Kistik Fibrozisli Hastalarda Malnütrisyon ve Beslenme Durumunun Saptanması

Amaç: Kistik fibrozisli hastalarda malnütrisyon ve beslenme durumunun saptanmasıdır. Bireyler ve Yöntem: Kistik fibrozis tanısı ile izlenen 2-20 yaş arası 166 hastanın 24 saatlik geriye dönük besin tüketim kaydı BEBIS 7.2 programı, yaşa göre ağırlık (WAZ), yaşa göre boy (HAZ), boya göre ağırlık (WHZ) ve yaşa göre beden kütle indeksi (BKIZ) Z skorları WHO Anthro ve Anthro Plus programları kullanılarak değerlendirilmiştir. Bulgular: Hastaların %10.1’inin WAZ, malnütrisyon olarak değerlendirilen -2SD’nin altında, %21.0’inin HAZ, bodur olarak tanımlanan -2SD’nin altındadır. Hastaların %25.3’ü sadece oral olarak normal besinler tüketmekte, %74.7’si ise oral besinlere ek olarak oral enteral ürün kullanmaktadır. Hastaların %41’inin sabah öğününü atladığı, en fazla atlanan öğünün her yaş grubunda sabah öğünü olduğu bulunmuştur. Hastaların %67’sinin RDA’ya göre önerilen günlük enerji alımı yetersiz (

Assessment of Nutritional Status and Malnutrition in Patients with Cystic Fibrosis

Aim: The aim of this study was to evaluate the nutritional status and malnutrition in children with cystic fibrosis. Subjects and Methods: A total of 166 patients with cystic fibrosis, aged 2-20 years were evaluated. A 24-hour dietary recall was calculated using BEBIS 7.2 programme, weight for age (WAZ), height for age (HAZ), weight for height (WHZ) and body mass index z scores (BMIZ) were evaluated using WHO Anthro and Anthro Plus programmes. Results: Out of total, 10.1% of patients were underweight (WAZ ≤-2SD), 21.0% of the patients were stunted (HAZ ≤2SD). 25.3% of the patients were on oral foods, 74.7% were on both oral foods and oral enteral feeds. 41% of the patients skipped the morning meal, the most skipped meal for all age groups was morning meal. When oral foods and enteral feeds were evaluated together, it was found that meeting the percentage of recommended dietay allowances (RDA) for energy, protein, carbohydrate and fat intakes were 67%, 69.5%, 68.2% and 68.9%, respectively (below the recommended level). Vitamin A, E and K intakes of 98.1%, 100%, and 82.3% of the patients were insufficient, respectively. It was found that 81%, 55.4% and 50.6% of the patients had insufficient dietary folic acid, niacin and vitamin C intakes. It was also seen that 66.4% of calcium intake, 44.5% of zinc intake and 13.4% of iron intake were inadequate. In addition, the standard of care of a physician or dietitian except it was found that 25.4% of patients using nutritional supplements or products without the advice. The most widely used feed supplement of omega-3 syrup (9.0%) were found to be. Conclusion: In patients with cystic fibrosis, malabsorption, energy imbalance, increased metabolic rate, are risks of malnutrition.

