Using Nutrition to Stay Healthy with CF: Presentation June 12, - - PowerPoint PPT Presentation

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Using Nutrition to Stay Healthy with CF: Presentation June 12, - - PowerPoint PPT Presentation

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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.

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June 12, 2007

Using Nutrition to Stay Healthy with CF: Presentation

This Web cast is supported by an unrestricted educational grant from Genentech, Inc.

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Using Nutrition to Stay Healthy with CF

Drucy Borowitz, M.D. Joseph Cronin, M.D. Christine Coburn-Miller, M.S.R.D.

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Our goal is healthy, full lives From childhood…

Taylor S.

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Through adulthood!

Nancy M. and her daughter

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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

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BMI is used for people

  • ver age 20 years

BMI = weight (height)2

BMI Calculator at www.cdc.gov

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BMI Percentile

Males Females

FEV1% Predicted

50 55 60 65 70 75 80 85 90 95 100 <5 5 10 1520 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95

FEV1 % Predicted vs. BMI Percentile Ages 6 to 20 years

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BMI Percentile

Males Females

FEV1% Predicted

50 55 60 65 70 75 80 85 90 95 100 <5 5 10 1520 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95

FEV1 % Predicted vs. BMI Percentile Ages 6 to 20 years

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BMI Percentile

Males Females

FEV1% Predicted

50 55 60 65 70 75 80 85 90 95 100 <5 5 10 1520 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95

FEV1 % Predicted vs. BMI Percentile Ages 6 to 20 years

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BMI Percentile

Males Females

FEV1% Predicted

50 55 60 65 70 75 80 85 90 95 100 <5 5 10 1520 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95

FEV1 % Predicted vs. BMI Percentile Ages 6 to 20 years

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FEV1 % Predicted vs. BMI Ages 21 to 40 years FEV1% Predicted BMI

Males Females 25 30 35 40 45 50 55 60 65 70 75 80 85 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Females ≥ 22 BMI Males ≥ 23 BMI

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FEV1 % Predicted vs. BMI Ages 21 to 40 years FEV1% Predicted BMI

Males Females 25 30 35 40 45 50 55 60 65 70 75 80 85 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Females ≥ 22 BMI Males ≥ 23 BMI

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2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

Age in years

1 2 3 4 5 6 7 8 9 10

Height velocity, cm/yr

<10 Weight Percentiles >50

The more you weigh early in life, the taller you’ll be as an adult

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2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

Age in years

1 2 3 4 5 6 7 8 9 10

Height velocity, cm/yr

<10 Weight Percentiles >50

The more you weigh early in life, the taller you’ll be as an adult

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2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

Age in years

1 2 3 4 5 6 7 8 9 10

Height velocity, cm/yr

<10 Weight Percentiles >50

The more you weigh early in life, the taller you’ll be as an adult

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2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

Age in years

1 2 3 4 5 6 7 8 9 10

Height velocity, cm/yr

<10 Weight Percentiles >50

The more you weigh early in life, the taller you’ll be as an adult

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2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

Age in years

1 2 3 4 5 6 7 8 9 10

Height velocity, cm/yr

<10 Weight Percentiles >50

The more you weigh early in life, the taller you’ll be as an adult

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Slide courtesy of Judy Marciel, C.P.N.P.

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Slide courtesy of Judy Marciel, C.P.N.P.

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Slide courtesy of Judy Marciel, C.P.N.P.

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Slide courtesy of Judy Marciel, C.P.N.P.

Lipase digests fats

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Slide courtesy of Judy Marciel, C.P.N.P.

Protease digests proteins

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Slide courtesy of Judy Marciel, C.P.N.P.

Amylase digests starches

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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
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June 12, 2007

Using Nutrition to Stay Healthy with CF: Presentation

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Number of Adults with CF in U.S.A.

1975

2000 4000 6000 8000 10000 12000 1970 1980 1990 2000 2006

1970 1975 1980 1985 1990 1995 2000 2005 2006 Year

2000 4000 6000 8000 10000 12000

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Education - Adults with CF

Some College 34% 9% 27% 30% Less than High School High School diploma College graduate

2005 CF Foundation’s Patient Registry

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Employment - Adults with CF

Homemaker Student Retired 36% 27% 14% 10% 8% 4% 1% Full-time Part-time Unemployed Disabled

2005 CF Foundation’s Patient Registry

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Marital Status - Adults with CF

Single Married/ Living Together Widowed Separated/Divorced 0.2% 4.9% 36% 58.9%

2005 CF Foundation’s Patient Registry

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June 12, 2007

Using Nutrition to Stay Healthy with CF: Presentation

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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)

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Child Behavior Typical Parent Response Behavioral Change Taking bites

  • Not noticing

Compliment child

  • n eating

Excess talking

  • Instructing

child to eat

  • Feeding child

Ignore child until they take a bite, then answer questions or engage in conversation

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Child Behavior Typical Parent Response Behavioral Change Complaints:

  • Not liking

food

  • Negotiating
  • Coaxing
  • Prompting
  • Making other

meals Ignore complaints & compliment child for eating foods Leaving the table

  • Coax child to

return

  • Instruct child

to return Set rules about staying at table during meals Guide back to table with minimal discussion

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Child Behavior Typical Parent Response Behavioral Change Complaints of being full

  • Coax
  • Prompt
  • Feeding
  • Negotiating

amount of food during the meal Set appropriate food intake expectations and meal length and set rewards Nutrition: How to Encourage Health Eating www.cff.org

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  • 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

Gastrostomy Feedings

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June 12, 2007

Using Nutrition to Stay Healthy with CF: Presentation

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Gastrostomy button as a fashion statement!

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BMI Calculator at www.cdc.gov

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  • 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

June 12, 2007 Using Nutrition to Stay Healthy with CF

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June 12, 2007

Using Nutrition to Stay Healthy with CF: Presentation