For an adult with CF, good nutrition means more that just eating
a balanced "normal" diet. A "normal" diet means eating a wide variety of foods
as no single food contains all essential nutrients (fuel). In fact, the human
body needs more than 40 different nutrients for good health! However, most
people with CF (around 80-85%) have problems digesting the food they eat.
The problem is caused by blocked pancreatic ducts (little tubes leading from
the pancreas to the small bowel). Normally, digestive enzymes are released in
pancreatic juices by the pancreas. They travel to your stomach and intestine
(bowel) where they break down food so that your body can absorb or "soak up" the
nutrients. In people with CF, however, these pancreatic juices are blocked from
reaching the intestine so they can't do their job of breaking down food.
Taking pancreatic enzymes with meals and snacks helps your body better absorb
nutrients. However even today's much improved enzymes cannot correct the problem
completely.
Energy Imbalances and CF
Most people with CF need more nutrients for energy, growth and maintenance of
overall health. These include protein, fat, vitamins and minerals. In general
you need one and a half times more energy than a person who doesn't have CF.
Because having CF makes it difficult for your body to obtain these nutrients
from food, this can create an energy imbalance-- that is, your body uses up more
energy than it takes in. This state can lead to weight loss and poor nutrition.
When you are poorly nourished you are more likely to get lung infections. You
will also have less energy to do your favorite activities. Finally, poor
nutrition will affect your overall health and quality of life.
How can you avoid this energy imbalance? First, you can begin by trying to modify
your everyday foods. Start with a well balanced diet for a healthy person of a
similar age as you. A well balanced diet includes foods from meats and/or meat
alternatives,
milk products, grain products, and fruits & vegetables. Next, modify your
daily intake by:
increasing portion sizes
adding high calorie snacks
adding high calorie food choices at meals
adding extra fats
limiting "calorie-poor" foods and beverages, such as coffee, tea and clear broth Also remember to drink a lot of fluids (8 cups or more a day).
People with CF also have higher salt requirement as they lose more salt in their sweat. In most cases the need for extra salt can be met by adding a little more salt to the food you eat daily.
Why high calorie, nutritious foods are important
Like many people, you're probably concerned about fat and "fatty foods" being "bad" for your cholesterol. However most people with CF have low or normal blood cholesterol level. Fat gives more than twice as many calories as protein or starchy foods, making it an economical fuel source for your body. So don't be shy about eating extra fats and fatty foods!
To help boost your nutritional levels and prevent vitamin deficiencies, you'll
need to take multivitamins/mineral supplements and additional ones as needed.
These may include vitamins E & K, iron and calcium. If you are considering
adding supplements to your diet, talk to your CF team first. As well, check with
your CF team before starting on any "alternative" therapy supplements.
When you're sick, you often have a very poor appetite. Yet, this is precisely
the time when your body needs even more food for breathing, and fighting
infection and fever. If you're finding it hard to eat well, you may want to take
some commercially made milkshake type "booster drinks". Some of the common brand
names are Ensure®/Ensure Plus®, Boost®/Boost Plus®, Resource®/Resource Plus®,
Scandishake® and Carnation® Instant Breakfast. Ask your dietitian/nutritionist
which is the best choice for you. In general "predigested" supplements, (which
tend to be expensive) are not necessary to take when you're ill.
Eating six to eight small meals/snacks a day can help get you back on the road
to better health. If you feel too tired to cook, try convenience foods such as
frozen entrees, deli or restaurant take-outs, or canned thick and chunky
soups.
During times of illness, it's important that you don't loose too much weight.
If you are unable to maintain your weight and nutritional needs with food and
supplements, you may want to consider "home tube feeding" such as a gastronomy
(G-tube).
Your CF team is likely to talk to you about this option when necessary, but
you can also talk to them first. For best results it's better to consider this
option when you have not lost too much ground nutritionally.
The Nutrition Plan that's Right for You
Not everyone with CF is created equal, with the same nutritional requirements. Your nutritional plan must be tailored to fit your unique needs. And, you will need to get this plan updated regularly. It should be updated even more often if you are planning to have a baby, pregnant, breast- feeding or on a lung transplant list.
Remember— there is much you can do to offset
the digestive problems caused by CF. Make eating well with your customized
nutrition plan a part of your daily routine!
