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Change in Classification of Nutrition Status
for Patients with CF and Nutrition Supplements
Karen Maguiness, MS, RD, CSPDuring the past year, the Cystic Fibrosis Foundation's (CFF) Clinical Practice Guidelines Subcommittee on Growth and Nutrition has been re-evaluating how weight status should be assessed in patients with Cystic Fibrosis (CF). An Ad Hoc Working Group was formed to review the literature and to make recommendations for screening and classification of weight status using data from the CFF Patient Registry. New analyses of the Registry data suggest an association between lung function (FEV1) and Body Mass Index. This association shows that persons with CF who are better nourished tend to have better lung function. The Working Group and Subcommittee on Growth and Nutrition determined the following as an indicator of optimal weight status. For children and adolescents, age 2-20 years old, a BMI percentile at or above the 50th percentile. For adults, age 20 years or older, a BMI at or above 22 for females, and a BMI at or above 23 for males. These new recommendations for weight status are clearly more stringent than the previous guidelines and thus we are "raising the bar". Please ask about Body Mass Index at your next clinic appointment and it will be calculated for you. The Subcommittee also recognizes that gains in weight and height are important factors in assessing nutritional status in pediatric patients, and should continue to be evaluated as part of a complete nutritional assessment. Particular attention should be given to providing "catch up" gain in weight and height for those patients requiring it, with emphasis on providing "catch up" growth as early after diagnosis as possible, so that full height potential may be reached. Unintended weight loss in adults also calls for nutritional evaluation and intervention. Methods to classify the nutritional status of infants with CF are in the process of being defined by the CFF. At a minimum, infants with CF should experience gains in weight and length similar to the general pediatric population. Nutrition supplements can be a helpful and convenient way to add extra calories to the diet. Some of the companies that manufacture pancreatic enzymes offer free nutrition supplements to patients with CF with proof of insurance. Additionally, the Women's, Infant's and Children's (WIC) supplemental feeding program offers some nutrition supplements to children until the age of 5. Patients who take Ultrase pancreatic enzyme replacement, with proof of insurance, may receive free vitamins and Scandishake or Scandical powder. Patients who take Creon pancreatic enzyme replacement, with proof of insurance, may receive free vitamins and Nestle Carnation Instant Breakfast Drink. Please call or ask for information at your next clinic appointment if you are interested in receiving these free supplements. [Keyword: Cystic Fibrosis] |
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