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- Title
Nutrición, fibrosis quística y aparato digestivo.
- Authors
Olveira, Gabriel; Olveira, Casilda
- Abstract
The prevalence of hyponutrition in cystic fibrosis is high although it may vary according to the different studies. Detection of hyponutrition should be done by combining different methods, depending on their availability. However, the simplest and most validated criterion is to measure at each visit the weight (and height in children) in order to calculate the body mass index and categorize hyponutrition according to absolute criteria: in adults < 18.5 kg/m², and in children as percentiles of the body mass index. Worsening of nutritional status is directly related to the decrease in lung function parameters and it has been proposed as a morbidity (and even mortality) predictive factor in people with cystic fibrosis, independently of the level of pulmonary dysfunction. Exocrine pancreatic insufficiency is present in approximately 70-90% of the patients with cystic fibrosis and the genotype-phenotype correlation is high. Most of the patients with exocrine pancreatic insufficiency tolerate a high-fat diet provided that they are treated with pancreatic enzymes at appropriate doses. The prevalence of diabetes increases with age, reaching 40% of the cases in patients older than 30 years. Clinical liver involvement is less prevalent (it affects approximately 1/3 of the patients). Other intestinal complications such as meconial ileus, gastroesophageal reflux, obstruction of the distal intestine, or fibrosing colon disease may also condition malnourishment. In patients with cystic fibrosis, a usual high-fat diet providing 120%-150% of the recommended calories is advised. If nutritional goals are not achieved or maintained with diet modifications, artificial supplements may be added, although the recommendation of their use has not been endorsed by solid scientific evidence. The most frequently used preparations usually are polymeric or hypercaloric. The indications for enteral (through a tube, especially gastrostomy) or parenteral nutritional support are similar to those used in other pathologies. Dietary and nutritional control should be included in a multidisciplinary program allowing for improvement in functional capacity and quality of life and reducing, at least from a theoretical viewpoint, the morbimortality associated with malnourishment in these patients.
- Subjects
MALNUTRITION; CYSTIC fibrosis; DIET in disease; BODY mass index; GASTROESOPHAGEAL reflux; PHENOTYPES; COLON diseases; PATIENTS
- Publication
Nutrición Hospitalaria, 2008, Vol 23, p71
- ISSN
0212-1611
- Publication type
Article