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Energy needs and growth in children with cystic fibrosis
Insights
Children with cystic fibrosis (CF) experience growth retardation due to inadequate energy intake. Supplementing energy intake and providing dietary counseling can promote normal growth in children with CF.
Area of Science:
- Pediatric Nutrition
- Gastroenterology
- Metabolic Disorders
Background:
- Children with cystic fibrosis (CF) often exhibit growth retardation.
- Adequate energy supply is crucial for normal growth velocity.
- Pancreatic enzyme replacement may not fully address malabsorption in CF.
Purpose of the Study:
- To evaluate the impact of dietary counseling and high-energy food supplementation on the growth of children with CF.
- To determine the relationship between energy intake, absorbed energy, and growth in pediatric CF patients.
- To identify key factors limiting growth in young children with CF.
Main Methods:
- A 2-year study involving eight children (4-9 years) with CF, divided into control and test periods.
- Intervention included dietary counseling and high-energy food supplementation during the test period.
- Measurement of dietary energy intake, absorbed energy, and growth parameters (weight and height).
Main Results:
- Increased energy intake during the test period led to significant weight gain (p < 0.05).
- A positive linear relationship was observed between absorbed energy and weight gain (p < 0.01).
- Normal growth rates for height and weight were achieved when absorbed energy reached 100-110% of requirements.
Conclusions:
- Children with CF frequently have insufficient energy intake, which is a primary factor limiting their growth.
- Absorbed energy intake, not just dietary intake, is the principal determinant of growth in young CF patients.
- Dietary interventions, including counseling and high-energy supplements, can effectively improve growth in children with CF.
Abstract:
Children with cystic fibrosis (CF) frequently have growth retardation. Standard growth velocity is dependent on an adequate supply of energy. The effect of dietary counselling and high energy food supplementation on the growth of eight children (aged 4 to 9 years) with CF was determined. The 2-year study was divided into control and test periods each lasting 1 year. Only during the test period did the mean energy intake reach or exceed 100% of the recommended energy requirements. When energy intake increased, weight growth increased significantly (p less than 0.05). Even with pancreatic enzyme replacement, the CF subjects had increased fecal energy losses. Thus, since dietary energy intake would overestimate energy available for metabolism, absorbed energy was determined. There was a positive linear relationship between absorbed energy and weight gain (p less than 0.01). Normal rates of weight gain were seen once absorbed energy intakes reached 100-110% of requirements. The children grew in height and weight at normal rates during the test period, whereas they showed retarded growth during the control period. Our data provide evidence that children with CF have inadequate energy intakes. Furthermore, we have shown that absorbed energy intake is the principal factor limiting the growth of CF children in the age group studied. Finally, it is possible to promote normal growth in CF children with dietary counselling and high energy supplements.