Food Choice and Dietary Intake among People with Tuberculosis in Peru: Implications for Improving Practice

Abstract

Background In Peru, tuberculosis (TB) is perceived as a nutritional disease. This perception, alongside factors including household food insecurity, may drive the food choices of people with TB and influence treatment outcomes. Objectives The objective of this qualitative study was to explore drivers of food choice among adults recently diagnosed with TB. Methods The study was conducted between April and December 2016 in the Huaycán district of Lima, Peru. Structured questionnaires were administered to 39 adults with TB at the time of diagnosis and after 1 mo of treatment to characterize food security and socioeconomic status. At 1 mo of treatment, 24-h dietary recalls, enhanced by recipes obtained from local street vendors, were administered to examine patterns of food consumption and determine mean daily intake of macro- and micronutrients. Among a subset of 9 participants, in-depth interviews were used to explore dietary beliefs and food choices associated with TB. Results Overall, 13.2% of participants were underweight at baseline, and 10.5% were overweight. At 1 mo of treatment, the mean caloric intake was 600 kcal/d over what was needed to maintain their current weight. Most of these additional kilocalories came from carbohydrates. Patients made active efforts to improve their diets during treatment, and were both receptive to, and actively sought out, nutritional advice. However, many patients reported significant unnecessary spending on questionable commercial products, such as expensive natural remedies and nutritional supplements. Conclusions The perceived connection between TB and diet creates both opportunities and challenges for treatment providers. Nutritional counseling provided through the national TB program should promote dietary quality through foods that are locally available, inexpensive, and aligned with cultural perceptions of health and wellness.

Systems Nutrology of persons with tuberculosis identifies specific dietary profiles associated with dysglycemia

“…On the other hand, as tuberculosis is often associated with worse nutritional status, it is expected that the intake of foods rich in carbohydrates such as potatoes will be stimulated in this population, as can be seen in DP1. It is remarkable to nd that health directions recommend consuming foods rich in complex carbohydrates such as potatoes, sweet potatoes, rice, wheat and cereals 26 In may setting such as that observed in Peru, malnutrition is due to excess to the consumption of foods with high energy content and low nutritional value, with the growing popularity of junk food, not expensive and ready to be eaten at any time. These new eating patterns have caused different health issues.…”

Systems Nutrology of Persons with Tuberculosis Identifies Specific Dietary Profiles Associated with Dysglycemia

“…On the other hand, as tuberculosis is often associated with worse nutritional status, it is expected that the intake of foods rich in carbohydrates such as potatoes will be stimulated in this population, as can be seen in DP1. It is remarkable to nd that health directions recommend consuming foods rich in complex carbohydrates such as potatoes, sweet potatoes, rice, wheat and cereals [31] In may setting such as that observed in Peru, malnutrition is due to excess to the consumption of foods with high energy content and low nutritional value, with the growing popularity of junk food, not expensive and ready to be eaten at any time. These new eating patterns have caused different health issues.…”

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

“…But in most cases, especially in low-and middle-income countries, under nutrition is a result of patients not being able to purchase additional food because of economic hardship due to illness and loss of jobs or because of local food insecurity. (27,28) Considering the financial burden and importance of increased nutrient intake, the national TB program in India has launched the Nikshay Poshan Yojana nationwide, a direct benefit transfer (DBT), where all the notified cases in the NIKSHAY portal receive Indian rupees (INR) 500 per month (~US$7) throughout the treatment for TB.…”