Using Nutrition to Stay Healthy with CF: Presentation June 12, 2007 This Web cast is supported by an unrestricted educational grant from Genentech, Inc.
Using Nutrition to Stay Healthy with CF Drucy Borowitz, M.D. Joseph Cronin, M.D. Christine Coburn-Miller, M.S.R.D.
Our goal is healthy, full lives From childhood… Taylor S.
Nancy M. and her daughter adulthood! Through
For children under 2 years of age weight-for-length is used Body Mass Index (BMI) Percentile is used for people ages 2-20 years BMI = weight (height) 2 BMI Calculator at www.cdc.gov
BMI is used for people over age 20 years BMI = weight (height) 2 BMI Calculator at www.cdc.gov
FEV 1 % Predicted vs. BMI Percentile Ages 6 to 20 years 100 95 90 FEV 1 % Predicted 85 80 75 70 65 60 55 50 <5 5 10 1520 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 BMI Percentile Males Females
FEV 1 % Predicted vs. BMI Percentile Ages 6 to 20 years 100 95 90 FEV 1 % Predicted 85 80 75 70 65 60 55 50 <5 5 10 1520 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 BMI Percentile Males Females
FEV 1 % Predicted vs. BMI Percentile Ages 6 to 20 years 100 95 90 FEV 1 % Predicted 85 80 75 70 65 60 55 50 <5 5 10 1520 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 BMI Percentile Males Females
FEV 1 % Predicted vs. BMI Percentile Ages 6 to 20 years 100 95 90 FEV 1 % Predicted 85 80 75 70 65 60 55 50 <5 5 10 1520 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 BMI Percentile Males Females
FEV 1 % Predicted vs. BMI Ages 21 to 40 years 90 85 80 FEV 1 % Predicted Females ≥ 22 BMI 75 Males ≥ 23 BMI 70 65 60 55 50 45 40 35 30 25 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 BMI Males Females
FEV 1 % Predicted vs. BMI Ages 21 to 40 years 90 85 80 FEV 1 % Predicted Females ≥ 22 BMI 75 Males ≥ 23 BMI 70 65 60 55 50 45 40 35 30 25 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 BMI Males Females
The more you weigh early in life, the taller you’ll be as an adult 10 Weight Percentiles 9 Height velocity, cm/yr <10 8 >50 7 6 5 4 3 2 1 0 8 9 10 11 12 13 14 15 16 17 18 19 20 21 2 3 4 5 6 7 Age in years
The more you weigh early in life, the taller you’ll be as an adult 10 Weight Percentiles 9 Height velocity, cm/yr <10 8 >50 7 6 5 4 3 2 1 0 8 9 10 11 12 13 14 15 16 17 18 19 20 21 2 3 4 5 6 7 Age in years
The more you weigh early in life, the taller you’ll be as an adult 10 Weight Percentiles 9 Height velocity, cm/yr <10 8 >50 7 6 5 4 3 2 1 0 8 9 10 11 12 13 14 15 16 17 18 19 20 21 2 3 4 5 6 7 Age in years
The more you weigh early in life, the taller you’ll be as an adult 10 Weight Percentiles 9 Height velocity, cm/yr <10 8 >50 7 6 5 4 3 2 1 0 8 9 10 11 12 13 14 15 16 17 18 19 20 21 2 3 4 5 6 7 Age in years
The more you weigh early in life, the taller you’ll be as an adult 10 Weight Percentiles 9 Height velocity, cm/yr <10 8 >50 7 6 5 4 3 2 1 0 8 9 10 11 12 13 14 15 16 17 18 19 20 21 2 3 4 5 6 7 Age in years
Judy Marciel, C.P.N.P. Slide courtesy of
Judy Marciel, C.P.N.P. Slide courtesy of
Slide courtesy of Judy Marciel, C.P.N.P.
Lipase digests fats Slide courtesy of Judy Marciel, C.P.N.P.
Protease digests proteins Slide courtesy of Judy Marciel, C.P.N.P.
Amylase digests starches Slide courtesy of Judy Marciel, C.P.N.P.
Basics of Preventive Nutrition • Eat high-calorie, high-fat meals and snacks every day • Establish good meal-time behaviors • Take enzymes with every meal and snack if your pancreas isn’t working • Take CF vitamins every day
Using Nutrition to Stay Healthy with CF: Presentation June 12, 2007
Number of Adults with CF in U.S.A. 12000 12000 10000 10000 8000 8000 6000 6000 4000 4000 2000 2000 0 0 1970 1980 1990 2000 2006 1970 1975 1980 1985 1990 1995 2000 2005 2006 1975 Year
Education - Adults with CF Less than High School 9% High School diploma 34% 27% College graduate 30% 2005 CF Foundation’s Some College Patient Registry
Employment - Adults with CF Retired Homemaker 1% Unemployed 4% 8% Part-time 10% 36% Full-time 14% Disabled 27% 2005 CF Foundation’s Patient Registry Student
Marital Status - Adults with CF Widowed Separated/Divorced 0.2% 4.9% Married/ Living 36% Single Together 58.9% 2005 CF Foundation’s Patient Registry
Using Nutrition to Stay Healthy with CF: Presentation June 12, 2007
What if Eating Becomes a Challenge? • Try simple behavioral changes • Seek an expert’s advice • Think about using tube feedings (e.g., gastrostomy, G-tube, GT, button, NG)
Child Typical Parent Behavioral Behavior Response Change Taking bites • Not noticing Compliment child on eating Excess • Instructing Ignore child until talking child to eat they take a bite, • Feeding child then answer questions or engage in conversation
Child Typical Parent Behavioral Behavior Response Change Complaints: • Coaxing Ignore complaints & • Not liking • Prompting compliment child food • Making other for eating foods • Negotiating meals Leaving the • Coax child to Set rules about table return staying at table • Instruct child during meals to return Guide back to table with minimal discussion
Child Typical Parent Behavioral Behavior Response Change Complaints of • Coax Set appropriate food being full • Prompt intake • Feeding expectations and • Negotiating meal length and amount of set rewards food during the meal Nutrition: How to Encourage Health Eating www.cff.org
Gastrostomy Feedings • A tube is inserted directly into the stomach through the skin • A high-calorie liquid goes into the stomach at night • The tube is disconnected during the day and closed
Using Nutrition to Stay Healthy with CF: Presentation June 12, 2007
Gastrostomy button as a fashion statement!
BMI Calculator at www.cdc.gov
• Originally broadcast in 2007 • Now in 2 parts – Presentation – Part 1 – Questions and Answers – Part 2 • Please contact your CF Care Center or the CF Foundation to get your questions answered – CF Foundation - info@cff.org or 1-800 FIGHT CF Using Nutrition to Stay Healthy with CF June 12, 2007
Using Nutrition to Stay Healthy with CF: Presentation June 12, 2007
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