TB Nurse Case ManagementSan Antonio, Texas

April 30 – May 02, 2019

The Role of Nutrition in TB Patients

Samantha Mezzetti, MS, RDN, LDN

Samantha Mezzetti, MS, RDN, LDN hasthe following disclosures to make:•No conflict of interests

•No relevant financial relationships with any commercial companies pertaining to this educational activity

Abbreviations

• AIDs: Acquired Immune Deficiency• BMI: Body Mass Index• DM: Diabetes Mellitus• HIV: Human Immunodeficiency Virus• IBW: Ideal Body Weight• TB: Tuberculosis• WHO: World Health Organization

What is Nutrition?

Nutrition is the intake of food, considered in relation to the body’s dietary needs. Good nutrition – an adequate, well balanced diet combined with regular physical activity – is a cornerstone of good health. Poor nutrition can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development, and reduced productivity.

-W.H.O.

Nutrition Recommendations

• National Dietary Guidelines

• WHO Guidelines• ADA’s Evidence-Based

Nutrition Practice Guidelines

• Research Studies

Nutritional Treatment and Care

Nutrition Care Process

1. Nutrition Assessment

2. Nutrition Diagnosis

3. Nutrition Intervention

4. Nutrition Monitoring and Evaluation

Nutrition Assessment1. Food/Nutrition-Related History

2. Anthropometric Measurements

3. Biochemical Data, Medical Tests, and Procedures

4. Nutrition-Focused Physical Findings

5. Client History

Common Comorbidities

• Malnutrition

• Micronutrient Deficiencies

– Vitamin D (risk factor)

– Anemia

• Poorly Controlled Diabetes

• AIDS/HIV

Nutrition Diagnosis• 3 Domains of a Nutrition Diagnosis

1. Intake2. Clinical3. Behavioral-Environmental

• PES Statement– Problem– Etiology– Signs and Symptoms

Nutrition Intervention• Food and/or Nutrient Delivery

– Should a high calorie &/or high protein diet be proscribed?– Should nutrient supplements or a multivitamin be proscribed?

• Nutrition Education– Dependent on comorbidities

• Nutrition Counseling– Dependent on comorbidities

• Coordination of Nutrition Care• S.M.A.R.T. Goals

Nutrition Monitoring and Evaluation

• Monitor progress• Measure outcome

indicators

• Evaluate outcomes• Evaluate patient

nutritional status

• Health Department• Food Banks• Religious Organizations• Community Gardens• Choose MyPlate• Handouts

References

• Diabetes and tuberculosis: a review of the role of optimal glycemic control , 26 February 2017. (http://www.jdmdonline.com/content/11/1/28/).

• Health topics, “Nutrition”. 26 February 2017. (http://www.who.int/topics/nutrition/en/).

• Nutrition and Tuberculosis: A Review of The Literature and Consideration for TB Control Programs, 26 February 2017. (http://pdf.usaid.gov/pdf_docs/PNADL992.pdf).

• Nutritional care and support for patients with tuberculosis. 26 February 2017. (www.who.int/nutrition/publications/guidelines/nutcare_support_patients_with_tb/en/).

• Pocket guide for International dietetics & nutrition terminology (IDNT) reference manual: standardized language for the nutrition care process. Third Edition. American Dietetic Association - 2011

• Tuberculosis and Nutrition, 26 February 2017. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2813110/).