Short-term nutritional supplementation during management of pulmonary exacerbations in cystic fibrosis: a controlled study, including effects of protein turnover.
Study design (if review, criteria of inclusion for studies)
controlled trial
Participants
12 CF patients treated, 10 not treated
Interventions
during pulmonary exacerbations patients received pulmonary therapy and either standard diet (n = 10) or adjunctive enteral supplements (n = 12).
Outcome measures
weight and protein turnover
Main results
Initial protein turnover, measured by [15N]glycine kinetics, showed alterations of protein synthesis (P Syn) and catabolism (P Cat), which correlated with the degree of underweight, and negligible net protein deposition (P Dep). With treatment both groups had significant increases in mean body weight and forced expiratory volume in 1 s, expressed as percent predicted value for height (FEV1) by 3 wk, but a significant correlation between initial underweight and subsequent weight gain was observed only in supplemented patients. Mean P Syn and P Dep increased significantly (p less than 0.001) only in the supplemented group. Pulmonary exacerbations in CF have important adverse effects on body-protein metabolism, similar to changes in protein-energy malnutrition and infection. These effects are reversed by short-term nutritional support.
Authors' conclusions
Strategic nutritional intervention should thus be considered in management, especially in malnourished patients.