The association of dietary patterns with latent tuberculosis infection among young adults: A case-control study in Shanghai

Abstract

Introduction: In developing and underdeveloped countries, undernutrition plays a major role in subverting the immune system, leading to an increase in TB infections; this study investigated the associations between dietary patterns and latent tuberculosis infection risk among young adults in Shanghai.

Methodology: In a case-control study, 96 cases of latent tuberculosis infection and 192 healthy controls were studied among contacts of students in clusters of tuberculosis epidemics in colleges from January 2021 to March 2023. A standardized questionnaire assessing sociodemographic, lifestyle, and dietary characteristics was applied. Food intake was estimated using a 95-item semiquantitative Food Frequency Questionnaire. Using the principal component analysis to extract dietary patterns from food groups intake. Logistic regression models were applied.

Results: Four dietary patterns were identified: “traditional balanced” pattern, “unsaturated fatty acid” pattern, “snack” pattern, and “protein and fruit” pattern. Four components explaining 64.52% of the total variation in consumption were derived. In a conditional logistic regression analysis, three models were created. After adjusting for various confounders, compared to “snack” pattern, the risk of latent TB infection was 91% lower in the “traditional balanced” pattern (OR 0.05, 95% CI 0.01, 0.38, p = 0.004).

Conclusions: To prevent TB infection among young adults living in high TB burden areas, a balanced dietary pattern rather than a "snack” pattern should be promoted in school settings. Future research should explore the risk of developing active tuberculosis in Mtb-infected people with different dietary patterns and the prevention of this risk by healthy dietary patterns.