using nutrition to stay healthy with cf: presentation · stay healthy with cf: presentation. this...
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![Page 1: Using Nutrition to Stay Healthy with CF: Presentation · Stay Healthy with CF: Presentation. This Web cast is supported by an unrestricted educational grant from Genentech, Inc. Using](https://reader034.vdocument.in/reader034/viewer/2022042404/5f18e387fb7b454c3c18b6a5/html5/thumbnails/1.jpg)
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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Throughadulthood!
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 over age 20 years
BMI = weight(height)2
BMI Calculator at www.cdc.gov
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BMI PercentileMales Females
FEV 1
% P
redi
cted
50556065707580859095
100
<5 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95
FEV1 % Predicted vs. BMI PercentileAges 6 to 20 years
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BMI PercentileMales Females
FEV 1
% P
redi
cted
50556065707580859095
100
<5 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95
FEV1 % Predicted vs. BMI PercentileAges 6 to 20 years
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BMI PercentileMales Females
FEV 1
% P
redi
cted
50556065707580859095
100
<5 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95
FEV1 % Predicted vs. BMI PercentileAges 6 to 20 years
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BMI PercentileMales Females
FEV 1
% P
redi
cted
50556065707580859095
100
<5 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95
FEV1 % Predicted vs. BMI PercentileAges 6 to 20 years
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90
FEV1 % Predicted vs. BMI Ages 21 to 40 years
FEV 1
% P
redi
cted
BMIMales Females
25303540455055606570758085
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Females ≥ 22 BMIMales ≥ 23 BMI
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90
FEV1 % Predicted vs. BMI Ages 21 to 40 years
FEV 1
% P
redi
cted
BMIMales Females
25303540455055606570758085
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Females ≥ 22 BMIMales ≥ 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 21Age in years
0123456789
10
Hei
ght v
eloc
ity, c
m/y
r
<10Weight 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 21Age in years
0123456789
10
Hei
ght v
eloc
ity, c
m/y
r
<10Weight 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 21Age in years
0123456789
10
Hei
ght v
eloc
ity, c
m/y
r
<10Weight 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 21Age in years
0123456789
10
Hei
ght v
eloc
ity, c
m/y
r
<10Weight Percentiles
>50
The more you weigh early in life, the taller you’ll be as an adult
![Page 17: Using Nutrition to Stay Healthy with CF: Presentation · Stay Healthy with CF: Presentation. This Web cast is supported by an unrestricted educational grant from Genentech, Inc. Using](https://reader034.vdocument.in/reader034/viewer/2022042404/5f18e387fb7b454c3c18b6a5/html5/thumbnails/17.jpg)
2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21Age in years
0123456789
10
Hei
ght v
eloc
ity, c
m/y
r
<10Weight 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.
Proteasedigests 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.
19750
2000400060008000
1000012000
1970 1980 1990 2000 20061970 1975 1980 1985 1990 1995 2000 2005 2006Year
2000
4000
6000
8000
10000
12000
0
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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
SingleMarried/Living
Together
WidowedSeparated/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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ChildBehavior
Typical Parent Response
BehavioralChange
Taking bites • Not noticing Compliment child on 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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ChildBehavior
Typical Parent Response
BehavioralChange
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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ChildBehavior
Typical Parent Response
BehavioralChange
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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• 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 - [email protected] or 1-800 FIGHT CF
June 12, 2007Using Nutrition to Stay Healthy with CF
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June 12, 2007
Using Nutrition to Stay Healthy with CF: Presentation