Cystic fibrosis - nutritional considerations
(CF) is a life-threatening disease that causes thick, sticky mucus to build up in the lungs and digestive tract. Persons with cystic fibrosis need to eat high-calorie and high-protein foods throughout the day.
The pancreas is an organ in the abdomen behind the stomach. An important job of the pancreas is to make enzymes. These enzymes help the body digest and absorb protein and fats. A buildup of sticky mucus in the pancreas from cystic fibrosis can lead to serious problems, including:
Stools that contain mucus, are foul smelling, or float
Gas, bloating, or distended belly
Problems getting enough protein, fat, and calories in the diet
Because of these problems, a person with cystic fibrosis may have a hard time managing a normal weight. Even when weight is normal, a person may not be getting the right nutrition. Children with cystic fibrosis may not grow or develop correctly.
The following are methods for adding protein and calories to the diet.
Enzymes, vitamins, and salt:
Most people with cystic fibrosis must take pancreatic enzymes. These enzymes help your body absorb fat and protein. Taking them all the time will decrease or get rid of foul-smelling stools, gas, and bloating.
Take enzymes with all meals and snacks.
Talk to your doctor about increasing or decreasing your enzymes, depending on your symptoms.
Ask your doctor about taking vitamins A, D, E, K, and extra calcium. Special formulas exist for patients with CF.
People who live in hot climates may need a small amount of extra table salt.
- Eat whenever you are hungry. This may mean eating several small meals throughout the day.
- Keep a variety of nutritious snack foods around. Try to snack on something every hour, such as cheese and crackers, muffins, or trail mix.
- Make an effort to eat regularly, even if it is only a few bites; or include a nutritional supplement or milkshake.
- Be flexible. If you are not hungry at dinner time, make breakfast, mid-morning snacks, and lunch your main meals.
Getting more calories and protein:
- Add grated cheese to soups, sauces, casseroles, vegetables, mashed potatoes, rice, noodles, or meat loaf.
- Use whole milk, half and half, cream, or enriched milk in cooking or beverages. Enriched milk has nonfat dry milk powder added to it.
- Spread peanut butter on bread products or use it as a dip for raw vegetables and fruit. Add peanut butter to sauces or use on waffles.
- Skim milk powder adds protein. Try adding 2 tablespoons of dry skim milk powder in addition to the amount of regular milk in recipes.
- Add marshmallows to fruit or hot chocolate. Add raisins, dates, or chopped nuts and brown sugar to hot or cold cereals, or have them for snacks.
- A teaspoon of butter or margarine adds 45 calories to foods. Mix it into hot foods such as soups, vegetables, mashed potatoes, cooked cereal, and rice. Serve it on hot foods -- hot breads, pancakes, or waffles absorb more butter than cool ones.
- Use sour cream or yogurt on vegetables such as potatoes, beans, carrots, or squash. It can also be used as a dressing for fruit.
- Breaded meat, chicken, and fish have more calories than broiled or plain roasted.
- Add extra cheese on top of frozen prepared pizza.
- Add coarsely chopped hard cooked egg and cheese cubes to a tossed salad.
- Serve cottage cheese with canned or fresh fruit.
- Add grated cheeses, tuna, shrimp, crabmeat, ground beef, diced ham or sliced boiled eggs to sauces, rice, casseroles, and noodles.
Accurso FJ. Cystic fibrosis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 89.
Stallings VA, Stark LF, Robinson KA, Feranchak AP, Quinton H. Evidence-based practice recommendations for nutrition-related management of children and adults with cystic fibrosis and pancreatic insufficiency: Results of a systematic review. Journal of the American Dietetic Association. 2008;108:832-839.
Egan M. Cystic fibrosis. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 395.
Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.