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Clinical Nutrition

Predictors of body composition changes during tuberculosis treatment in Mwanza, Tanzania

European Journal of Clinical Nutrition volume 69, pages 1125–1132 (2015)Cite this article

Subjects

Abstract

Background/Objectives:

Gains in fat mass and lean mass during tuberculosis (TB) treatment may determine functional recovery and survival; yet, data are scarce. We aimed to assess predictors of fat and fat-free mass during 2 months of intensive TB treatment in a cohort in Mwanza, Tanzania.

Subjects/Methods:

Fat and fat-free mass were determined at the start of TB treatment and repeated after 2 months using the deuterium dilution technique. Gains in fat and fat-free mass were determined and predictors assessed using regression analysis.

Results:

Data for 116 patients were available at baseline and during follow-up. Of these, 38.8% were females, mean age was 37.3 (s.d. 13.5) years, 69% (81) had sputum-positive TB, 45.7% (53) were HIV infected and 25% (29) were current smokers. The mean weight gain was 3.3 kg (95% confidence interval: 2.7; 3.8), and it did not differ by sex. However, compared with females, males had 1.0 (0.4; 1.6) kg/m2 lower fat mass but 0.7 (0.2; 1.3) kg/m2 higher fat-free mass gain. Current smoking was associated with higher fat mass (0.7 kg/m2, 0.04; 1.4) but lower fat-free mass (−0.5 kg/m2, −1.2; 0.07) gain. Among HIV-infected patients, antiretroviral therapy (ART) led to a lower fat gain (−1.2 kg/m2, −2.2; −0.2) but to a higher fat-free mass among sputum-negative (2.9 kg/m2, 0.8; 5.1) but not sputum-positive patients.

Conclusions:

During intensive phase of TB treatment, sex, smoking and ART were predictors of body composition. Larger studies are needed to further understand predictors of body composition during recovery, to help design interventions to improve treatment outcomes.

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Acknowledgements

We thank all the health staff who were involved in the study, as well as all study participants. In addition, we are grateful to Christine Slater (IAEA) for her help on evaluation and interpretation of the deuterium dilution data. This study was supported by the Danish Council for Independent Research—Medical Sciences (grant 22-04-0404) by Danida through the Consultative Research Committee for Development Research (104.Dan.8-898.), the University of Copenhagen through the Cluster in International Health and the International Atomic Energy Agency (IAEA). The funding bodies had no role in the study design, data collection, data analysis, data interpretation or decision to publish the findings.

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Authors and Affiliations

  1. Mwanza Intervention Trials Unit, Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania

    G PrayGod, K Jeremiah & J Changalucha

  2. Muhimbili Research Centre, National Institute for Medical Research, Dar es Salaam, Tanzania

    N Range

  3. Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark

    D Faurholt-Jepsen, M Faurholt-Jepsen & H Friis

  4. Clinical Research Centre, University of Copenhagen, Hvidovre Hospital, Hvidovre, Denmark

    M G Aabye

  5. Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    P Magnussen

  6. Department of Infectious Diseases, Odense University Hospital, Odense, Denmark

    A B Andersen

  7. Childhood Nutrition Research Centre, UCL-Institute of Child Health, London, UK

    J C K Wells

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Correspondence to G PrayGod.

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PrayGod, G., Range, N., Faurholt-Jepsen, D. et al. Predictors of body composition changes during tuberculosis treatment in Mwanza, Tanzania. Eur J Clin Nutr 69, 1125–1132 (2015). https://doi.org/10.1038/ejcn.2015.37

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