Management of TB Patient - Normal Weight

a. Recommendation for patient with BMI between 21 and 25 kg/m2

The current body weight is consistent with a BMI in the normal range (18.5-24.9kg/m2). Patients should be advised to maintain their weight in this range

Advise

Diet

• Adequate and balanced
  Cereals and Pulses
  Milk
  Oils and Nuts
  Fruits and Vegetables
  Eggs, Flesh Foods
• Recommended protein-rich foods like pulse, milk and dairy products, eggs, and flesh foods to enable recovery of lost muscle mass
• Frequent feeds initially when appetite is likely to be poor
• Later, when normal appetite returns, advise 3 meals and at least 2 snacks

Supplements

• Costlier foods and nutritional supplements are not necessarily better than locally available foods
• A multivitamin pill is adequate to meet micronutrient requirements if intake is very poor>

Healthy lifestyle

• Advice patient to be active as possible. It improves appetite and muscle mass
• Smoking and alcohol is harmful to TB patients, and should be avoided

Monitor

Weight Gain

• Weigh every month
• If follow up BMI is > 25kg/m2 advise restriction of calories and increase activity levels
• If patients lose weight after returning from work, and BMI falls below 21 kg/m2, advise extra intake of calories and proteins

Drug Toxicity

•  Assess patient for drug toxicity if, after initial improvement, appetite decreases or if there is vomiting

b. Recommendation for patient with BMI 18.5-21 kg/m2

The current body weight is consistent with a BMI in the normal range (18.5-24.9kg/m2). Patient should be advised to maintain their weight in this range. Adequate nutrition is crucial for recovery

Assess

• Appetite and Oral intake, performance status, vital signs, anaemia, pedal edema, medical  condition

Advise

Diet

• Adequate and balanced
  Cereals and Pulses
  Milk
  Oils and Nuts
  Fruits and Vegetables
  Eggs, Flesh Foods
• Cereals, oils and nuts are energy rich, while pulses, milk and dairy products, eggs and flesh foods are rich in proteins. Underweight patients needs more of these foods
• Frequent feeds initially, when appetite is likely to be poor 
• Later, when normal appetite returns, advice 3 meals and at least 2 snacks

Supplements

• Costlier foods and nutritional supplements are not necessarily better than locally available foods• 
• A multivitamin pill is adequate to meet micronutrient requirements if intake is very poor

Healthy lifestyle

• Advice patient to be active as possible. It improves appetite and muscle mass
• Smoking and alcohol is harmful for TB patients, and should be avoided

Monitor

Weight Gain

• Weigh every month
• If follow up BMI is > 25kg/m2 advice restriction of calories and increase activity levels
• If patients lose weight after returning from work, and BMI falls below 21 kg/m2, advice extra intake of calories and proteins

Drug Toxicity

• Assess patient for drug toxicity if, after initial improvement, appetite decreases or if there is vomiting