Better nutrition in TB patients’ families can cut down new infections by over 40%, says Lancet study

New evidence from Reducing Activation of Tuberculosis by Improvement of Nutritional Status (RATIONS) trial shows that improved nutrition among contacts of patients with infectious lung TB can reduce the incidence of all forms of TB by 40 per cent and of infectious TB by nearly 50 per cent. Significantly, it also found that early weight gain in underweight patients with TB can reduce their risk of mortality by 60 per cent

When an 18-year-old tribal from Jharkhand was detected with TB, he was a wasted body, weighing just 26 kg, bound to a bed and with no hope of living. With the family barely managing to get one square meal a day, his condition deteriorated. But when given nutritious food packets, the boy’s body weight increased by 16 kg in six months. He was part of a trial that showed a good diet and nutrition not only helped in preventing tuberculosis (TB) incidence in vulnerable people living with infected patients but also curbed mortality in patients themselves. The findings were a result of two new studies by ICMR and have been published in The Lancet and The Lancet Global Health journals. Conducted in Jharkhand, these offer the first evidence that providing extra nutrition is effective in preventing TB cases and mortality in India.

New evidence from Reducing Activation of Tuberculosis by Improvement of Nutritional Status (RATIONS) trial shows that improved nutrition among contacts of patients with infectious lung TB can reduce the incidence of all forms of TB by 40 per cent and of infectious TB by nearly 50 per cent. Significantly, it also found that early weight gain in underweight patients with TB can reduce their risk of mortality by 60 per cent. An early weight gain in the first two months was associated with 60 per cent lower risk of TB mortality. The other benefits to patients were higher treatment success, better weight gain

As per the trial, 10 345 household contacts of 2,800 TB patients were randomised to receive regular food parcels and additional micronutrients –750 kcal, 23 gm proteins. A total of 5,621 people were given the nutrient-dense food for a year while 4,724 people received food parcels with no extra nutrition. At the end of the trial, there was a 39 per cent reduction in TB incidence in the intervention group versus the control one. The second study followed 2,800 patients with TB over six months and found that weight gain during the extra nutrition treatment was associated with reduced risk of mortality, especially within the first two months when deaths occur. Instantaneous risk of death was reduced by 13 per cent for a one per cent weight gain and 61 per cent for 5 per cent weight gain.