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Carbohydrate malabsorption is minimal in school-age cystic fibrosis children
R D Hoffman1, J N Isenberg, G K Powell
1Department of Pediatrics, University of Texas Medical Branch, Galveston 77550.
Insights
Children with cystic fibrosis (CF) show minimal carbohydrate malabsorption despite fat and protein issues. Carbohydrate may be a viable energy source for CF patients with high energy needs.
Area of Science:
- Pediatric Nutrition
- Gastroenterology
- Metabolic Disorders
Background:
- Cystic Fibrosis (CF) leads to significant malabsorption of fats and proteins.
- Increased energy demands are common in children with CF.
- Dietary management is crucial for improving nutritional status in CF.
Purpose of the Study:
- To assess carbohydrate absorption in school-age children with CF.
- To evaluate the impact of CF on carbohydrate digestion and utilization.
- To explore alternative energy sources for CF patients.
Main Methods:
- Balance studies were conducted on 15 school-age children with CF over one year.
- Stool analysis included conventional methods for fat and protein, and an anthrone method for carbohydrate.
- Thin-layer chromatography was used to detect short-chain fatty acids in stool.
Main Results:
- Despite significant fat and protein malabsorption, less than 1% of ingested carbohydrate was lost intact.
- Fecal carbohydrate excretion was independent of intake, unlike fat and protein.
- No short-chain fatty acids were detected in stool samples.
Conclusions:
- Carbohydrate malabsorption is minimal in school-age children with CF.
- Carbohydrate represents a potentially valuable energy source for CF patients.
- Further research into carbohydrate utilization in CF is warranted.
Abstract:
Fifteen school-age cystic fibrosis children, participating in a year-long nutritional management study, were hospitalized at six-month intervals for balance studies during which they continued "free-choice" diets and their usual enzyme supplementation. Stools were analyzed for fat and protein by conventional methods and for carbohydrate using a recently validated anthrone method. Despite persistent fat and protein malabsorption, less than 1% of ingested carbohydrate was lost intact in the stools. Comparison of baseline and placebo balance studies showed fecal excretion of carbohydrate to be independent of intake, in contrast to the fat and protein results. Using a thin-layer chromatography method capable of detecting microgram quantities of urinary organic acids, no short-chain fatty acids were detected in the stool. Further exploration of carbohydrate as a dietary energy source for this patient group with increased energy demands should be pursued.