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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

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