Nutrition in Far Advanced Tuberculosis A Preliminary Study

¹ The Thoracic Diseases Service, Birmingham Veterans Administration Hospital, Van Nuys, California.

1) Decreased glucose tolerance was found in 37 of 47 patients with far advanced pulmonary tuberculosis. These patients all demonstrated poor appetites except for the breakfast meal. The glucose tolerance curves showed prolongation of hyperglycemic levels beyond the third and fourth hours following ingestion of the glucose. On the premise that their poor appetites for the succeeding meals were due to prolonged hyperglycemia a two meal high protein diet was devised with 8 hours between meals.

2) Careful weight, food intake, and blood protein studies were made on 24 far advanced tuberculous patients on this diet. These patients showed a weight reversal from a previous average loss of 2.5 pounds per man two months prior to the diet to an average gain of 1.9 pounds pen man during two months on the diet. A critical level of food intake for weight maintenance in this group was found to be 2700 calories divided into 297 grams carbohydrates, 128 grams protein and 120 grams fat. Above this level the great majority of these patients gained weight regardless of fever or other evidence of toxicity.

3) Hemoglobin levels of patients on this diet showed a general increase over the levels 2 months prior to the diet. Total blood proteins showed no essential change over those of the controls. Protein loss in the sputum was found to be negligible.