Two talks, presented today at the 30th Annual North American Cystic Fibrosis Conference (NACFC), focused on the role of nutrition in children with cystic fibrosis (CF).
In a first presentation, “Have we journeyed to Junk?,” Tamarah Katz, MSc (Nutr&Diet), with the Sydney Children’s Hospital, quantified how much core (e.g., fruit, vegetables) and non-core foods (e.g., snacks, sweetened beverages) contribute to the diet of children with CF, and compared these results with those of healthy controls. Katz and her team also investigated how socioeconomic status or gender impacts the children’s nutrition.
The team recruited children with CF from the Sydney Children’s Hospital, Australia. Patients underwent the Australian Child and Adolescent Eating Survey (ACAES), a validated Food Frequency Questionnaire (FFQ) reporting an individual’s standard dietary consumption for the previous six months. Additional parameters included net household income, level of parental education, and postal code.
Comparable levels of household income, maternal level of education, as well as age and gender distribution were found between CF children and healthy controls. But researches found that non-core foods made up significantly more of the total energy intake of CF children compared to healthy children. They also observed a clear gender effect in terms of nutrition: boys with CF consumed significantly more snacks and other non-core foods than they did fruits, vegetables and other core foods.
Although neither children with CF nor controls met the current Australian Dietary Guidelines for core food intake, children with CF (especially boys) meet their habitual daily energy intake through nutrient-poor, non-core foods. As a consequence, they showed lower scores for nutrient-dense core foods, which are known to prevent chronic disease.
Katz emphasized that more attention is required to ensure that CF diet in children is not weighed toward junk food.
In a second talk, “A Clinical Look at Macronutrient Intake in Preschoolers,” presented by Stephanie Filigno, PhD, from Cincinnati Children’s Hospital Medical, researchers examined macronutrient intake in young children diagnosed with CF. Macronutrients are those nutrients that provide energy, and are therefore consumed in larger quantities. The three primary macronutrients are carbohydrates, proteins, and fat.
This analysis is particularly important, since macronutrients can have broad benefits, including halting metabolic mechanisms associated with chronic illness and acute infections.
Researchers recruited 78 children with CF and pancreatic insufficiency (ages 2–6), who took part in a randomized clinical trial to determine the effects of two treatments, a behavioral and nutrition treatment versus an education and attention-control treatment, on energy intake and growth. Researchers quantified children’s dietary intake at baseline and post-treatment (month 6).
The team observed that only 18% of children were meeting the 120% Estimated Energy Requirement (EER) at baseline; and only 40% met the 35% of daily energy intake from fat minimum recommendation.
Looking at macronutrients specifically, the team found that 35.3% of energy intake was based on fat, 12.7% from protein, and 52.0% from carbohydrates. Researchers also found a negative relationship at baseline between carbohydrate and fat intake. Dinner and snacks presented different outcomes: while dinner was the meal with the highest percentage of caloric intake from protein and fat (consumed at 15.6% and 38.6%, respectively), snacks had the highest percentage of calories from carbohydrates (64.2%).
These results, they concluded, show that many children are still not meeting the established 2002 CF Foundation nutrition guidelines of at least 35% of daily energy intake derived from fat, consumed throughout the day. But all children met the 2016 CF Foundation preschool recommendations for daily protein intake.
According to Filigno, the findings highlight the importance of family dinner routines during a child’s preschool years, to promote a proper and balanced intake of fat and protein. Moreover, researchers identify the necessity to improve and substitute high carbohydrate foods and beverages during snacks.
The CF conference, which opened on Thursday, runs through Saturday in Orlando, Florida.