CF: Macronutrient Distribution

CF: Macronutrient Distribution

• Intervention
  In participants with CF, what is the relationship between dietary macronutrient distribution and mortality?

  • Conclusion

    In participants with cystic fibrosis (CF), there were no studies identified that reported on the relationship between dietary macronutrient distribution and mortality.

  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Search Plan and Results: CF: Dietary Intake: Macronutrient Distribution 2018
     
  In participants with CF, what is the relationship between dietary macronutrient distribution and lung function?

  • Conclusion

    In pediatric and adult participants with cystic fibrosis (CF) who were primarily pancreatic insufficient and on PERT, limited, cross-sectional evidence suggests no association between macronutrient distribution and % of predicted FEV1. Estimated protein intake ranged from 10-23% of energy, fat intake ranged from 20-46% of energy and carbohydrate intake ranged from 32-67% of energy.
    
     

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In participants with CF, what is the relationship between dietary macronutrient distribution and lung function?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Forte G, Pereira J, Drehmer M, Simon M. Anthropometric and dietary intake indicators as predictors of pulmonary function in cystic fibrosis patients. Jornal Brasileiro de Pneumologia 2012; 38:470-6
      • Gordon C, Anderson E, Herlyn K, Hubbard J, Pizzo A, Gelbard R, Lapey A, Merkel P. Nutrient status of adults with cystic fibrosis. Journal of the American Dietetic Association 2007; 107:2114-9
      • Moen IE, Nilsson K, Andersson A, Fagerland MW, Fluge G, Hollsing A, Gilljam M, Mared L, Pressler T, Santi H, Storrøsten OT, Hjelte L. Dietary intake and nutritional status in a Scandinavian adult cystic fibrosis-population compared with recommendations. Food and Nutrition Research 2011; 55:
  • Search Plan and Results: CF: Dietary Intake: Macronutrient Distribution 2018
     
  In participants with CF, what is the relationship between dietary macronutrient distribution and quality of life?

  • Conclusion

    In participants with cystic fibrosis (CF), there were no studies identified that reported on the relationship between dietary macronutrient distribution and quality of life.

  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Search Plan and Results: CF: Dietary Intake: Macronutrient Distribution 2018
     
  In participants with CF, what is the relationship between dietary macronutrient distribution and anthropometric measures and growth?

  • Conclusion

    In adults with cystic fibrosis (CF) who were primarily pancreatic insufficient (PI) and on PERT, limited, cross-sectional evidence suggests no association between macronutrient distribution and BMI when estimated protein intake ranged from 8-23% of energy, fat intake ranged from 20-49% of energy and carbohydrate intake ranged from 32-67% energy. In children with CF who were PI and on PERT, the relationship between the % energy intake from fat and BMI z-score was unclear, since direction of correlation varied according to participant age.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In participants with CF, what is the relationship between dietary macronutrient distribution and anthropometric measures and growth?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Gordon C, Anderson E, Herlyn K, Hubbard J, Pizzo A, Gelbard R, Lapey A, Merkel P. Nutrient status of adults with cystic fibrosis. Journal of the American Dietetic Association 2007; 107:2114-9
      • Olveira G, Dorado A, Olveira C, Padilla A ,Rojo-Martínez G, García-Escobar E, Gaspar I, Gonzalo M, Soriguer F. Serum phospholipid fatty acid profile and dietary intake in an adult Mediterranean population with cystic fibrosis. The British Journal of Nutrition 2006; 96:343-9
      • White H, Wolfe S, Foy J, Morton A, Conway S, Brownlee K. Nutritional intake and status in children with cystic fibrosis: does age matter?. Journal of Pediatric Gastroenterology and Nutrition 2007; 44:116-23
  • Search Plan and Results: CF: Dietary Intake: Macronutrient Distribution 2018
     
  In participants with CF, what is the relationship between dietary macronutrient distribution and morbidities (length of stay, antibiotic use)?

  • Conclusion

    In participants with  cystic fibrosis (CF), there were no studies identified that reported on the relationship between dietary macronutrient distribution and morbidities such as length of stay and antibiotic use.

