CF patients eat high-fat diet despite guidelines: Review

Researchers say weight, food habits becoming concerns

Margarida Maia, PhD avatar

by Margarida Maia, PhD |

Share this article:

Share article via email
An illustration shows a sliced loaf of bread, pretzels, and other grains.

Despite recent guidelines recommending nutrient consumption similar to the general population, many adults and late adolescents with cystic fibrosis (CF) still follow a high-fat, high-energy diet, according to a review done by researchers in Australia.

The findings suggest that “overall, diet intakes of adults with CF appear to be less than optimal and that concerns about diet, weight and food may be emerging in this population,” the researchers wrote.

The review, “Dietary intake and quality among adults with cystic fibrosis: A systematic review,” was published in Nutrition & Dietetics.

Living with CF may come with challenges to maintaining a healthy weight or meeting nutritional needs, particularly when the disease interferes with how well nutrients are taken up into the bloodstream. People with CF in the past were counseled to follow high-fat, high-energy diets.

Over time, better clinical practices and advances in CFTR modulators have switched concerns to weight and health problems resulting from energy-dense, nutrient-poor diets. However, not much is known about the eating habits of people with CF.

Recommended Reading
A woman is shown standing on a scale to determine her weight.

Younger adults with frequent flares at risk of weight gain with Trikafta

High-fat diet, more grains and proteins

The researchers looked at studies on eating habits and diet quality and intake among adults and adolescents with CF, ages 15 and older, that were published from January 2000 to November 2022.

Data from 19 studies involving a total of 2,236 patients revealed that their diets were generally less than optimal. Not all studies used the same methods to assess diet quality and intake, which complicated the review.

Thirteen studies reported that patients were consuming high-energy diets, and when studies reported energy intake as a proportion of needs met, energy intake was as much as 34% too high, even when looking at CF-specific or individually tailored standards.

Two studies using the Healthy Eating Index (HEI) found that patients had lower diet quality scores than the general population. HEI scores range from 0 to 100, where 100 indicates that an individual’s diet reflects the national dietary guidelines.

In another study that compared food intake to Australian dietary guidelines, patients reported eating significantly more servings per day of grains and protein-rich foods than recommended, while meeting all other recommendations.

Two studies found no significant differences in dieting or mindful eating between patients and the general population. However, in one of the studies, CF patients (21% of males and 24% of females) felt more pressured to eat than those without CF (1% for both sexes).

Two studies used semi-structured interviews with open-ended questions to explore dietary experiences. Patients often referred to childhood dietary experiences, using food as medicine, and adjusting intake based on current body weight.

Adults and late adolescents with CF “may be consuming diets of poor quality, consuming too much energy and a macronutrient profile not consistent with general guidelines for healthy eating,” the researchers wrote. Macronutrients include sugars, proteins, and fats.

“Further research exploring the eating attitudes and concerns of young adults with CF may be of interest, especially as their dietary needs transition in response to accessing CFTR modulator therapy,” the researchers concluded.