According to the World Health Organisation (WHO), 2022 saw an estimated 10.6 million people fall ill with tuberculosis (TB) worldwide. This included 5.8 million men, 3.5 million women and 1.3 million children.
Year after year, millions of people lose their lives due to TB disease, and this can be compounded by the prevalence of HIV-TB coinfection and ongoing issues with drug-resistant TB strains, which makes treatments more lengthy and more costly.
TB Is A Health Crisis
It is almost impossible to comprehend that a curable disease that has existed for more than 2000 years is still a major health challenge in 2023, particularly amongst people living in poverty.
TB is an infectious disease caused by Mycobacterium tuberculosis, a bacterium that primarily affects the lungs. It spreads through airborne bacteria released in tiny droplets when an infectious person with active TB disease coughs or sneezes.
Typically, close and prolonged contact with an infectious person is necessary for transmission of the bacteria, and not everyone who is exposed to the bacteria develops active TB disease. In many cases, the immune system can keep the TB infection dormant. However, those with weakened immune systems, such as people living with HIV, are more susceptible to developing active TB disease.
Why poverty, nutrition, TB, and HIV intersect
Malnutrition is another factor that leads to a weak immune system and a higher risk of developing TB disease. Food insecurity is a major cause of malnutrition in parts of the world, and so is chronic substance abuse, which often results in being underweight.
Since nutrition plays a vital role in determining the strength of the immune system, undernourishment, including significant loss of fat and muscle mass, is one of the risk factors for TB. Where there is malnutrition, poverty, overcrowding, stress, alcoholism, and drug addiction, there is TB.
Due to a lack of access to healthcare, malnutrition is typically already severe at this stage of diagnosis. The body requires extra amounts of energy, protein, and nutrients to fight off infection. Healthy weight is also essential to the effectiveness of TB drug regimens.
However, promoting weight gain and maintaining body mass can be challenging, as both HIV and TB disease states interfere with the body’s ability to absorb nutrients.
The role of nutrients during TB treatment
TB patients undergoing treatment must focus on their daily nutrition. Loss of appetite and digestive complaints are common symptoms, making it more difficult to take in sufficient nutrients.
It’s important to remember, though, that TB is a curable disease. It does require antibiotic treatment that can last for many months, and strictly adhering to the drug treatment all the way to the end is vital to prevent the recurrence of infection and avoid developing drug-resistant TB infections.
People suffering from TB have high daily protein and energy needs, as well as significant nutrition requirements when it comes to vitamins and minerals. They commonly experience micronutrient deficiencies, namely vitamins A, E, and D and the minerals calcium, iron, zinc, and selenium, and these deficiencies are a particular problem.
Micronutrients play a significant and complex role in immune function. Whenever the immune system is compromised, successful TB treatment is at stake. Therefore, nutritional deficiencies are associated with increased risk and severity of TB disease, delays in recovery, and longer, more frequent hospital visits.
Improving the Nutrition of People with TB
It’s best to focus on eating a varied, healthy diet, and staying away from unhealthy habits like smoking, drinking alcohol and sugary drinks. Drink lots of clean water throughout the day to hydrate. Aim to have a minimum of three mixed meals a day because when meals are mixed, we have the best absorption of nutrients.
Remember that physical activity or light exercise is important to rebuild muscles. If you’re experiencing a loss of appetite, try five to six smaller meals per day.
Mixed meals mean ensuring that we use a combination of foods from the four basic food groups in one meal:
- Starches such as cereal, rice, maize meal, wholewheat bread, potatoes, and butternut
- Vegetables and fruit which provides our body with all the vitamins and minerals it needs to support the immune system
- Protein-rich foods such as milk, eggs, yogurt, beans, lentils, chicken, meat, and fish
- Oils and fats as well as nuts and seeds
Mixed meals containing all four food groups:
- Chicken stew with onion and carrots, served with green beans and corn meal (maize porridge)
- Beans and hominy (samp) with beetroot, cooked cabbage and onion
- Peanut butter and bread with a banana
- An orange with a cheese sandwich
- Corn meal (maize porridge) with milk or fermented milk (maas), a little margarine, and sugar with an apple or fruit of your choice
- Oats porridge with yogurt, a banana, and a little sugar
- Beef stew with tomatoes, green beans, and carrots served with rice or lentils
- Chicken sandwich and an apple
- Bean stew with rice and steamed frozen vegetables
- Sardines (pilchards) on bread with salad
- Beans and bread with cooked spinach and tomato
- Beef mince with tomato, spinach, and onion served with pasta
- Bread with a boiled egg and a banana
- Soy mince with mixed vegetables and rice or pap
- High protein cereal with milk, margarine, and a banana
- Vegetable soup with chickpeas or barley and a slice of bread
Takeaway
Nutrition plays a vital role in the recovery and well-being of TB patients. Seeking professional guidance from a registered dietitian can help you optimize your nutrition and follow an affordable meal plan that suits your tastes.
Remember, a well-nourished body is better equipped to combat TB and helps you regain your strength.
Who are the authors?
Janke Draper
Janke Draper is a Registered Dietitian, lactation consultant, and a spokesperson for ADSA (Association for Dietetics in South Africa).
She completed her B.Sc. Dietetics degree at the University of the Free State (UFS) and then obtained her Master’s degree in dietetics at the UFS.
Faaizah Laher is a Registered Dietitian at Garden City Clinic, in Johannesburg, where she works as a clinical dietitian in the ICU, High Care, Surgical Wards, and Medical Wards.
Faaizah Laher
She spends her days guiding her outpatient clients in achieving their weight loss, diabetic, and renal nutrition goals. During this time she helps them achieve their individual nutrition goals, one step at a time. Before completing her community service at Chris Hani Baragwanath Hospital, Faaizah completed her Bachelor’s degree in Nutrition and Dietetics at the University of the Free State. She is constantly updating her knowledge and updating her skills by reading scientific articles and attending courses to make sure she is at the forefront of the new developments in Nutrition!
Being a mom to 3 busy little girls, Faaizah is passionate about healthy, delicious meals, colorful lunchboxes, and flavorful interesting meals. Using her family as her drawing board, Faaizah is constantly developing and testing new recipes, flavors, and combinations, to offer her clients recipes and ideas that will keep them on the path to a healthy lifestyle.