  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Search Plan and Results: CF: Dietary Intake: Macronutrient Distribution 2018
     
  In participants with CF, what is the relationship between dietary macronutrient distribution and gastrointestinal symptoms?

  • Conclusion

    In adults and pediatric participants with cystic fibrosis (CF) (ages 0-33.4 years) on PERT, limited, observational evidence suggests that dietary macronutrient distribution, specifically fat intake, was not associated with GI symptoms or DIOS.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In participants with CF, what is the relationship between dietary macronutrient distribution and gastrointestinal symptoms?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Declercq D, Van Biervliet S, Robberecht E. Nutrition and pancreatic enzyme intake in patients with cystic fibrosis with distal intestinal obstruction syndrome. Nutrition in Clinical Practice 2015; 30:134-7
      • Proesmans M, De Boeck K. Evaluation of dietary fiber intake in Belgian children with cystic fibrosis: is there a link with gastrointestinal complaints?. Journal of Pediatric Gastroenterology and N 2002; 35:610-4
  • Search Plan and Results: CF: Dietary Intake: Macronutrient Distribution 2018
     
  In participants with CF, what is the relationship between dietary macronutrient distribution and lipid profile?

  • Conclusion

    In children and adolescents with cystic fibrosis (CF) ages 10-18, limited, cross-sectional evidence suggests no relationship between dietary macronutrient distribution and lipid profile (total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides levels and the triglyceride/HDL-cholesterol ratio). Ranges of macronutrients measured with a 3-day food record were approximately 12-16% of energy from protein, 38-62% of energy from carbohydrate, and 25-45% of energy from fat.
     

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In participants with CF, what is the relationship between dietary macronutrient distribution and lipid profile?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Woestenenk J, Schulkes D, Schipper H, van der Ent C, Houwen R. Dietary intake and lipid profile in children and adolescents with cystic fibrosis. Journal of Cystic Fibrosis 2017; 16:410-417
  • Search Plan and Results: CF: Dietary Intake: Macronutrient Distribution 2018
     
  In participants with CF, what is the relationship between dietary macronutrient distribution and fat-soluble vitamin levels?

  • Conclusion

    In adults with cystic fibrosis (CF) (31.4 ±9.1 years) of whom 78% were pancreatic insufficient (PI) and on PERT, one cross-sectional study suggested no relationship between dietary protein intake (11-23% of energy) and serum 25-hydroxy vitamin D levels, based on interview of food frequency by an RDN. Relationships between intakes of other macronutrients and fat-soluble vitamin levels were not reported.
    
     

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In participants with CF, what is the relationship between dietary macronutrient distribution and fat-soluble vitamin levels?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Gordon C, Anderson E, Herlyn K, Hubbard J, Pizzo A, Gelbard R, Lapey A, Merkel P. Nutrient status of adults with cystic fibrosis. Journal of the American Dietetic Association 2007; 107:2114-9
  • Search Plan and Results: CF: Dietary Intake: Macronutrient Distribution 2018
     
  In participants with CF, what is the relationship between dietary macronutrient distribution and glycemia?

  • Conclusion

    In adults with cystic fibrosis (CF) of whom 70% were pancreatic insufficient (classified as having normal, impaired glucose tolerance or CFRD), one small, cross-sectional study suggests no relationship between dietary macronutrient distribution and glucose fluctuations. Range of macronutrients measured via a 3-day food diary demonstrated fat intake was 21-47% of energy, protein intake was 10-22% of energy and carbohydrate intake was 32-65% of energy.
    
    
     

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In participants with CF, what is the relationship between dietary macronutrient distribution and glycemia?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Ziai S, Coriati A, St-Pierre D, Chabot K, Desjardins K, Leroux C, Richter M, Rabasa-Lhoret R. Glucose Fluctuations are Not Modulated by the Proportion of Calories from Macronutrients or Spontaneous Total Energy Expenditure in Adults with Cystic Fibrosis. Canadian Journal of Diabetes 2016; 40:389-392
  • Search Plan and Results: CF: Dietary Intake: Macronutrient Distribution 2018