifampin. Pediatr Infect Dis J. 2002;21(11):1088–1090. Available from: https://doi.org/10.1097/01.inf.0000036438.62348.ab
  27. Ayiraveetil R, Sarkar S, Chinnakali P, Jeyashree K, Vijayageetha M, Thekkur P, et al. Household food insecurity among patients with pulmonary tuberculosis and its associated factors in South India: a cross-sectional analysis. BMJ Open. 2020;10(2):e033798. Available from: https://doi.org/10.1136/bmjopen-2019-033798
  28. Lee GO, Paz-Soldan VA, Riley-Powell AR, Gómez A, Tarazona-Meza C, Villaizan paliza K, et al. Food Choice and Dietary Intake among People with Tuberculosis in Peru: Implications for Improving Practice. Current Developments in Nutrition. 2020;4(2):1–9. Available from: https://doi.org/10.1093/cdn/nzaa001
  29. Feleke BE, Feleke TE, Biadglegne F. Nutritional status of tuberculosis patients, a comparative cross-sectional study. BMC Pulmonary Medicine. 2019;19(1):1–9. Available from: https://doi.org/10.1186/s12890-019-0953-0
  31. Shukla A, Pandey S, Singh SP, Sharma J. Nutritional status of pulmonary tuberculosis patients: A hospital-based cross-sectional study. Indian J Community Fam Med. 2019;5(2):134–140. Available from: https://doi.org/10.4103/ijcfm.ijcfm_39_19
  32. Dalvi SM, Patil VW, Ramraje NN, Yeram N, Meshram P. Study of vitamins in pulmonary Tuberculosis. International Journal of Research in Medical Sciences. 2019;7(9):3329–3336. Available from: https://doi.org/10.18203/2320-6012.ijrms20193909
  33. Rohini K, Bhat S, Srikumar PS, Kumar AM. Assessment of Serum Calcium and Phosphorus in Pulmonary Tuberculosis Patients Before, During and After Chemotherapy. Indian Journal of Clinical Biochemistry. 2014;29(3):377–381. Available from: https://doi.org/10.1007/s12291-013-0383-3
  35. Ren Z, Zhao F, Chen H, Hu D, Yu W, Xu X, et al. Nutritional intakes and associated factors among tuberculosis patients: a cross-sectional study in China. BMC Infectious Diseases. 2019;19(1):1–8. Available from: https://doi.org/10.1186/s12879-019-4481-6
  36. Simon AK, Hollander GA, Mcmichael A, Mcmichael A. Evolution of the immune system in humans from infancy to old age. Proc. Biol. Sci. 1821;282(1821):1–12. Available from: https://doi.org/10.1098/rspb.2014.3085
  37. Amarya S, Singh K, Sabharwal M. Changes during aging and their association with malnutrition. Journal of Clinical Gerontology and Geriatrics. 2015;6(3):78–84. Available from: https://doi.org/10.1016/j.jcgg.2015.05.003
  38. Dallongeville J, Marécaux N, Fruchart JC, Amouyel P. Cigarette Smoking Is Associated with Unhealthy Patterns of Nutrient Intake: a Meta-analysis. The Journal of Nutrition. 1998;128(9):1450–1457. Available from: https://doi.org/10.1093/jn/128.9.1450
  39. Oh J, Choi R, Park HD, Lee H, Jeong BH, Park HY, et al. Evaluation of vitamin status in patients with pulmonary tuberculosis. Journal of Infection. 2017;74(3):272–280. Available from: https://doi.org/10.1016/j.jinf.2016.10.009
  40. Gibson RS, Charrondiere UR, Bell W. Measurement Errors in Dietary Assessment Using Self-Reported 24-Hour Recalls in Low-Income Countries and Strategies for Their Prevention. Advances in Nutrition: An International Review Journal. 2017;8(6):980–991. Available from: https://doi.org/10.3945/an.117.016980

Copyright

© 2022 Jovita et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Published By India Association for Parenteral and Enteral Nutrition (IAPEN)

  • 26 December 2022

Year: 2022, Volume: 10, Issue: 1


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