{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T16:56:50Z","timestamp":1769273810320,"version":"3.49.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2015,8,1]],"date-time":"2015-08-01T00:00:00Z","timestamp":1438387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tuberculosis predominantly affects socioeconomically disadvantaged communities. The extent to which specific dietary and lifestyle factors contribute to tuberculosis susceptibility has not been established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 200 residents of a village in Northern Quebec were investigated during a tuberculosis outbreak and identified to have active tuberculosis, latent tuberculosis infection, or neither. Participants completed questionnaires about their intake of food from traditional and commercial sources, and provided blood samples. Adults were asked about recent smoking and drug and alcohol intake. Nutritional adequacy was evaluated with reference to North American standards. Multiple dietary, lifestyle, and housing factors were combined in a logistic regression model evaluating the contributions of each to disease and infection.<\/jats:p>\n                    <jats:p>Findings: After adjusting for potential confounding, new infection was associated with inadequate intake of fruit and vegetables (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.03\u20134.3), carbohydrates (OR, 4.4; 95% CI, 1.2\u201316.3), and certain vitamins and minerals. A multivariable model, combining nutrition, housing, and lifestyle factors, found associations between new infection and inadequate fruit and vegetable intake (OR, 2.3; 95% CI, 1.0\u20135.1), living in the same house as a person with smear-positive tuberculosis (OR, 14.7; 95% CI, 1.6\u2013137.3), and visiting a community gathering house (OR, 3.7; 95% CI, 1.7\u20138.3). Current smoking was associated with new infection (OR, 9.4; 95% CI, 1.2\u201372) among adults completing a detailed lifestyle survey.<\/jats:p>\n                    <jats:p>Interpretation: Inadequate nutrition was associated with increased susceptibility to infection, but not active tuberculosis. Interventions addressed at improving nutrition may reduce susceptibility to infection in settings where access to healthy foods is limited.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1513\/annalsats.201503-156oc","type":"journal-article","created":{"date-parts":[[2015,6,22]],"date-time":"2015-06-22T16:36:55Z","timestamp":1434991015000},"page":"1153-1162","source":"Crossref","is-referenced-by-count":7,"title":["Inadequate Diet Is Associated with Acquiring\n                    <i>Mycobacterium tuberculosis<\/i>\n                    Infection in an Inuit Community. A Case\u2013Control Study"],"prefix":"10.1093","volume":"12","author":[{"given":"Gregory J.","family":"Fox","sequence":"first","affiliation":[{"name":"Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University, Montreal, Quebec, Canada"},{"name":"McGill International Tuberculosis Centre, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robyn S.","family":"Lee","sequence":"additional","affiliation":[{"name":"McGill International Tuberculosis Centre, Montreal, Quebec, Canada"},{"name":"Department of Epidemiology & Biostatistics, McGill University, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Lucas","sequence":"additional","affiliation":[{"name":"Department of Social & Preventive Medicine, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faiz Ahmad","family":"Khan","sequence":"additional","affiliation":[{"name":"Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University, Montreal, Quebec, Canada"},{"name":"McGill International Tuberculosis Centre, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Francois","family":"Proulx","sequence":"additional","affiliation":[{"name":"Public Health Unit of the R\u00e9gie R\u00e9gionale de la Sant\u00e9 et de Services Sociaux of Nunavik, Quebec City, Quebec, Canada; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Hornby","sequence":"additional","affiliation":[{"name":"Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shelley","family":"Jung","sequence":"additional","affiliation":[{"name":"Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Benedetti","sequence":"additional","affiliation":[{"name":"Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University, Montreal, Quebec, Canada"},{"name":"McGill International Tuberculosis Centre, Montreal, Quebec, Canada"},{"name":"Department of Epidemiology & Biostatistics, McGill University, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel A.","family":"Behr","sequence":"additional","affiliation":[{"name":"McGill International Tuberculosis Centre, Montreal, Quebec, Canada"},{"name":"Montreal University Health Centre, McGill University, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dick","family":"Menzies","sequence":"additional","affiliation":[{"name":"Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University, Montreal, Quebec, Canada"},{"name":"McGill International Tuberculosis Centre, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2015,8,1]]},"reference":[{"key":"2026012303391162000_bib1","article-title":"Global tuberculosis report 