Dietary intake and nutritional status in a Scandinavian adult cystic fibrosis-population compared with recommendations

Abstract

Background: Malnutrition is a well-known complication in cystic fibrosis (CF). There is good evidence that maintaining a normal body-weight correlates well with improved survival in CF. Energy intake in excess of 120% of the estimated average requirement (EAR) has been advised since 1980s. Objectives: To investigate the nutritional intake and status in the adult Scandinavian CF-population. Subjects/Methods: A cross-sectional multi-centre study was used to investigate the nutritional status of 456 adult CF-patients (2003-2006). Height and weight were measured and body mass index (BMI) and z-scores were calculated. Pulmonary function was examined by dynamic spirometry. A 7-day pre-coded food record (FR) obtained energy and nutrient intake data in 180 patients. Results: The mean energy intake was 114 (SD 30.0)% of EAR and thus significantly lower than the target of 120% EAR (p <0.001) for patients with pancreatic insufficiency (PI) (n=136). Mean BMI was 22.0 (SD 2.9), the prevalence of BMI <18 was 13% and the prevalence of BMI ≥25 was 15% (n=136). Mean BMI was 20.8 (SD 2.4) in PI-patients with FEV₁<70% and 23.2% (SD 3.0), in PI-patients with FEV₁ ≥70%, mean difference 2.4, (95% CI: 1.5, 3.3) (p <0.001), but there was no difference in energy intake. BMI ≥18.5 and a reported energy intake <120% were revealed in 54% of the PI-patients. Conclusions: The energy intake did not reach the recommended 120% EAR, but the prevalence of underweight was lower than reported in other studies. The recommendation may exceed the requirement for a number of CF-patients. The nutritional status must still be closely monitored and nutritional advice and intervention should be individualised and adjusted to actual needs.

Keywords: cystic fibrosis; adult; body mass index; energy intake; nutritional requirement; forced expiratory volume

(Published: 17 November 2011)

Citation: Food & Nutrition Research 2011, 55: 7561 - DOI: 10.3402/fnr.v55i0.7561