Diet and feeding in cystic fibrosis

Diet and food in cystic fibrosis are a fundamental component in the management and prognosis of this disease. Keep reading and know why in this article.

Cystic fibrosis is a hereditary and degenerative chronic disease. It mainly affects the lungs and digestive system. It is produced by the mutation of a protein that is involved in the secretion of mucus and in the regulation of the transport of chlorine and sodium.

In certain cases of cystic fibrosis, an exocrine pancreatic insufficiency is diagnosed. This means that the pancreas is unable to secrete those enzymes responsible for the digestion of dietary lipids.

So, nutritional status plays a fundamental role both in the development of the disease and in the quality of life of the patients. A good diet prevents the deterioration of lung function and decreases the risk of infections.

Why does malnutrition occur in cystic fibrosis?

Malnutrition is a factor of morbidity and mortality and deterioration of the quality of life. Malnutrition in cystic fibrosis It is motivated by an imbalance between energy consumption and caloric expenditure, determined by three factors: the increase in requirements, the decrease in intake and the increase in losses.

  • Energy expenditure and metabolism: Baseline energy expenditure (GEB) is increased. Pulmonary disease, together with superinfections and with the increase in respiratory work, causes the increase in GEB.
  • Decrease in intake: Generally, patients with cystic fibrosis tend to be prone to complications that limit food intake by mouth, with the consequent digestive alterations due to low calorie intake.
  • Loss of energy: This is due to the loss of nutrients in feces due to maldigestion and malabsorption, which causes an energy imbalance.

Read also: How to distribute carbohydrates well?

Recommendations on feeding in cystic fibrosis

Maintaining a correct nutritional status is one of the main objectives to ensure proper growth in children and achieve a better quality of life.

Before making the necessary changes in the diet, It is necessary to make an exhaustive assessment of dietary habits and evaluation of anthropometric measures. The body mass index (BMI) in women should be positioned around 22 kg / m2 and in men, around 23 kg / m2.

Food in cystic fibrosis will be similar to that of a healthy person. But we must not forget a series of special recommendations:

  • Increase in energy intake: contribute between 120-150% of the energy needs by age and weight. In case of weight loss, it is recommended to exceed 150%.
  • Protein intake: It is necessary to provide 120% -150% of the recommended protein requirements by age and weight.
  • Carbohydrates: Carbohydrates should represent between 40-45% of the total caloric value. Consumption of complex carbohydrates is recommended, avoiding simple sugars to maintain control of blood glucose. If respiratory failure exists, intake should be restricted to 30%.
  • Lipid intake: they represent 40-45% of the total intake. It should be taken into account that the contribution of saturated fatty acids should not exceed 10%.
  • Minerals: an adequate supply of minerals such as calcium, zinc, iron and sodium should be ensured.
  • Fat-soluble vitamins: it is necessary to supplement with vitamins A, D and E and, depending on the analytical, with vitamin K.

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But how should this series of recommendations be carried out?

It is recommended to distribute meals in 3 main meals and two or three intermediate meals. It is of vital importance, in order to increase the energy contribution, to include healthy caloric foods in the elaborations, such as:

  • Healthy oils, like extra virgin olive oil.
  • Nuts.
  • Blue fish
  • Dairy products and whole derivativess: cream, butter, cheeses.
  • Foods with sugar, such as candy or homemade pastries, ice cream.

Supplementation

On some occasions, the diet is insufficient and supplementation is necessary with fortified milks, carbohydrate and / or protein gels or artificial feeding (enteral or parenteral nutrition).

As we mentioned earlier, there are cases in which there is insufficiency of the exocrine pancreas and enzyme supplementation is necessary forever. If enzymes are not supplied exogenously, fat is not digested or absorbed and excreted with feces.