Analysis of diet energetical value in cystic fibrosis children

摘要

In cystic fibrosis patients energy balance is characterised by a certain variety related to increased energy needs and frequent occurrence of energy intake disturbances. High-energy diet (120-150% of energy daily allowance, depending on age and sex) is indispensable to adequate energy balance. The aim of the study was to estimate the value of daily food allowances in cystic fibrosis children, and to assess the degree to which the recommendations are realised. The study comprised 36 patients (25 boys and 11 girls) aged 1 to 18 years. Research was based on 24-hour nutritional questioning. The questionnaires were collected during 7 successive days. Due to existing body height and weight deficits, the calculated energy value was compared to the required and real body weight. In the case of the required body weight, patients followed the recommendations regarding energy supply for health peers in 90.3±37.3%, and in the case of the real body weight the numbers were respectively 104.0±38.5%. Great variety of individual results was observed. In order to obtain energy intake recommended for cystic fibrosis children, its value should be increased by 678±757 Kcal and 1285±898 Kcal for 120% and 150% of daily needs, respectively. In the recent years, an important improvement in the nutrition of cystic fibrosis children has been obtained in the Wielkopolska (Great Poland) region, yet the majority of patients still do not fully follow the recommendations. In the case of patients with large body weight deficit, the balancing of the diet could be started with values adequate to real body weight and gradually increased until energy values resulting from the required body weight are reached. The obtained data indicate a permanent need for daily food allowances analysis and for a correction of the performed nutritional management. High-energy and high-protein diet, nutritional education, and dietetic counselling should be recommended to all patients, followed by an intensification of the steps described above, increase in caloric density of the recommended diet, and behavioural analysis. In the case of severe nutritional condition disturbances and lack of efficiency of the previous therapy, high-energy supplements should be added, while eneteral feeding (nasogastric tube or gastrostomy) and partial or total parenteral nutrition should be taken into consideration.