6MWT Case Study

DISCUSSION

In this study, nutritional supplementation of tempeh led to a significantly higher change in body weight, handgrip strength, and performance in 6MWT in the intervention compared with the control group. The intervention group showed the change of 2.80 kg in body weight after two months supplementation compared to 1.44 kg in the control group. Thus, the provision of fermented soybean increased body weight gain of 1.36 kg in the intervention group. In addition, it was also found that the BMI gain of the intervention group was higher than the control group. These results are similar to the results of a nutritional supplementation study among TB patients HIV (-), where there was an increase of body weight change of 1.73 kg after six
It was expected to provide confirmative information about the effect of nutritional supplementation on physical function among active pulmonary tuberculosis patients. The result of the test was in line with the outcome of the handgrip strength change. The 6MWT change of the intervention group presented slightly higher mean values in distance covered compared to the control group. The enhancement of the 6MWT outcome in this study was 23.93 m. The result is comparable with that of a two-month supplementation of arginine among TB patients that resulted in 30.0 m improvement. A related review study also supports the notion that the macronutrient supplementation among patients with active pulmonary tuberculosis may improve physical function in addition to body weight. Besides 6MWT, other tools have been applied to assess functional ability in TB active patients, such as timed stand test, quality of life-scale questionnaire, St George’s respiratory questionnaire, and forced expiratory volume in 1
Patients who were in the treatment group took supplementation not as an additional intake but as a replacement of their daily intake. Consumption of soy foods leads to satiety, which can depress calorie and protein intake. Also, in contrast to healthy persons, TB patients with abnormalities in leptin regulation and inflammation are associated with suppression of eating appetite or low BMI. Therefore, these factors may contribute to ineffectiveness of the supplementation to increase calorie and protein intake among participants of the intervention group

On the contrary, the beneficial effects of the supplementation on the study outcomes s may be due to the nature of soy foods, which possess "anti-inflammatory" properties. Several evidence showed that soy food supplementation reduced inflammation markers in postmenopausal women. Moreover, isoflavones isolated from soybean has been described giving a positive effect for postmenopausal women who have elevated C-reactive protein inflammatory marker. Thus, the wasting process might be suppressed by decreased inflammation, and thus, body mass can be more efficiently