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  • 1.Haack A, Carvalho G, Novaes MR. Multidisciplinary care in cystic fibrosis: a clinical-nutrition review. Nutr Hosp 2012;27(2):362-371.
  • 2.Leonard A, Davis E, Rosenstein BJ, Zeitlin PL, Paranjape SM, Peeler D, et al. Description of a standardized nutrition classification plan and its relation to nutritional outcomes in children with cystic fibrosis. J Pediatr Psychol 2010; 35(1):6-13.
  • 3.Stallings VA, Stark LJ, Robinson KA, Feranchak AP, Quinton H. Evidence-based practice recommendations for nutrition-related management of children and adults with cystic fibrosis and pancreatic insufficiency: Results of a systematic review. J Am Diet Assoc 2008;108(5):832-839.
  • 4.Martinez CC, Escribano A, Nunez GF, Garcia ML, Lujan J, Martinez RL. Nutritional intervention in children and adolescents with cystic fibrosis. Relationship with pulmonary function. Nutr Hosp 2005;20(3):182-188.
  • 5.Moran, A. Abnormal glucose tolerance in CF-when should we offer diabetes treatment? Pediatr Diabetes 2009;10(3): 159-161.
  • 6.Simon M. Associação entre o estado nutricional e a ingestão dietética em pacientes com fibrose cística. J Bras Pneumol 2009;35(10):966-972.
  • 7.Inger E. Dietary intake and nutritional status in a Scandinavian adult cystic fibrosis-population compared with recommendations. Citation: Food & Nutrition Research 2011;55:7561.
  • 8.Beslenme Bilgi Sistemleri Versiyon 7.2. (2010). [Elektronik Sürüm]. Entwickelt an der Universität Hohenheim, Stutgart, Germany.
  • 9.Cystic Fibrosis Foundation Patient Registry. Annual Data Report 2009, Bethesda.
  • 10.Ersöz DD. Kistik fibrozis tanı ve tedavi rehberi, Türk Toraks Dergisi, İstanbul 2011.
  • 11.Moen IE, Nilsson K, Andersson A, Fagerland MW, Fluge G, Hollsing A, et al. Dietary intake and nutritional status in a Scandinavian adult cystic fibrosis-population compared with recommendations. Food Nutr Res 2011;55:7561.
  • 12.Taylor C. UK Cystic fibrosis trust nutrition Working Group, 11st ed. London, Bromley; 2002.
  • 13.White H, Morton AM, Peckham DG, Conway SP. Dietary intakes in adult patients with cystic fibrosis-do they achieve guidelines? J Cyst Fibros 2004;3(1):1-7.
  • 14.Smith C, Winn A, Seddon P, Ranganathan S. A fat lot of good: balance and trends in fat intake in children with cystic fibrosis. J Cyst Fibros 2012;11(2):154-157.
  • 15.Matthew R, Sanders K, Turner MT, Clare R. Wall L, Waugh ML. Mealtime behavior and parent-child interaction: A comparison of children with cystic fibrosis, children with feeding problems, and nonclinic controls. J Pediatr Psychol 1997;22(6):881-900.
  • 16.Trabulsi J, Ittenbach RF, Schall JI, Olsen IE, Yudkoff M, Daikhin Y, et al. Evaluation of formulas for calculating total energy requirements of preadolescent children with cystic fibrosis. Am J Clin Nutr 2007;85(1):144- 151.
  • 17.Borowitz D, Baker RD, Stallings V. Consensus report on nutrition for pediatric patients with cystic fibrosis. J Pediatr Gastroenterol Nutr 2002;35(3):246-259.
  • 18.Marcus M, Lee S, Lai H. Use of alternative medicines in children and adults with CF. Building Block 2000;24:12- 14.
  • 19.Committee on Children with Disabilities, American Academy of Pediatrics. Counseling families who choose complementary and alternative medicine for their child with chronic illness or disability. Pediatrics 2001;107:598-601.
  • 20.Carolyn D, Berdanier J, Dwyer T, Heber D, Hooper L. Complementary and alternative medicine use among adults and Children. Cochrane Database Syst. Rev.2004;4: CD003177.
  • 21.Pekcan, G. Beslenme durumunun saptanması. T.C. Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdürlüğü Şubat 2008.
  • 22.Davies PS, Erskine JM, Hambidge KM, Accurso FJ. Longitudinal investigation of energy expenditure in infants with cystic fibrosis. Eur J Clin Nutr 2002;56(10):940-946.
  • 23.Inger E. Dietary intake and nutritional status in a Scandinavian adult cystic fibrosis-population compared with recommendations. Citation: Food & Nutrition Research 2011;55:7561.
  • 24.Hardin DS. GH improves growth and clinical status in children with cystic fibrosis - a review of published studies. Eur J Endocrinol 2004;151(1):81-85.
  • 25.McDonald CM. Validation of a nutrition risk screening tool for children and adolescents with cystic fibrosis ages 2-20 years. J Pediatr Gastroenterol Nutr 2008;46(4):438-446.
Beslenme ve Diyet Dergisi-Cover
  • ISSN: 1300-3089
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 1972
  • Yayıncı: Türkiye Diyestisyenler Derneği