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TB and nutrition: what's new?

In a nutshell

There are many reasons to believe nutrition supplements should be beneficial in prevention and treatment of TB.

Apart from vitamin D (see issue #313), interesting new work has focused on iron, cholesterol, zinc and vitamin A. However, at this stage there is insufficient clinical evidence to allow us to reach definitive conclusions about any one type of nutrient supplement.

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References

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1. Tang, AM. et al. Nutrition and infection. Ch.12 in: Nelson, KE et al (eds). Infectious disease epidemiology: theory and practice. Jones and Bartlett, Sudbury MA, 2000.
2. Gauss, H. Nutrition and tuberculosis. Chest. 1934;2:2024.
3. Helman, AD. Nutrition supplements for tuberculosis. Arb Clin Nutr Upd. 2005(Jan);198:13.
4. Pakasi, TA. et al. Vitamin A deficiency and other factors associated with severe tuberculosis in Timor and Rote Islands, East Nusa Tenggara Province, Indonesia. Eur J Clin Nutr. 2009 Sep;63(9):1130–5.
5. Ramakrishnan, K. et al. Serum zinc and albumin levels in pulmonary tuberculosis patients with and without HIV. Jpn J Infect Dis. 2008 May;61(3):202–4.
6. Kassu, A. et al. Alterations in serum levels of trace elements in tuberculosis and HIV infections. Eur J Clin Nutr. 2006 May;60(5):580–6.
7. Sahiratmadja, E. et al. Iron deficiency and NRAMP1 polymorphisms (INT4, D543N and 3'UTR) do not contribute to severity of anaemia in tuberculosis in the Indonesian population. Br J Nutr. 2007 Oct;98(4):684–90.
8. Friis, H. et al. Acute- phase response and iron status markers among pulmonary tuberculosis patients: a cross-sectional study in Mwanza, Tanzania. Br J Nutr. 2009 Jul;102(2):310–7.
9. McDermid, JM. et al. Iron and infection: effects of host iron status and the iron-regulatory genes haptoglobin and NRAMP1 (SLC11A1) on host-pathogen interactions in tuberculosis and HIV. Clin Sci (Lond). 2006 May;110(5):503–24.
10. Lounis, N. et al. Iron and Mycobacterium tuberculosis infection. J Clin Virol. 2001 Feb;20(3):123–6.
11. Gordeuk, VR. et al. Circulating cytokines in pulmonary tuberculosis according to HIV status and dietary iron content. Int J Tuberc Lung Dis. 2009 Oct;13(10):1267–73.
12. Miner, MD. et al. Role of cholesterol in Mycobacterium tuberculosis infection. Indian J Exp Biol. 2009 Jun;47(6):407–11.
13. Pérez-Guzmán, C. et al. Hypocholesterolemia: a major risk factor for developing pulmonary tuberculosis? Med Hypotheses. 2006;66(6):1227–30.
14. Martens, GW. et al. Hypercholesterolemia impairs immunity to tuberculosis. Infect Immun. 2008 Aug;76(8):3464–72.
15. Jordao, L. et al. Effects of omega-3 and -6 fatty acids on Mycobacterium tuberculosis in macrophages and in mice. Microbes Infect. 2008 Oct;10(12–13):1379–86.
16. McFarland, CT. et al. Dietary polyunsaturated fatty acids modulate resistance to Mycobacterium tuberculosis in guinea pigs. J Nutr. 2008 Nov;138(11):2123–8.
17. Pérez-Guzmán, C. et al. A cholesterol-rich diet accelerates bacteriologic sterilization in pulmonary tuberculosis. Chest. 2005 Feb;127(2):643–51.
18. Karyadi, E. et al. A double-blind, placebo-controlled study of vitamin A and zinc supplementation in persons with tuberculosis in Indonesia: effects on clinical response and nutritional status. Am J Clin Nutr. 2002 Apr;75(4):720–7.
19. Hanekom, WA. et al. Vitamin A status and therapy in childhood pulmonary tuberculosis. J Pediatr. 1997 Dec;131(6):925–7.
20. Range, N. et al. The effect of micronutrient supplementation on treatment outcome in patients with pulmonary tuberculosis: a randomized controlled trial in Mwanza, Tanzania. Trop Med Int Health. 2005 Sep;10(9):826–32.
21. Semba, RD. et al. Micronutrient supplements and mortality of HIV-infected adults with pulmonary TB: a controlled clinical trial. Int J Tuberc Lung Dis. 2007 Aug;11(8):854–9.
22. Schön, T. et al. Arginine as an adjuvant to chemotherapy improves clinical outcome in active tuberculosis. Eur Respir J. 2003 Mar;21(3):483–8.
23. Paton, NI. et al. Randomized controlled trial of nutritional supplementation in patients with newly diagnosed tuberculosis and wasting. Am J Clin Nutr. 2004 Aug;80(2):460–5.
24. Hemilä, H. et al. Vitamin E supplementation may transiently increase tuberculosis risk in males who smoke heavily and have high dietary vitamin C intake. Br J Nutr. 2008 Oct;100(4):896902.
25. Hernández-Garduño, E. Vitamin E supplementation may transiently increase tuberculosis risk in males who smoke heavily and have high dietary vitamin C intake--comments by Hernández-Garduño. Br J Nutr. 2009 Jan;101(1):145.

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