What’s in a Cystic Fibrosis-Friendly Diet?

Medically reviewed by Nancy Choi, MD on November 21, 2016Written by Corey Whelan on November 21, 2016
cystic fibrosis diet

Is there a connection?

Good nutrition is important for everyone’s overall health and growth. This is especially true if you’re living with cystic fibrosis. Living with cystic fibrosis can pose significant challenges, including issues with fat absorption, nutrient intake, and appetite. If you have this disorder, there are ways to get the nutrition you need, through daily, proactive habits.

How does cystic fibrosis affect the body?

Cystic fibrosis (CF) is an inherited rare disorder that has no known cure. If both of your parents are carriers of the CF gene mutation, you have a 25 percent chance of being born with this disorder.

CF adversely impacts your body’s epithelial cells. These cells help regulate the balance of salt and water. They’re found in the sweat glands, pancreas, and lungs. This is where sweat, mucus, and digestive juices are formed. In people with CF, these thin, slippery fluids become sticky and thick. This can cause significant problems with breathing, nutrient absorption, and digestion.

Oftentimes, people with CF also develop exocrine pancreatic insufficiency (EPI). This can cause further problems with digestion due to excessive amounts of mucus in the pancreas. This mucus blocks pancreatic enzymes from reaching the intestines, where they would normally support the digestive process. Without the enzymes in the right place, this blocks absorption of fat, protein, and carbohydrates, along with the vitamins and minerals they contain. All of these are important for growth.

Learn more: The connection between exocrine pancreatic insufficiency and cystic fibrosis »

How does cystic fibrosis affect my diet and nutritional needs?

Without enough protein, fat, and other nutrients, it’s harder to stave off colds and other infections. It’s also more difficult for your body to keep your lungs clear and healthy. You may also become underweight.

If you have CF, you need to eat a balanced diet consisting of fat, protein, dairy, fruits, and vegetables. You’ll need to increase the amount of each in your diet to ensure that your body is able to absorb enough of these nutrients.

You can do this by adding the following to your diet:

  • Protein: Foods high in protein, such as beef, chicken, eggs, fish, and soy, are important for preventing muscle loss.
  • Zinc: Foods high in zinc include kidney beans, beef, spinach, liver, eggs and seafood. Zinc is important for staving off infections.
  • Salt: People with CF have saltier sweat, which may cause electrolyte imbalance and dehydration. Salty snacks, pickles, and sports drinks can help replace the salt you lose while sweating. You can also cook vegetables in chicken broth instead of water.
  • Calcium: Foods high in calcium help reduce your risk of osteoporosis, a concern for people with CF. Dairy products, such as high-fat yogurt, whole milk, and high-fat cheese are all good sources.
  • Iron: Iron helps fight off infection and produces oxygen-carrying red blood cells. Foods high in iron include liver, tuna, lamb, seafood, eggs, beef, and turkey.
  • Antioxidants: Fruits and vegetables are good sources of antioxidants and important for fighting off bacterial infection. People with CF may experience high amounts of airway inflammation in the lungs, making bacterial infection more likely and very dangerous to your health.
  • Fiber: Your doctor may recommend eating high-fiber foods to help reduce the risk of intestinal blockages. Many high-fiber breakfast cereals are also high in protein.

How can I get more calories?

People with this condition need more fat and calories than most people do. Meals that may be considered too high in fat for others, such as cheeseburgers with a side of fries, are okay choices for people with CF.

In general, you can increase your calorie consumption if you:

  • Choose high-fat ground beef.
  • Opt for whole milk instead of skim.
  • Sprinkle bacon and cheese on salad, into eggs, and other prepared dishes.
  • Make smoothies packed with peanut butter, whole milk, and bananas.
  • Fry eggs with extra butter.
  • Spread an extra layer of mayonnaise on sandwiches.
  • Eat pasta with olive oil and freshly-grated parmesan cheese, with Alfredo sauce, or with added bacon.
  • Snack on high-quality dark chocolate.

You should typically avoid anything labeled as:

  • diet
  • low-fat
  • no-fat
  • reduced calorie

How can I get more protein?

Foods high in protein help build muscle, repair tissue, and keep bones healthy and strong. It’s important you get ample amounts of protein daily. In addition to eating protein-packed meals, try these ideas:

  • Drink high-protein shakes when you’re not up to eating a large meal or sip them as snacks.
  • Add meat and cheese to your morning scrambled eggs. Bacon, salami, baloney, and sausage are all good choices.
  • Swap out white rice for quinoa, a complete protein food that contains nine essential amino acids.
  • Skim milk powder is filled with casein, a slowly digested protein. Add skim milk powder to juice, breakfast cereal, pancake mix, shakes, and malted milk.
  • Eat high-fat Greek yogurt instead of regular yogurt
  • Enjoy high-protein almonds as a snack. You can sprinkle them onto cottage cheese, another protein booster, for an added nutritional punch.

Other ways to ensure adequate nutrient intake

Your doctor or nutritionist may recommend taking fat-soluble vitamins, such as vitamins A, D, E, and K. These are important for growth and they also aid in healing. Fat-soluble vitamins are critical for fat to be absorbed properly. If you are unable to take in enough fat from food, you may be missing out on these nutrients. Talk with your doctor about how to best fit these vitamins into your diet plan. Most people with pancreatic insufficiency will take these vitamins.

You may also require supplements containing B vitamins, protein, and other nutrients with each meal. These may be prescribed by a doctor and are usually determined by your individual, dietary needs.

Some people with CF benefit from getting extra nutrients and calories through temporary tube feeding if they aren’t able to maintain their nutrition by eating by mouth. Tube feeding can supply up to 2,000 calories while you sleep. The feeding tube is inserted into your stomach through a simple, surgical procedure.

If you have EPI, you will need to take supplemental pancreatic enzymes with meals and snacks to replace the enzymes your pancreas can’t supply.

Tips for meal planning

Spending a little extra time planning your food intake can go a long way toward ensuring your health. Consider planning your meals for the following day so that you aren’t scrambling to pick a last-minute meal. Be sure to include multiple small meals to get you through the day, or include three larger meals plus snacks.

It can also help to prepare meals in advance. You can even freeze extra servings of the foods you enjoy eating most, such as lasagna, quiche, or shepherd’s pie. Having ready-made, delicious meals may come in handy on days when your appetite is low or if you aren’t able to cook.

Make sure to include calorie-dense fat and protein food sources in each meal. You’ll also want to have lots of healthy, grab-and-go snacks on hand at all times. Things like trail mix, cheese sticks, and tuna on crackers are easy, healthy choices.

The bottom line

Maintaining a balanced diet will likely take some extra work and planning, but it’s worth it to ensure your nutritional needs are being met. It may help to create a team of professionals who can supply guidance, and friends or family members who can help with food preparation tasks, supply support, and camaraderie. You don’t have to go it alone.

Your nutritional needs will change over time, based upon your age and overall health. Creating healthy habits can help to get you through challenging periods more easily. It’s normal to have days when you don’t feel well or are too tired to cook. If you can rely on proactive behaviors, you may be able to transcend those times more easily.

Keep reading: Cystic fibrosis »

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