2014","author":"World Health Organization","year":"2014"},{"key":"2026012303391162000_bib2","doi-asserted-by":"crossref","first-page":"2240","DOI":"10.1016\/j.socscimed.2009.03.041","article-title":"Drivers of tuberculosis epidemics: the role of risk factors and social determinants","volume":"68","author":"L\u00f6nnroth","year":"2009","journal-title":"Soc Sci Med"},{"key":"2026012303391162000_bib3","first-page":"286","article-title":"The relationship between malnutrition and tuberculosis: evidence from studies in humans and experimental animals","volume":"8","author":"Cegielski","year":"2004","journal-title":"Int J Tuberc Lung Dis"},{"key":"2026012303391162000_bib4","doi-asserted-by":"crossref","first-page":"e115","DOI":"10.1371\/journal.pmed.0040115","article-title":"Malnutrition and infection: complex mechanisms and global impacts","volume":"4","author":"Schaible","year":"2007","journal-title":"PLoS Med"},{"key":"2026012303391162000_bib5","first-page":"1215","article-title":"Tuberculosis and poverty: what could (and should) be done?","volume":"14","author":"Benatar","year":"2010","journal-title":"Int J Tuberc Lung Dis"},{"key":"2026012303391162000_bib6","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1093\/infdis\/jis608","article-title":"Childhood tuberculosis and malnutrition","volume":"206","author":"Jaganath","year":"2012","journal-title":"J Infect Dis"},{"key":"2026012303391162000_bib7","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1017\/S0950268810000907","article-title":"Impact of malnutrition on clinical presentation, clinical course, and mortality in MDR-TB patients","volume":"139","author":"Podewils","year":"2011","journal-title":"Epidemiol Infect"},{"key":"2026012303391162000_bib8","doi-asserted-by":"crossref","first-page":"e21161","DOI":"10.1371\/journal.pone.0021161","article-title":"Nutrition, diabetes and tuberculosis in the epidemiological transition","volume":"6","author":"Dye","year":"2011","journal-title":"PLoS One"},{"key":"2026012303391162000_bib9","doi-asserted-by":"crossref","first-page":"e20","DOI":"10.1371\/journal.pmed.0040020","article-title":"Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis","volume":"4","author":"Lin","year":"2007","journal-title":"PLoS Med"},{"key":"2026012303391162000_bib10","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1111\/imj.12089","article-title":"Marijuana \u2018bong\u2019 smoking and tuberculosis","volume":"43","author":"Thu","year":"2013","journal-title":"Intern Med J"},{"key":"2026012303391162000_bib11","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1093\/ije\/31.5.940","article-title":"The association of housing density, isolation and tuberculosis in Canadian First Nations communities","volume":"31","author":"Clark","year":"2002","journal-title":"Int J Epidemiol"},{"key":"2026012303391162000_bib12","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.5588\/ijtld.12.0385","article-title":"Burden of tuberculosis in indigenous peoples globally: a systematic review","volume":"17","author":"Tollefson","year":"2013","journal-title":"Int J Tuberc Lung Dis"},{"key":"2026012303391162000_bib13","article-title":"Canadian tuberculosis standards 7th edition","author":"Public Health Agency of Canada","year":"2013"},{"key":"2026012303391162000_bib14","article-title":"Health profile of Nunavik 2011: demographic and Socioeconomic Conditions","author":"Nunavik Regional Board of Health and Social Services with the collaboration of Institut national de sant\u00e9 publique du Qu\u00e9bec","year":"2011"},{"key":"2026012303391162000_bib15","author":"Blanchet","year":"2008"},{"key":"2026012303391162000_bib16"},{"key":"2026012303391162000_bib17","author":"United States Department of Agriculture"},{"key":"2026012303391162000_bib18","author":"Health Canada"},{"key":"2026012303391162000_bib19","article-title":"Diet, nutrition and the prevention of chronic diseases: report of a joint FAO\/WHO expert consultation","author":"World Health Organization","year":"2003"},{"key":"2026012303391162000_bib20","article-title":"Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (macronutrients)","author":"National Research Council","year":"2005"},{"key":"2026012303391162000_bib21","article-title":"Dietary reference intakes for calcium and vitamin D","author":"Institute of Medicine","year":"2011"},{"key":"2026012303391162000_bib22","article-title":"Dietary reference intakes for water, potassium, sodium, chloride, and sulfate","author":"National Research Council","year":"2005"},{"key":"2026012303391162000_bib23","article-title":"Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc","author":"National Research Council","year":"2001"},{"key":"2026012303391162000_bib24","article-title":"Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline","author":"Institute of Medicine","year":"1998"},{"key":"2026012303391162000_bib25","article-title":"Vitamin D blood levels of Canadians","author":"Janz","year":"2013","journal-title":"Statistics Canada"},{"key":"2026012303391162000_bib26","author":"Ahmad Khan"},{"key":"2026012303391162000_bib27","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1093\/aje\/kwn301","article-title":"Optimal serum cotinine levels for distinguishing cigarette