Macronutrient intake in preschoolers with cystic fibrosis and the relationship between macronutrients and growth

Stephanie S Filigno; Shannon M Robson; Rhonda D Szczesniak; Leigh A Chamberlin; Meredith A Baker; Stephanie M Sullivan; John Kroner; Scott W Powers

doi:10.1016/j.jcf.2017.01.010

Macronutrient intake in preschoolers with cystic fibrosis and the relationship between macronutrients and growth

J Cyst Fibros. 2017 Jul;16(4):519-524. doi: 10.1016/j.jcf.2017.01.010. Epub 2017 Feb 6.

Authors

Stephanie S Filigno¹, Shannon M Robson², Rhonda D Szczesniak³, Leigh A Chamberlin⁴, Meredith A Baker⁵, Stephanie M Sullivan⁴, John Kroner⁴, Scott W Powers⁶

Affiliations

¹ Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA. Electronic address: stephanie.filigno@cchmc.org.
² Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA; Department of Behavioral Health and Nutrition, University of Delaware, 26 N College Avenue Newark, Delaware 19716, USA.
³ Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue Cincinnati, OH 45229, USA; Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
⁴ Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
⁵ Vascular Biology Program, Department of Surgery, Boston Children's Hospital, Boston, 300 Longwood Avenue Boston, MA 02115, USA.
⁶ Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.

Abstract

Background: Adequate nutrition is essential for growth in children with cystic fibrosis (CF). The new CF Foundation Clinical Practice Guidelines bring attention to monitoring macronutrient intake as well as total energy.

Methods: Dietary intake of 75 preschool children with CF and pancreatic insufficiency was examined and compared to the Clinical Practice Guidelines. Regression analyses examined relationships between macronutrient intake and growth.

Results: Approximately 45% of children met the 110% minimum recommended dietary allowance (RDA) recommendation. Children consumed 35.3% (6.1) of total daily energy intake from fat, 12.7% (1.7) from protein, and 52.0% (6.1) from carbohydrates. Percent energy from protein was associated with height growth.

Conclusions: Many preschoolers with CF are not meeting nutrition benchmarks for total energy and fat. To optimize nutrition early, dietary monitoring with frequent individualized feedback is needed. Optimizing intake of macronutrients that promote growth, especially fat and protein, should be a primary clinical target.

Keywords: Behavioral intervention; Children; Nutrition.

MeSH terms

Child Development / physiology
Child, Preschool
Cystic Fibrosis* / diagnosis
Cystic Fibrosis* / diet therapy
Cystic Fibrosis* / epidemiology
Cystic Fibrosis* / physiopathology
Diet Therapy / methods
Diet Therapy / standards
Dietary Carbohydrates / analysis*
Dietary Fats / analysis*
Dietary Proteins / analysis*
Energy Intake
Exocrine Pancreatic Insufficiency* / diagnosis
Exocrine Pancreatic Insufficiency* / epidemiology
Female
Growth / physiology
Humans
Male
Nutritional Status
Practice Guidelines as Topic
Recommended Dietary Allowances*
United States / epidemiology

Substances

Dietary Carbohydrates
Dietary Fats
Dietary Proteins

Abstract

MeSH terms

Substances

Grants and funding