The relationship between malnutrition and tuberculosis

Cegielski, J.P. and McMurray, D.N., 2004. The relationship between malnutrition and tuberculosis: evidence from studies in humans and experimental animals. The international journal of tuberculosis and lung disease, 8(3), pp.286-298.

  • Malnutrition increases the risk of tuberculosis (TB) due to weakened cell-mediated immunity (CMI).
  • Malnourished individuals are more likely to progress from primary or latent TB infection to active disease.
  • Poverty links poor nutrition and higher TB risk, with malnutrition and TB rates rising together in such populations.
  • Case Study 1: Denmark during WWI
    • Denmark exported most protein-rich foods during the war, causing a rise in TB rates.
    • After a German blockade in 1918, local food availability improved, and TB rates dropped.
    • TB rates continued to rise in neighboring warring countries without improved nutrition.
  • Case Study 2: Trondheim, Norway Naval Training School
    • High TB rates due to crowded and unhygienic conditions.
    • TB rates did not decline with better housing and hygiene.
    • TB morbidity dropped after diet was fortified with nutritious foods.
  • Case Study 3: WWII British and Russian POWs
    • Both groups had the same prison diet, but British prisoners received additional Red Cross food supplements.
    • British prisoners had significantly lower TB rates (1.2%) compared to Russian prisoners (15-19%).
    • Better nutrition correlated with higher plasma proteins and lower TB severity in British prisoners.
    • Malnourished prisoners had rapid onset and severe TB, indicating poor CMI.
  • Understanding the timing between malnutrition and TB onset is crucial to assess cause-effect relationships.
  • TB itself can cause malnutrition-like symptoms, complicating cause-effect analysis in studies.
  • Low intake of fruits, vegetables, and vitamin C may lead to higher hospitalization rates rather than higher TB rates.
  • Vitamin supplementation has been shown to reduce the risk of TB among family contacts of active TB cases.

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