Twenty-one HIV-negative adults with newly diagnosed pulmonary tuberculosis were hospitalized for 8 weeks and randomly assigned to receive a cholesterol-rich diet (800 mg/day of cholesterol) or a normal diet (250 mg/day of cholesterol). The extra amount of cholesterol in the high-cholesterol diet was derived from butter, beef liver, egg yolk, and milk products. All patients received the same 4-drug antitubercular regimen (isoniazid, rifampin, pyrazinamide, and ethambutol) and no patient had a drug-resistant strain of Mycobacterium tuberculosis. After 2 weeks, sputum cultures had become negative in 80% of patients receiving the high-cholesterol diet and in 9% of those receiving the normal diet (p < 0.002). In addition, the bacillary population (p = 0.0002) and sputum production (p < 0.05) decreased faster in the high-cholesterol group than in the normal-diet group.
Comment: Hypocholesterolemia is common among tuberculous patients and is associated with mortality in miliary cases. Some in vitro studies have shown that cholesterol is necessary for the functioning of macrophages and lymphocytes, which play a role in the immune response to infection. The results of the present study demonstrate that a cholesterol-rich diet accelerates recovery in patients with pulmonary tuberculosis. Such patients are often generally malnourished, so it is possible that other nutrients present in egg yolk, beef liver, and milk (such as protein and B vitamins) also contributed to their recovery.
Perez-Guzman C, et al. A cholesterol-rich diet accelerates bacteriologic sterilization in pulmonary tuberculosis. Chest 2005; 127:643-651.
COPYRIGHT 2005 The Townsend Letter Group
COPYRIGHT 2005 Gale Group
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