Study design (if review, criteria of inclusion for studies)
randomized trial; crossover study design
Participants
8 children (6 years 11 months old to 14 years 7 months old)
Interventions
enteric coated (EC) pancreatic enzymes before or during meals (15 minutes after beginning of meal) during two consecutive 7-day treatment periods for each child.
Outcome measures
fat excretion
Main results
No difference in fat excretion was documented for the total group when the children who took enzymes before meals were compared with those who took enzymes during meals. However, a stepwise multiple regression analysis of the difference (before minus during) in fat excretion on sex, age, enzyme number, and treatment order documented a positive correlation of age with fat excretion (r = .83). Mean fat excretion in younger children (less than 10 years old) decreased significantly when enzymes were given before meals (7.14 +/- 1.95%) rather than during meals (9.92 +/- 1.61%) (P = .004). The difference in fat excretion (mean = 2.78 +/- 0.55%, range = 1.4% to 4%) translates into a half to one full year's growth potential.
Authors' conclusions
Younger children with cystic fibrosis may benefit clinically from taking EC enzymes before meals.