Changes in nutritional priorities and management in people with CF

Nutritional priorities for people with cystic fibrosis (PwCF) are shifting rapidly with widespread use of highly effective cystic fibrosis transmembrane conductance regulator (CFTR) modulators. As undernutrition becomes less common with increasing longevity, adiposity- and age-driven metabolic risks have emerged as growing concerns for the CF population. Evidence now demonstrates that lean mass and muscle function, rather than body weight alone, are more closely aligned with pulmonary health, although these relationships may be altered based on CFTR modulator use. Modern nutrition care guidelines emphasize individualized assessment, body composition monitoring, optimization of diet quality, and lifestyle strategies that support muscle health and metabolic resilience. Additionally, growing understanding of gut dysbiosis and its potential modulation through diet, probiotics, and CFTR modulator therapy highlights new opportunities to improve gastrointestinal and systemic health. Together, these evolving insights underscore the need to modernize nutrition targets and develop evidence-based dietary and behavioral interventions suited to an aging CF population in the modulator era.