Abstract:

Tuberculosis is a chronic consumptive infectious disease intrinsically associated with malnutrition. In patients with tuberculosis, malnutrition can result from multiple pathways including chronic inflammatory responses, gastrointestinal malabsorption, and multi-organ involvement. Such nutritional impairment further compromises host immune defenses through various mechanisms, thereby adversely affecting treatment outcomes. Thus, malnutrition not only worsens tuberculosis prognosis but also elevates the risk of disease development. Individualized nutritional interventions-particularly high-protein, high-calorie diets and micronutrient supplementation-have been shown to significantly improve clinical outcomes in tuberculosis patients. This review systematically summarizes the bidirectional vicious cycle between malnutrition and tuberculosis, detailing the pathophysiological processes by which tuberculosis induces malnutrition, and elucidates the molecular mechanisms through which malnutrition impairs treatment outcomes via diminished cellular immunity, disrupted metabolic homeostasis, and exacerbated chronic inflammation. It further evaluates clinical evidence supporting nutritional strategies-such as high-protein, high-calorie diets, vitamin D and trace element supplementation, and specific fatty acid interventions-in improving body weight, immune function, and treatment outcomes in tuberculosis patients. The overarching aim of this article is to provide a scientific rationale for nutritional support in tuberculosis management and to inform evidence-based clinical practice and public health strategies.

Key words: Tuberculosis, Malnutrition, Treatment outcome, Prognosis