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Nutritional assessment in adults with cystic fibrosis.
Nutrition. 2019 Nov - Dec; 67-68:110518.N

Abstract

OBJECTIVES

Clinical experience with patients with cystic fibrosis (CF) suggests a nutritional risk in this population. In addition to the lung pathology, a main pathophysiologic concern is the viscous mucus blocking pancreatic ducts, leading to reduced production of pancreatic enzymes. Therefore, maldigestion and consequently malabsorption (particularly fat and fat-soluble vitamins) occur, resulting in steatorrhea, vitamin deficiencies, and subsequently manifest malnutrition. The aim of this study was to investigate the nutritional status and determine the prevalence of malnutrition in an adult Swiss CF cohort.

METHODS

This was an observational cohort study in which the nutritional status and dietary habits of patients with CF and healthy controls were compared. Assessment was based on the nutritional risk screening (NRS-2002), dietary habits (7-d dietary record), body composition (bioelectrical impedance analysis), anthropometrics, resting energy expenditure (REE; indirect calorimetry), and physical or mental function (hand-grip strength, Short Form-36 v2).

RESULTS

Nineteen patients (15 men, mean age 32 y) and 15 controls (8 men, mean age 49 y) were included. Eight patients (42%) were at nutritional risk (NRS-2002 ≥3). Patients had higher energy intake/body weight (P = 0.021) with lower body fat percentage (P < .001), body mass index (P = 0.030), and physical/mental health scores (P < 0.001) than controls. Energy intake was higher than REE in patients (P = 0.003), but not in controls (P = 0.373).

CONCLUSIONS

Prevalence of malnutrition was high in this CF cohort, coinciding with low body fat percentage and low body mass index despite high energy and protein intake. Energy requirements of patients with CF should be estimated as approximately twice the Harris-Benedict REE and 1.7 times indirect calorimetry REE, while ensuring adequate intake of pancreatic enzymes.

Authors+Show Affiliations

Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, University Hospital of Bern and University of Bern, Bern, Switzerland.Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, University Hospital of Bern and University of Bern, Bern, Switzerland. Electronic address: emilie.reber@insel.ch.Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, University Hospital of Bern and University of Bern, Bern, Switzerland.Department of Pulmonary Medicine, University Hospital of Bern, Bern, Switzerland.Department of Pulmonary Medicine, University Hospital of Bern, Bern, Switzerland.Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, University Hospital of Bern and University of Bern, Bern, Switzerland.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

31473521

Citation

Schönenberger, Katja A., et al. "Nutritional Assessment in Adults With Cystic Fibrosis." Nutrition (Burbank, Los Angeles County, Calif.), vol. 67-68, 2019, p. 110518.
Schönenberger KA, Reber E, Bally L, et al. Nutritional assessment in adults with cystic fibrosis. Nutrition. 2019;67-68:110518.
Schönenberger, K. A., Reber, E., Bally, L., Geiser, T., Lin, D., & Stanga, Z. (2019). Nutritional assessment in adults with cystic fibrosis. Nutrition (Burbank, Los Angeles County, Calif.), 67-68, 110518. https://doi.org/10.1016/j.nut.2019.05.010
Schönenberger KA, et al. Nutritional Assessment in Adults With Cystic Fibrosis. Nutrition. 2019 Nov - Dec;67-68:110518. PubMed PMID: 31473521.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nutritional assessment in adults with cystic fibrosis. AU - Schönenberger,Katja A, AU - Reber,Emilie, AU - Bally,Lia, AU - Geiser,Thomas, AU - Lin,Dagmar, AU - Stanga,Zeno, Y1 - 2019/06/12/ PY - 2018/12/10/received PY - 2019/04/17/revised PY - 2019/05/06/accepted PY - 2019/9/2/pubmed PY - 2020/10/21/medline PY - 2019/9/2/entrez KW - Cystic fibrosis KW - Malnutrition KW - Nutritional assessment KW - Nutritional screening KW - Pancreatic enzyme replacement therapy SP - 110518 EP - 110518 JF - Nutrition (Burbank, Los Angeles County, Calif.) JO - Nutrition VL - 67-68 N2 - OBJECTIVES: Clinical experience with patients with cystic fibrosis (CF) suggests a nutritional risk in this population. In addition to the lung pathology, a main pathophysiologic concern is the viscous mucus blocking pancreatic ducts, leading to reduced production of pancreatic enzymes. Therefore, maldigestion and consequently malabsorption (particularly fat and fat-soluble vitamins) occur, resulting in steatorrhea, vitamin deficiencies, and subsequently manifest malnutrition. The aim of this study was to investigate the nutritional status and determine the prevalence of malnutrition in an adult Swiss CF cohort. METHODS: This was an observational cohort study in which the nutritional status and dietary habits of patients with CF and healthy controls were compared. Assessment was based on the nutritional risk screening (NRS-2002), dietary habits (7-d dietary record), body composition (bioelectrical impedance analysis), anthropometrics, resting energy expenditure (REE; indirect calorimetry), and physical or mental function (hand-grip strength, Short Form-36 v2). RESULTS: Nineteen patients (15 men, mean age 32 y) and 15 controls (8 men, mean age 49 y) were included. Eight patients (42%) were at nutritional risk (NRS-2002 ≥3). Patients had higher energy intake/body weight (P = 0.021) with lower body fat percentage (P < .001), body mass index (P = 0.030), and physical/mental health scores (P < 0.001) than controls. Energy intake was higher than REE in patients (P = 0.003), but not in controls (P = 0.373). CONCLUSIONS: Prevalence of malnutrition was high in this CF cohort, coinciding with low body fat percentage and low body mass index despite high energy and protein intake. Energy requirements of patients with CF should be estimated as approximately twice the Harris-Benedict REE and 1.7 times indirect calorimetry REE, while ensuring adequate intake of pancreatic enzymes. SN - 1873-1244 UR - https://www.unboundmedicine.com/medline/citation/31473521/Nutritional_assessment_in_adults_with_cystic_fibrosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0899-9007(19)30074-7 DB - PRIME DP - Unbound Medicine ER -