@cfmcquaid.bsky.social @tbtakenseriously.bsky.social @jaseddon.bsky.social @petedodd24.bsky.social @tb-lshtm.bsky.social #endtb

Key message: Eliminating undernutrition could prevent millions of people from developing TB. Scaling up nutritional interventions (which are likely to have myriad social and health benefits), particularly for
populations in greatest need, should be an integral part of the global TB response.

We estimated that eliminating moderate/severe undernutrition (BMI<17) would avert ~17% of global adult incidence, while eliminating all undernutrition (BMI<18.5) would avert ~27%, three times higher than current estimates.

So...what would happen to the global TB epidemic if we hypothetically "eliminated" undernutrition? In this preprint, we combined estimates from our new review (doi.org/10.1093/ije/...) with population-specific BMI distributions to find out...(doi.org/10.1101/2025...)

We estimated that eliminating moderate/severe undernutrition (BMI<17) would avert ~17% of global adult incidence, while eliminating all undernutrition (BMI<18.5) would avert ~27%, three times higher than current estimates.

Key message: Addressing undernutrition must be central to the global TB response. #EndTB @cfmcquaid.bsky.social @reinhouben.bsky.social @raclark18.bsky.social @tb-lshtm.bsky.social

Based on these results and the global BMI distribution, we estimated a relative risk of tuberculosis associated with undernutrition of 5.0 (95% CI: 4.2–5.9), substantially higher than previous estimates.

Our results show how TB risk is highest at the lowest BMI values and decreases nonlinearly as BMI increases, with the steepest reduction in risk occurring when moving through underweight and normal weight ranges, and more modest reductions continuing through overweight and obese ranges.

We found an inverse, dose-response, nonlinear relationship between BMI and TB risk in the full underweight to obese range, consistent across populations and countries with a high versus lower TB burden.

Nutritional status is a key determinant of TB. In this updated systematic review and dose-response meta-analysis (43 cohorts inc > 26 million people) we redefined the relationship between body mass index (BMI) and TB. doi.org/10.1093/ije/...

Key message: Interventions to address household poverty and interrelated personal risk factors could substantially reduce TB burden in Peru. Our results inform intervention design; and support more effective implementation of poverty reduction/social protection within the global TB response.

The global TB epidemic is driven by social determinants. In this case-control study in Peru, we characterised the associations between multidimensional household poverty, personal risk factors, and TB. @tb-lshtm.bsky.social idpjournal.biomedcentral.com/articles/10....

The Union's TB Undernutrition working group is hosting a webinar with Dr Matthew Saunders.

📅 21 August at 2pm CET

Dr Saunders (@lshtm.bsky.social‬) will share findings from a new analysis that redefines the relationship between BMI and TB incidence.

📧 To join email [email protected].