CF and Macronutrients

Adequate calories to support normal growth and development are essential, especially in the presence of pancreatic insufficiency. Energy intake should be based on the patterns of weight gain and growth in the person. If an individual has significant growth deficits, lung disease, or malabsorption, energy requirements may be significantly increased. Currently there is no perfect method to estimate the caloric needs of a person with CF. Instead, a steady rate of weight gain in growing individuals should be the goal. For adults, the desired outcome is to maintain an acceptable weight in relation to height with optimal fat and muscle stores.

To obtain adequate calories and compensate for any fat malabsorption, individuals with CF often require a greater fat intake than what is normally recommended for the general population. Fat restriction is not recommended, because fat is an important energy source, and pancreatic enzyme replacement therapy is used to aid its absorption. Medium-chain triglycerides (MCT) require less lipase activity than long-chain fatty acids and may be utilized as a better source of fat calories. MCT have a fatty acid chain length between 6 and 12 carbons, making them short enough to be water soluble. They require less bile salt for solubilization and can be transported as free fatty acids through the portal system. Adequate protein intake is essential to meet the needs of growing individuals and maintain protein stores. Good nutrition also plays an important role in preparing the individual with cystic fibrosis for potential transplant later on in life.

Nutrition management is critical for the health and survival of patients with cystic fibrosis-related diseases. Since a majority of these patients have difficulty maintaining weight, calorie restriction is never appropriate. For patients on insulin, carbohydrate counting offers a great degree of flexibility. Patients should be able to eat as they choose with appropriate insulin coverage. Although carbohydrate is not restricted, patients should be taught to distribute carbohydrate calories throughout the day and to avoid concentrated carbohydrate loads.

CF diagram

Sixty Five Roses

Cystic fibrosis is the most common fatal genetic disorder in North America. The disorder produces thick, sticky mucus secretions that may seriously impair the function of multiple organs in the body. Most notably, these organs are the pancreas and lungs. Just a few decades ago, an infant born with CF seldom survived to adulthood. Today, the outlook is much brighter, with adults reaching their 30’s, 40’s, and some even into their 50’s.

Cystic fibrosis has three major consequences: chronic lung disease, pancreatic insufficiency, and abnormally high electrolyte concentrations in the sweat. Chronic lung disease develops because the airways in the lungs become congested with mucus, causing breathings to be strenuous. As the thick mucus stagnates in the bronchial tubes, bacteria multiply there. Lung infections are the usual cause of death in people with cystic fibrosis.

Cystic fibrosis causes some degree of pancreatic insufficiency in all cases, with about 90% of cases serious enough to require enzyme replacement therapy. With aging, damage to the pancreas deteriorates. The thick mucus obstructs the pancreatic ducts and interferes with the secretion of digestive enzymes, pancreatic juices, and pancreatic hormones. Eventually, the pancreatic cells are surrounded by mucus and are gradually replaced by fibrous tissues. Malabsorption of many nutrients including fat, protein, vitamins, and minerals often leads to malnutrition. Additionally, the secretion of insulin may be affected resulting in glucose intolerance and diabetes.

The therapy of cystic fibrosis aims to promote appropriate growth and development and prevent respiratory failure and complications. Treatment includes respiratory, diet, and drug therapy.

Nutrient losses through malabsorption, frequent infections, rapid turnover rate of protein and essential fatty acids, high protein catabolism, and high basal energy expenditures raise energy needs for people with cystic fibrosis to between 120%-150% of the RDA for gender and age. Extra energy is needed simply to breathe. RDs estimate individual energy requirements based on basal metabolic rate, activity level, pulmonary function, and degree of malabsorption.

Obtaining enough energy can be complicated, but because people with CF frequently experience a loss of appetite that is aggravated by repeated infections, emotional stress, and drug therapy. Coughing to clear the lungs may trigger vomiting or reflux of foods from the stomach. Thus the person with cystic fibrosis finds it difficult to take in enough food energy, protein, and other nutrients to meet needs.

NIH- Cystic Fibrosis

Cystic Fibrosis Foundation

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The Food Production Plan to End Hunger is Out of this World!

NASA is funding research into 3D printed food which would provide astronauts with meals during long space flights. The futuristic food printers would use cartridges of powder and oils which would have a shelf life of 30 years.

While the idea may seem like something out of a Sci-Fi movie, the process of printing food has already been proven possible. The brains behind the innovation, Anjan Contractor, previously printed chocolate in a bid to prove his concept.

Anjan Contractor’s company, Systems & Materials Research Corporation, just got a six month, $125,000 grant from NASA to create a prototype of his universal food synthesizer. Contractor and his company, will now use NASA’s $125,000 grant to attempt to…. PRINT AN EDIBLE PIZZA! The grant was applied for on March 28th, 2013. Reportedly, the pizza printer is still in the conceptual stage and will begin to be built in two weeks.

But Contractor, a mechanical engineer with a background in 3D printing, envisions a much more mundane—and ultimately more important—use for the technology. He sees a day when every kitchen has a 3D printer, and the earth’s 12 billion people feed themselves customized, nutritionally-appropriate meals synthesized one layer at a time, from cartridges of powder and oils they buy at the corner grocery store. Contractor’s vision would mean the end of food waste, because the powder his system will use is shelf-stable for up to 30 years, so that each cartridge, whether it contains sugars, complex carbohydrates, protein or some other basic building block, would be fully exhausted before being returned to the store.

