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How a Cholesterol Rich Diet Helps Cure Tuberculosis
Carlos Perez-Guzman, Mario H. Vargas,Francisco Quinonez,et al. A Cholesterol-Rich Diet Accelerates Bacteriologic Sterilization in Pulmonary Tuberculosis. CHEST 2005; 127: 643-651
Background: 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
good functioning of macrophages and lymphocytes.
Study objectives: To determine whether a cholesterol-rich diet could accelerate sputum sterilization
in patients with pulmonary tuberculosis.
Design: An 8-week follow-up, randomized, controlled trial carried out from March 2001 to
January 2002.
Setting: A third-level hospital for respiratory diseases in Mexico City.
Patients and interventions: Adult patients with newly diagnosed pulmonary tuberculosis were
hospitalized for 8 weeks and randomly assigned to receive a cholesterol-rich diet (800 mg/d
cholesterol [experimental group]) or a normal diet (250 mg/d cholesterol [control group]). All
patients received the same four-drug antitubercular regimen (ie, isoniazid, rifampin, pyrazinamide,
and ethambutol).
Measurements and results: Every week, a quantitative sputum culture and laboratory tests were
done and respiratory symptoms were recorded. Patients in the experimental group (10 patients)
and the control group (11 subjects) were HIV-negative and harbored Mycobacterium tuberculosis
that was fully sensitive to antitubercular drugs. Sterilization of the sputum culture was achieved
faster in the experimental group, as demonstrated either by the percentage of negative culture
findings in week 2 (80%; control group, 9%; p = 0.0019) or by the Gehan-Breslow test for
Kaplan-Meier curves (p = 0.0037). Likewise, the bacillary population decreased faster
(p = 0.0002) in the experimental group. Respiratory symptoms improved in both groups, but
sputum production decreased faster in the experimental group (p < 0.05). Laboratory test results
did not differ between the groups.
Conclusions: A cholesterol-rich diet accelerated the sterilization rate of sputum cultures in
pulmonary tuberculosis patients, suggesting that cholesterol should be used as a complementary
measure in antitubercular treatment.
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COMMENT: Tuberculosis is a disease which largely disappeared during the first half of the last century, and is now returning. The last couple of decades, since we started to eat a 'healthy' diet, has seen a massive increase in the numbers of cases accross the industrialised world. Could our low-fat, cholesterol-free lifestyle be the reason? It is certainly true that cholesterol in needed for a strong immune system.
A cholesterol-rich diet may well reduce the risk of contracting the disease in the first place — and other diseases?
For more detail on cholesterol and its functions, see www.cholesterol-and-health.org.uk
Last updated 19 March 2005
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