For Adults
For people with CF, a suitable diet is vital. A healthy, well-nourished body can deal more effectively with chest infections or weight loss caused by illness.
It is essential that energy and protein intake is high. Adults with CF have higher energy needs; especially those who have frequent chest infections or are losing a lot of fat in their stools. Protein intake should be twice as much as the recommended adult amount.
There has to be a balance between sugary or fatty energy rich foods and foods that contain protein, vitamins and minerals, sausages for example. Although there is no need to avoid any particular foods, there are some that should be consumed in plenty:
- Fatty foods (butter, ice cream, chocolate)
- Sugary foods (jam, puddings, sweets)
- Milk and dairy products (cheese, yogurts)
- Starchy foods (pasta, rice, bread)
- Protein foods (fish, eggs, meat)
- Vitamin/mineral-rich foods (fruit, vegetables)
Fatty foods
As fat is one of the most concentrated sources of energy, fatty foods are the most efficient way of increasing your energy intake. If you have problems tolerating fat or certain foods upset you, changing your pancreatic enzymes could make the problems subside.
If you have spent years on a low fat diet, you may dislike the taste of foods like butter, chocolate and fried foods. Possible alternatives are nuts, biscuits, cakes and oily fish that are high in energy but taste less fatty.
Pancreatic Enzymes
Approximately 85% or more of people with CF have pancreatic insufficiency and need to take pancreatic enzymes to aid digestion. Different enzymes suit different people, so if you have queries about type or dosage you should consult your doctor. You should only stop taking enzymes on the advice of your doctor. Otherwise you run the risk of bowel blockage, which would need hospital treatment.
For information on enzymes, consult 'Eating Well with CF, a guide for adults', which can be downloaded here.
Vegetarian Diet
Although both vegetarian and vegan diets contain the essential nutrients, they are restrictive which can make it difficult to maintain a high energy intake. Strict vegan diets are particularly low in energy and can be bulky and filling. They are not advisable for adults with CF. However, a high-energy vegetarian diet is possible with expert help. Consult your doctor or dietitian if feel strongly about becoming vegetarian.
Vitamin supplements
Vitamin A, D and E supplements must be taken regularly and are available in the form of a prescribed multivitamin supplement. Without supplements, blood levels can fall and there is the risk of deficiency. Supplements differ for children and adults, so your supplement may change when you first attend an adult clinic.
Weight Gain
Keeping your weight at a reasonable level can be difficult, especially if you suffer from chest infections. Here are some tips:
- Only try to actively gain weight when you are well. Chest infections use extra energy so during illness, concentrate on maintaining your weight.
- Eat regularly, as an erratic diet can reduce your average energy intake. Organise a meal plan and stick to it.
- Eat three meals a day and try to eat at least one snack between each meal.
- Try to have a high energy drink before you go to bed. Avoid drinking such drinks at the expense of food - they are a useful substitute when you have a poor appetite.
- Increase the energy content of your food.
- Do not rely on prescribed supplements like high energy drinks and glucose polymers to increase your weight.
- If you are having difficulty maintaining your weight, consult your doctor or dietitian.
Weight Loss
Poor appetite and weight loss are often the first signs of a chest infection. Appetite can be slow to return, but you should try to maintain a high energy diet regardless. Here are some helpful suggestions:
- Abandon 'knife and fork' meals if they are too filling. Snacks can contain just as much energy.
- Try to have a snack or high energy drink every two hours.
- Consume energy in liquid form when you are unwell; high energy drinks may be more palatable then food.
- If you are unable to make your own drinks, you might want to try prescribed supplements such as glucose powder or liquid glucose.
Tube Feeding
In the event of extreme weight loss, tube feeding may be an option of ensuring a high energy intake. There are two types of tube feeding:
- Nasogastric (a tube down the nose)
- Gastronomic (a tube directly into the stomach)
The type of tube will depend upon your needs and the policy of your treatment centre. However, if the treatment will last more than a few weeks, a gastronomy tube is probably the best option. It is hidden from view and cannot be dislodged or coughed out during physiotherapy. The feed administered through the tube will vary from centre to centre. To find out more about of tube feeding, consult your doctor or dietitian.
Certain aspects of adult life (i.e. starting work, living away from home, diabetes or pregnancy) may affect your diet.
