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Cystic fibrosis - nutritional considerations

Definition

Cystic fibrosis (CF) is a potentially life-threatening disease that causes thick, sticky mucus to build up in the lungs and digestive tract. Persons with cystic fibrosis need to eat high calorie and high protein foods throughout the day.

This article discusses the nutritional needs for persons with CF. For specific information about the disease itself, see the article on cystic fibrosis.

Function

The collection of sticky mucus associated with cystic fibrosis leads to serious digestion problems, including malabsorption.

Pancreatic enzymes are prescribed to improve the digestion and absorption of fat, carbohydrates, and protein.

The dietary needs of a person with cystic fibrosis are based on the severity of the symptoms, specifically the amount of malabsorption and extent of lung disease. The goal is to provide adequate nutrients to achieve normal growth and development. Nutritious, high-calorie, high-protein foods are essential from infancy through adulthood. Calorie and protein needs can be 50 - 100% greater than the Recommended Daily Allowance.

Historically, low-fat diets were encouraged to reduce problems with fat malabsorption. With pancreatic enzyme treatment, fat can provide 35 - 45% of calories, depending on the person's ability to tolerate it. A multivitamin is also recommended, since persons with CF absorb fat-soluble vitamins (vitamins A, D, E, K) poorly. Liberal salt use is encouraged, since persons with CF lose large amounts of salt in their sweat.

Side Effects

The most serious complication of CF is infection in the lungs. Nutrition plays an important role in strengthening the patient's immune system to fight infection.

Recommendations

The following are methods for adding protein and calories to the diet. In addition to these tips, make sure that you are taking a multivitamin containing vitamins A, D, E and K:

• Eat whenever you are hungry. This may mean eating several small meals throughout the day.
• Keep a variety of nutritious snack foods around. Try to snack on something every hour. Try cheese and crackers, muffins, or trail mix.
• Make an effort to eat regularly, even if it's only a few bites; or include a nutritional supplement or milkshake.
• Be flexible. If you aren't hungry at dinner time, make breakfast, mid-morning snacks and lunch your main meals.
• Add grated cheese to soups, sauces, casseroles, vegetables, mashed potatoes, rice, noodles or meat loaf.
• Use whole milk, half and half, cream, or enriched milk in cooking or beverages. Enriched milk has non-fat dry milk powder added to it.
• Spread peanut butter on bread products or use it as a dip for raw vegetables and fruit. Add peanut butter to sauces or use on waffles.
• Skim milk powder adds protein -- try adding two tablespoons of dry skim milk powder in addition to the amount of regular milk in recipes.
• Add marshmallows to fruit or hot chocolate. Add raisins, dates, or chopped nuts and brown sugar to hot or cold cereals or for snacks.
• A teaspoon of butter or margarine adds 45 calories to foods. Mix it into hot foods such as soups, vegetables, mashed potatoes, cooked cereal, and rice. Serve it on hot foods -- hot breads, pancakes, or waffles absorb more butter than cool ones.
• Sour cream or yogurt can be used on vegetables such as potatoes, beans, carrots, or squash. They can also be used as a dressing for fruit.
• Breaded meat, chicken, and fish have more calories than broiled or plain roasted.
• Add extra cheese on top of frozen prepared pizza.
• Coarsely chopped hard cooked egg and cheese cubes are tasty in a tossed salad.
• Serve cottage cheese with canned or fresh fruit.
• Add grated cheeses, tuna, shrimp, crabmeat, ground beef, diced ham or sliced boiled eggs to sauces, rice, casseroles, and noodles.

Review Date:7/5/2007
Reviewed By:William McGee, M.D., M.H.A., Chairman, Nutrition Committee, Baystate Medical Center, Springfield, MA and Assistant Professor of Medicine and Surgery,Tufts University School of Medicine, Boston, MA. Review provided by VeriMed Healthcare Network.

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