Dean Cruikshank

Nutritional Supplements

People with CF are at increased risk of malnutrition due to the increased thickness of mucous. This also leads to lung and digestive symptoms. For example, mucous in the ducts of the pancreas can lead to pancreatic insufficiency. This means that the pancreas has a reduced ability to create digestive enzymes and bicarbonate, leading to malabsorption.

Patients with CF need about 120-140% of the RDA (recommended daily allowance) for energy, and about 40% from fat. This means that you should be eating high calorie foods to ensure that you are getting enough energy.
Remember, there is a difference between dietary sources of products and supplements of products. For example, the garlic in your pasta sauce is not concentrated, whereas if you take garlic in a pill or supplement it is a concentrated form and should be monitored closely.
Nutrition in CF includes vitamins, minerals (link), essential fatty acids, probiotics, and more. Proper nutrition is shown to help with lung function and ultimately survival in CF. Click the links to learn more about each aspect of nutrition.

1.Vitamins
Patients with lung disease often have oxidative stress, due to frequent infection and inflammation. Fat soluble vitamins (A, D, E, and K) are known to be powerful anti-oxidants. However, patients with CF tend to have poor absorption of these vitamins. Vitamin A has been studied to show some benefit for lung function.
Overall, antioxidant research in CF has shown varied results. Some minor improvements in lung function were seen with vitamin supplements; however, with fat-soluble vitamins, toxicity is a concern since these can easily be stored and accumulated in fatty tissue.
Too much vitamins (toxicity) can cause many symptoms, which is a very serious health complication. Your care team will work with you to ensure your vitamin levels are at a healthy range. Click to learn more about vitamins

2.Amino acids, Essential Fatty Acid products
A study looking at types of omega-3 fatty acid supplementation found that there was no real change in lung function (FEV1) for patients supplemented with omega-3 fatty acids. For those supplemented with a specific fatty acid called DHA (docosahexaenoic acid), again no change in lung function was found in the short term. In the long term, a one year supplementation of patients with omega-3 fatty acids found an increase or improvement in lung function and a decrease in pulmonary exacerbations. Further research will need to be done to understand the effect of supplementing on lung function. Click here to learn more about fatty acids.

3. Minerals
Some important minerals required for important biological process include calcium, iron, magnesium, potassium and zinc. Pregnant women and all of us, as we age can have changes in the amount of iron and calcium we require. Click the links for more information.
Be cautioned. Zinc can also potentially interact with some CF antibiotics like ciprofloxacin (Cipro) and doxycycline (Vibramycin). It can also influence hemoglobinA1C levels (blood sugar monitoring). Speak to your CF doctor and dietician to ensure your blood sugar levels are in a normal range.

4.Probiotics
Probiotics are like "friendly" bacteria that live in our digestive tract. They aid in digestion and are involved in warding off "unfriendly" or bad bacteria that can cause harm. Probiotics can be recommended when someone is taking antibiotics. Click here for more information.