The printer will first print a layer of dough, which will be cooked while being printed. Tomato powder will then be mixed with water and oil to print a tomato sauce. The topping for the pizza will be a “protein layer” which could come from any source – animals, milk, or plants. The concept is to use basic “building blocks” of food in replaceable powder cartridges. Each block will be combined to create a range of foods which can be created by the printer. The cartridges will have a shelf life of 30 years – more than long enough to enable long-distance space travel.

Contractor and his team hope the 3D printer will be used not only by NASA, but also by regular Earthlings. His vision would mean the end of food waste, due to the powder’s long shelf life. There are some conveniences which would come along with the printer. For example, recipes could be traded with others through software. Each recipe would have a set of instructions which tells the printer which cartridge of powder to mix with which liquids, and at what rate and how it should be sprayed.

Another perk includes personalized nutrition. “If you’re male, female, someone is sick—they all have different dietary needs. If you can program your needs into a 3D printer, it can print exactly the nutrients that person requires,” Contractor said.

Many economists believe that current food systems can not supply 12 billion people with food security efficiently. This pizza printer is trying to change that number through this NASA grant.

The Audacious Plan to End Hunger

Pizza From a PrinterNASA__

NASA

NASA_

Eating After a Lap-Band Surgery

In the recent news of New Jersey’s Governor Chris Christie’s efforts to lose weight, it’s important for people everywhere to really understand the extent of a lap-band surgery.  So far the New Jersey native has lost 40 pounds. But, it’s important to keep in mind, after having major surgery like this, that maintaining weight loss will be attributable to adopting a healthy diet and lifestyle. Here are some diet tips to follow after lap-band surgery:

        Eat small portions

o   Limiting portion sizes is essential to patients after having surgery. A lap-band surgery decreases the size of your stomach and could even make it painful to consume large quantities of food. It is recommended that patient also eat slowly and chew their food thoroughly to avoid discomfort.

        Focus on high protein foods

o   Proteins provide a sense of satiety and fullness. But, focusing on soft proteins is important after surgery. Some examples of soft proteins are Greek yogurt, low-sodium soups, or cottage cheese.

        Avoid drinking and eating at the same time

o   Avoiding the consumption of drinking and eating at the same time is one of the most important rules to follow post-surgery. Staying hydrated is very important as well. So patients should stop drinking at least 10 minutes before eating and then avoid drinking at least 45 minutes after finishing a meal. The main concern here is to prevent vomiting from occurring.

        Limit pasta, rice, and bread

o    Since eating fiber is healthy for people without surgery, it is not suggested that it should be avoided completely. Most patients simply do not tolerate pastas and bread products because they absorb fluids and expand. These types of foods can make patients feel uncomfortable and too full.

        Consume soft fruits and vegetables

o   In the first few weeks post-surgery, patients will need to puree fruits and vegetables. Later these patients can introduce whole fruits and vegetables. The skins of fruits and vegetables (like apple skins or cucumber skins).

The main message that people should know is that lap-band surgery is a tool to maintain weight in patients. The surgery is not a quick-fix or a solution. It is only efficient if the patient is aware of what they’re putting in their stomach and how much of it as well.

What to eat after lap-band surgery

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Southern Grocery Shopping

Southern Grocery Cart

It’s easy to throw healthy eating habits out the window when you’re away from home and your regular routine. Andrea D’Ambrosio, RD talks about ways to create a healthy winter routine while staying on a budget.

Plan ahead and stick to a list
Being prepared before you grab your grocery cart will help you avoid impulse purchases. It also gives you time to look at flyers, find sales and clip coupons. Try taking advantage of no-name products and avoiding shopping while you’re hungry.

Shop in season and avoid being wasteful
Buy in-season foods from local farmer’s markets, which is cheaper, and be resourceful with leftovers, using up excess food before it goes to waste, she says.

Consider vegetarian alternatives
If you study your grocery bill, meat products are often among the most expensive items. Consider planning meals with vegetarian alternatives like lentils, beans and soy. Check out vegetarian websites for heart- and budget-healthy meal ideas, she suggests.

Here are 5 friendly foods and the reasons you should add them to your grocery list:

  1. Fresh, seasonal fruit: A favorite snack to boost energy levels between meals if you feel a little hungry (power of carbs) and allows you to benefit from vitamins, minerals and antioxidants.
  1. Low-fat (1 percent) or non-fat milk: In order to maintain our bone density, we need to consume adequate dairy to receive calcium, phosphorous, magnesium and protein, which are all essential for bone growth and development.
  1. Whole grains: According to the Journal of Nutrition (2011), oats, barley, rice and quinoa all lower risk of chronic diseases such as coronary heart disease, diabetes and cancer, as well contribute to body-weight management and gastrointestinal health. Try buying whole-grain pasta and remember to look for the words “whole grain” on the label.
  1. Almonds: But just a handful a day, and make them unsalted! A portion-controlled (quarter cup) serving of almonds is excellent for lowering cholesterol because of the unsaturated fats, making them a heart-healthy choice. Almonds are high in vitamin E, a powerful antioxidant, and are naturally high in fiber and a good source of protein!
  1. Edamame: Green soybeans, made popular in Japanese cuisine but available in grocery stores, add a nice nutritional punch. These tasty soybeans can be added as a side dish, steamed in the pod or consumed as a snack or appetizer. Nutritionally speaking, they are another heart-healthy source of protein, fiber and vitamins.

http://www.thestar.com/specialsections/snowbirds/article/1301135–fill-your-southern-grocery-cart-with-healthy-foods

http://www.dieteticdirections.com/

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