Dietary intake of energy-dense, nutrient-poor and nutrient-dense food sources in children with cystic fibrosis

Authors

Rosie Sutherland, University of New South Wales
Tamarah Katz, Sydney Children's Hospital
Victoria Liu, University of New South Wales
Justine Quintano, University of Wollongong
Rebecca Brunner, University of WollongongFollow
Chai Tong, University of New South Wales
Clare E. Collins, University of Newcastle
Chee Ooi, University of New South Wales, Sydney Children's Hospital

RIS ID

127380

Publication Details

Sutherland, R., Katz, T., Liu, V., Quintano, J., Brunner, R., Tong, C. Wei., Collins, C. E. & Ooi, C. Y. (2018). Dietary intake of energy-dense, nutrient-poor and nutrient-dense food sources in children with cystic fibrosis. Journal of Cystic Fibrosis, 17 (6), 804-810.

Abstract

Background: Prescription of a high-energy, high-fat diet is a mainstay of nutrition management in cystic fibrosis (CF). However, families may be relying on energy-dense, nutrient-poor (EDNP) foods rather than nutrient-dense (ND) foods to meet dietary targets. We aimed to evaluate the relative contribution of EDNP and ND foods to the usual diets of children with CF and identify sociodemographic factors associated with higher EDNP intakes.

Methods: This is a cross-sectional comparison of children with CF aged 2-18 years and age- and gender-matched controls. Dietary intake was assessed using the Australian Child and Adolescent Eating Survey (ACAES) food frequency questionnaire.

Results: Children with CF (n = 80: 37 males; mean age 9.3 years) consumed significantly more EDNP foods than controls (mean age 9.8 years) in terms of both total energy (median [IQR]: 1301 kcal/day (843-1860) vs. 686 kcal/day (480-1032); p < 0.0001), and as a proportion of energy intake (median [IQR]: 44% (34-51) vs. 31% (24-43); p < 0.0001). Although children with CF met their estimated energy requirements (median [IQR]: 158% (124-187) vs. 112% (90-137); p < 0.0001) and their diets were high in fat (median [IQR]: 38% (35-41) vs. 34% (32-36); p < 0.0001), this was largely attributable to EDNP foods. High EDNP intakes (≥10 serves/day) were associated with socioeconomic disadvantage (p = 0.01) and rural residential location (p = 0.03).

Discussion: The energy- and fat-dense CF diet is primarily achieved by overconsumption of EDNP foods, rather than ND sources. This dietary pattern may not be optimal for the future health of children with CF, who are now expected to survive well into adulthood.