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Nutritional assessment in children with cystic fibrosis

Background: Optimal nutrition, including consuming 35–40% of calories (kcal) as fat, is a vital part of the management of cystic fibrosis (CF), and involves accurate assessment of dietary intake. Methods: We compared 3 methods of nutritional assessment in 8–14yo children (n=20) with CF: 1) a 24h Dietary Recall, 2) a 72h weighed Home Record, and 3) 1 120h weighed intake while inpatient at the General Clinical Research Center (GCRC). Results: Percent of kcal consumed as fat was significantly greater from the 24h Recall (37 ± 6%) than during admission to the GCRC (32 ± 5%) with the Home Record being intermediate (Kruskal‐Wallis P = 0.0173). The number of children consuming <35% of their kcal as fat also differed significantly: 68% of subjects consumed <35% of kcal from fat according to the 24h Recall, 58% from the Home Record, and 25% at the GCRC (Pearson P=0.0178). When % of kcal from fat were compared to growth parameters, the intake at the GCRC was significantly correlated with BMI z‐score (r2=0.25, P=0.026) and weight z‐score (r2=0.18, P=0.063), but neither the Home Record nor the 24h Recall were correlated with BMI or wt z‐scores (r2<0.10 and P>0.6 in all cases), suggesting that the 24h Recall and the Home Record were less reflective of usual intake than the GCRC Record. Conclusions: Nutritional assessment in children with CF is difficult, and 24h Recalls may be inadequate to identify children with sub‐optimal nutritional intakes.