Researchers in India tested whether special high-calorie nutrition drinks could help people with tuberculosis gain weight during treatment. They gave 335 people with TB either the nutrition drinks plus regular eating advice, or just eating advice alone. After two months, more people drinking the special supplements gained weight (54% vs 39%), and by the end of treatment, more had gained significant weight (56% vs 41%). The drinks were well-liked and safe, with only minor stomach issues. This suggests that these affordable, easy-to-use supplements could be a helpful tool to support TB patients’ recovery alongside other nutrition programs.

The Quick Take

  • What they studied: Whether special high-calorie nutrition drinks could help people with tuberculosis gain weight during their treatment
  • Who participated: 335 adults in India with confirmed TB and mild-to-moderate undernutrition (BMI between 14-18.5). About half received the nutrition drinks, and half received standard advice only
  • Key finding: People who drank the special nutrition supplements were twice as likely to gain at least 5% of their body weight in two months, and about twice as likely to gain 10% or more by the end of treatment
  • What it means for you: If you or someone you know has TB and is underweight, these affordable nutrition drinks may help speed up weight gain during treatment. However, this study was done in India, so talk with your doctor about whether this approach is available and right for your situation

The Research Details

This was a randomized controlled trial, which is considered one of the strongest types of medical research. Researchers randomly divided 335 people with TB into two groups: one group received two packets of special high-calorie nutrition drink daily for up to six months, plus standard eating advice; the other group received only the standard eating advice. The study took place in Faridabad, India between 2020 and 2023.

The nutrition drinks were designed to be energy-dense, meaning they packed a lot of calories and nutrients into a small amount of food. This is important for people with TB because their bodies need extra energy to fight the infection and recover. The researchers tracked how much weight each person gained at two months and again at the end of treatment (around six months).

Because this was an open-label trial, both the doctors and participants knew who was getting the drinks and who wasn’t. While this isn’t ideal (blinded studies are considered stronger), it’s often necessary for nutrition studies where people can taste the difference.

This study design is important because it shows cause-and-effect. By randomly assigning people to groups, researchers could be more confident that the nutrition drinks—not other factors—caused the weight gain difference. This type of evidence is what doctors use to make treatment recommendations. The study also measured real-world outcomes that matter to patients: actual weight gain during TB treatment.

This study has several strengths: it was randomized (reducing bias), had a reasonable sample size (335 people), and tracked people for a full treatment course. The researchers also adjusted their results for other factors that might affect weight gain. However, it was open-label (not blinded), which means knowing they were getting supplements might have motivated people in the intervention group. The study was also done in one location in India, so results might differ in other countries or settings

What the Results Show

The main results were clear and consistent. At the two-month mark, 53.9% of people receiving the nutrition drinks gained at least 5% of their body weight, compared to only 39.3% of those getting standard advice alone. This difference was statistically significant, meaning it’s unlikely to have happened by chance. By the end of treatment (around six months), 55.8% of the supplement group had gained at least 10% of their body weight, compared to 41.0% in the control group.

When researchers adjusted for other factors that might affect weight gain (like age, gender, and how severe the TB was), the nutrition drinks still showed strong benefits. People receiving the supplements were about twice as likely to achieve these weight gain goals. Specifically, at two months the adjusted odds ratio was 2.02, and at six months it was 1.89. In simpler terms, this means the supplements roughly doubled the chances of meaningful weight gain.

The supplements were also well-accepted by participants. Most people who received them took them regularly throughout the study period, which is important because a treatment only works if people actually use it. This high adherence suggests the drinks tasted acceptable and didn’t cause major problems that would make people stop using them.

Beyond the main weight gain results, the study found that gastrointestinal (stomach and digestive) symptoms were more common in the group receiving supplements. This included issues like bloating, gas, or mild stomach discomfort. However, these symptoms were mild enough that no one needed to stop taking the supplements or change their treatment. This is reassuring because it shows the supplements were safe, even if they caused minor temporary discomfort for some people. The high adherence rates despite these minor symptoms suggest people felt the benefits were worth any temporary digestive issues.

This research fills an important gap in TB nutrition science. While doctors have long known that undernutrition worsens TB outcomes, there hasn’t been much strong evidence testing whether specific nutrition supplements help. This study provides some of the first randomized controlled trial evidence that energy-dense supplements can meaningfully improve weight gain in TB patients. The findings support what nutrition experts have theorized: that people with TB need extra calories and nutrients to recover properly, and that supplements can help deliver these when regular food isn’t enough.

Several limitations should be considered. First, this study was done in one city in India, so results might be different in other countries with different food availability or TB patient populations. Second, it was open-label, meaning both doctors and patients knew who was getting supplements, which could have influenced behavior. Third, the study only measured weight gain—it didn’t track whether the weight gain led to better TB cure rates or fewer complications, though previous research suggests it should. Finally, the study only included people with mild-to-moderate undernutrition (BMI 14-18.5), so we don’t know if results would be the same for people who are severely malnourished

The Bottom Line

For people with TB who are underweight: Energy-dense nutrition supplements appear to be a helpful addition to standard TB treatment and dietary advice. They roughly doubled the chances of meaningful weight gain in this study. Confidence level: Moderate (this is good evidence, but from one location). For healthcare providers: These supplements may be a practical, affordable tool to support nutritional recovery in TB patients, especially in settings where food insecurity is common. They should be offered alongside, not instead of, standard TB treatment and dietary counseling.

This research is most relevant for people with TB who are underweight or malnourished, particularly in low-income settings where food access is limited. It’s also important for TB doctors, public health programs, and organizations working to improve TB treatment outcomes. People with TB who are already at a healthy weight probably don’t need these supplements. People with severe malnutrition might need different approaches. Anyone considering these supplements should discuss them with their TB doctor first.

Based on this study, you might expect to see meaningful weight gain within two months of starting the supplements, with continued improvement over the full six-month treatment period. However, individual results will vary depending on how much you eat overall, your specific TB treatment, and other health factors. Weight gain is a gradual process, so patience is important

Want to Apply This Research?

  • Track weekly weight measurements and supplement intake. Set a goal of gaining at least 5% of body weight within two months, then 10% by end of TB treatment. Log which days you took the supplements and any digestive symptoms to identify patterns
  • If using these supplements, commit to taking both daily packets consistently. Pair supplement use with a reminder system (phone alarm, app notification) at the same time each day. Track adherence as a percentage—aim for 90% or higher. Also log any side effects to discuss with your doctor
  • Weigh yourself weekly at the same time of day (morning, after bathroom) and record in the app. Create a simple chart showing weight over time. At two-month and six-month marks, calculate total weight gain percentage. Share this data with your TB doctor to monitor overall treatment progress and adjust nutrition plan if needed

This research describes a specific nutrition intervention studied in India for people with tuberculosis. These findings should not replace medical advice from your doctor. If you have TB or suspect you do, consult with a healthcare provider before starting any supplements. This study was conducted in a specific population in India; results may differ in other settings or populations. Always discuss nutrition supplements with your TB treatment team, as they may interact with TB medications or other health conditions. This summary is for educational purposes and does not constitute medical advice.