Nutritional Status & Dietary Pattern of Tuberculosis Patients in India: A Systematic Review

Abstract

This systematic review aimed to evaluate existing evidence on the nutritional status and dietary patterns of tuberculosis (TB) patients in India, with particular emphasis on undernutrition, micronutrient deficiencies, and dietary factors influencing treatment outcomes and disease management. A comprehensive literature search was conducted across PubMed, Scopus,
Cochrane Library, Google Scholar, and Web of Science to identify peer- reviewed original studies published in English that assessed nutritional status or dietary patterns among adult or pediatric TB patients in India. Study selection followed PRISMA guidelines, involving title and abstract screening and subsequent full-text evaluation, while reviews, editorials, case reports, conference papers, and laboratory-based studies were excluded. Seventeen eligible studies conducted across different regions of India were included in the analysis. The findings consistently demonstrated a high prevalence of undernutrition among TB patients, with 59–80% exhibiting a body mass index below 18.5 kg/m². Energy intake was reported to be approximately 30–40% lower than recommended levels, alongside inadequate protein consumption. Additionally, widespread deficiencies of key micronutrients, particularly zinc, vitamin D, and iron, were observed. Contributing factors included food insecurity, limited dietary diversity, lack of nutritional counselling, and poor hygiene conditions. Although selected intervention studies reported improvements in nutritional status and treatment outcomes following dietary supplementation and counselling, nutritional care remains inconsistently integrated into TB control programs. Overall, nutritional deficiencies remain an under-addressed determinant of TB outcomes in India, necessitating integrated nutritional interventions.