Table 2 Summary of selected reports relating nutrition to tuberculosis (adapted from Cegielski and McMurray, 2003 [7]).

• During World War I, Denmark, a noncombatant, became a heavy exporter of meats and dairy products to the UK. The resulting food shortage in Denmark was associated with a clear uptick in active tuberculosis (TB). Cessation of exports due to the German blockade in 1918 led to the restoration of domestic food supplies and returned TB rates to normal.

• Sailors-in-training in Norway had an unexpectedly high rate of active TB. Physical improvements in housing produced no change, but a marked upgrade in diet reduced the incidence of TB and other infections.

• In a prisoner-of-war camp in World War II, British and Russian prisoners were treated similarly by the Germans, but the British were better nourished because of weekly Red Cross food packages. The Russians, with their reduced level of nutrition, showed a high rate of TB, while the British TB rate stayed at the usual level for British civilians.

• Among US Navy recruits in World War II, tuberculin test results on recruitment were independent of nutrition status (based on body height and weight), but TB incidence following recruitment correlated inversely with nutrition.

• Among 1.7 million Norwegians age 14 and older followed for 8–19 years, the incidence of pulmonary TB (smear positive and smear negative) was inversely related to BMI for both males and females, with a five-fold difference between the highest and lowest weight groups.

• The inaugural NHANES study (started 1971 and followed up 1982–1992) found that low nutrition was associated with a six- to 12-fold higher risk of TB than normal nutrition. The population in the upper 40% of adiposity had markedly reduced incidence of TB compared with those with normal adiposity.