smokers and nonsmokers within different racial\/ethnic groups in the United States between 1999 and 2004","volume":"169","author":"Benowitz","year":"2009","journal-title":"Am J Epidemiol"},{"key":"2026012303391162000_bib28","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1111\/j.0006-341X.2001.00120.x","article-title":"Akaike\u2019s information criterion in generalized estimating equations","volume":"57","author":"Pan","year":"2001","journal-title":"Biometrics"},{"key":"2026012303391162000_bib29","author":"SAS Institute"},{"key":"2026012303391162000_bib30","article-title":"State of the knowledge: Inuit Public Health 2011","author":"Cameron","year":"2011"},{"key":"2026012303391162000_bib31","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1503\/cmaj.121536","article-title":"Tuberculosis in Nunavut: looking back, moving forward","volume":"185","author":"Orr","year":"2013","journal-title":"CMAJ"},{"key":"2026012303391162000_bib32","doi-asserted-by":"crossref","first-page":"223","DOI":"10.14430\/arctic4481","article-title":"Monetary poverty in Inuit Nunangat","volume":"68","author":"Duhaime","year":"2015","journal-title":"Arctic"},{"key":"2026012303391162000_bib33","doi-asserted-by":"crossref","first-page":"S345","DOI":"10.1177\/15648265100314S404","article-title":"Addressing tuberculosis in the context of malnutrition and HIV coinfection","volume":"31","author":"Semba","year":"2010","journal-title":"Food Nutr Bull"},{"key":"2026012303391162000_bib34","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1164\/rccm.201201-0023OC","article-title":"Can social interventions prevent tuberculosis?: the Papworth experiment (1918\u20131943) revisited","volume":"186","author":"Bhargava","year":"2012","journal-title":"Am J Respir Crit Care Med"},{"key":"2026012303391162000_bib35","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1093\/ajcn\/49.1.112","article-title":"Relationship of vitamin A and vitamin E intake to fasting plasma retinol, retinol-binding protein, retinyl esters, carotene, alpha-tocopherol, and cholesterol among elderly people and young adults: increased plasma retinyl esters among vitamin A-supplement users","volume":"49","author":"Krasinski","year":"1989","journal-title":"Am J Clin Nutr"},{"key":"2026012303391162000_bib36","doi-asserted-by":"crossref","first-page":"20130428","DOI":"10.1098\/rstb.2013.0428","article-title":"Human genetics of tuberculosis: a long and winding road","volume":"369","author":"Abel","year":"2014","journal-title":"Philos Trans R Soc Lond B Biol Sci"},{"key":"2026012303391162000_bib37","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1017\/S0950268897007917","article-title":"The natural history of tuberculosis: the implications of age-dependent risks of disease and the role of reinfection","volume":"119","author":"Vynnycky","year":"1997","journal-title":"Epidemiol Infect"},{"key":"2026012303391162000_bib38","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1017\/S0007114509992224","article-title":"Assessing dietary intake in a population undergoing a rapid transition in diet and lifestyle: the Arctic Inuit in Nunavut, Canada","volume":"103","author":"Sharma","year":"2010","journal-title":"Br J Nutr"},{"key":"2026012303391162000_bib39","first-page":"50","article-title":"Contribution of selected traditional and market foods to the diet of Nunavik Inuit women","volume":"61","author":"Blanchet","year":"2000","journal-title":"Can J Diet Pract Res"},{"key":"2026012303391162000_bib40","first-page":"41","article-title":"Iron sufficiency of Canadians","volume":"23","author":"Cooper","year":"2012","journal-title":"Health Rep"},{"key":"2026012303391162000_bib41","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1017\/S136898001300178X","article-title":"Reliability of self-reported sun exposure in Canadian women and estimation of lifetime exposure to vitamin D from sun and diet","volume":"17","author":"Cook","year":"2014","journal-title":"Public Health Nutr"},{"key":"2026012303391162000_bib42","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/nyas.12498","article-title":"Clinical and economic outcomes of nutrition interventions across the continuum of care","volume":"1321","author":"de van der Schueren","year":"2014","journal-title":"Ann N Y Acad Sci"}],"container-title":["Annals of the American Thoracic Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/annalsats\/article-pdf\/12\/8\/1153\/66553894\/annalsats_12_8_1153.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/annalsats\/article-pdf\/12\/8\/1153\/66553894\/annalsats_12_8_1153.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T08:39:23Z","timestamp":1769157563000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/annalsats\/article\/12\/8\/1153\/8429279"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,8,1]]},"references-count":42,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2015,8,1]]},"published-print":{"date-parts":[[2015,8,1]]}},"URL":"https:\/\/doi.org\/10.1513\/annalsats.201503-156oc","relation":{},"ISSN":["2329-6933","2325-6621"],"issn-type":[{"value":"2329-6933","type":"print"},{"value":"2325-6621","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2015,8]]},"published":{"date-parts":[[2015,8,1]]}}}