Tuesday, June 06, 2006

Cystic Fibrosis and Nutrition

Cystic Fibrosis and Nutrition
June 2, 2006 02:55:02 AM PST

Cystic fibrosis (CF), called "65 Roses" by many of the 30,000 children and adults in the United States with the inherited genetic disease, particularly affects the respiratory and digestive systems.

CF makes children sick by disrupting the normal function of epithelial cells - cells that make up the sweat glands in the skin and that also line passageways inside the lungs, liver, pancreas, and digestive and reproductive systems.

A defect in these cells causes problems with the balance of salt and water in the body, leading it to produce thick mucus, which clogs the lungs, setting the stage for infections and other breathing problems. In children with CF, this mucus can also prevent the normal absorption of key nutrients and fat in the intestines, leading to poor digestion, slow growth, difficulty gaining weight, greasy bowel movements, and a decreased ability to fight infection.

About 85% to 90% of CF patients have pancreatic insufficiency by the time they're 8 or 9 years old. This means that the enzymes created in the pancreas that digest fat, starch, and protein aren't properly passed into the intestines. This causes problems in absorbing the necessary amounts of several important nutrients.

Important ways that you can help your child with CF grow healthy and strong include providing good overall nutrition along with extra fat and calories and prescribed enzymes (see the section Beyond Food - Enzymes and Tube Feeding).

Your Child's Nutritional NeedsIn general, children with CF may need 30% to 50% more of the recommended daily allowance of calories for their age group. This means that:
A toddler with CF may need 1,700 to 1,950 calories daily.
A child with CF may need 2,300 to 3,000 calories daily.
A teen with CF may need 2,900 to 4,500 calories daily.
These calorie needs may be even higher when a child is ill (even a low-grade infection can greatly increase your child's calorie needs).

Every child with CF has different nutritional needs. You'll work with your child's CF dietitian to determine how many calories he or she needs each day. The dietitian will track your child's growth and weight gain over time and will provide you with a nutrition plan.

Some parents of children with CF (and the kids as well) find that counting calories is bothersome. For this reason, it may be more helpful to focus more generally on your child's growth pattern and on adding calorie boosters with fat in them to the foods your child normally eats. That's because gram for gram, fat has more than twice the number of calories as protein and carbohydrates.

In addition to calories, kids with CF have some specific nutritional needs to help them thrive:
Calcium. Patients with pancreatic insufficiency have difficulty absorbing calcium and are especially at risk for developing osteoporosis (weak, brittle bones).

Even patients who don't have pancreatic insufficiency have a greater risk of developing the condition. All dairy products are good sources of calcium (and the full-fat varieties are good sources of fat and calories as well). Many juices also now include calcium.

Essential fatty acids. The body needs to get these particular types of fat from the diet. Found in plant oils, safflower oil, and soybean oils, they help in the building of cell membranes and may play a role in lung function.

Fat-soluble vitamins (vitamins A, D, E, and K). Important for growth and healing, these vitamins are absorbed along with fat. And because most children with CF have trouble digesting fat, they often have low levels of fat-soluble vitamins and need to take supplements.

Iron. Many children (both with and without CF) are at risk for developing iron deficiency anemia, which can cause fatigue and poor resistance to infection. Fortified cereal, meats, dried fruits, and deep green vegetables are good sources of iron.

Salt. Children with CF lose a lot of salt in their sweat, especially during hot weather and when they exercise. Your CF dietitian may ask you to add salt to your infant's formula and to give your older child salty snacks. During hot weather and when your child plays sports, the dietitian may recommend sending sports drinks to school for activities and physical education class.

Zinc. Important for growth, healing, and fighting infection, zinc is found in meats, liver, eggs, and seafood.

Meals at Home and Away. You'll need to work with your child's CF dietitian to create meal plans that include plenty of snacks, especially for toddlers who eat smaller meals. (Toddlers with or without CF may eat as many as six small meals a day.) When your child is older, schedule snacks so that he or she is eating enough, but isn't simply snacking all day.

Yahoo! Health: Children's Health News


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