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Home > Living Well > Health Library > Cystic Fibrosis (Holistic)
Help avoid deficiencies of fat-soluble vitamins by taking daily amounts of vitamin A (5,000 IU), vitamin D (1,000 IU), and vitamin E (100 IU); also take 5 mg of vitamin K every three days
Work with a nutritionist to determine how much vegetable oil or fish oil should be included in your diet to prevent essential fatty acid deficiency
Get plenty of salt in your diet to replace the large amounts lost through sweating
Cystic fibrosis (CF) is an inherited disease that results in impaired transport of chloride into and out
of cells. The digestive and respiratory systems are most affected.
The most common manifestation of cystic fibrosis is frequent respiratory infection. Impaired digestion and
malabsorption due to pancreatic insufficiency and
blocked liver ducts is often seen as well. Management of this condition requires the help of a qualified
Symptoms include a persistent cough with thick and often greenish-colored mucus, failure to grow normally, recurrent sinus and bronchial infections, and frequent, bulky, foul-smelling stools. Infants may experience a set of acute symptoms, including a distended abdomen, failure to pass stool, and vomiting. Although the course of the disease is highly variable, largely dependent upon the severity and frequency of respiratory infections, CF inevitably leads to debility and death. Average survival is to age 31.
Aerobic exercise appears to improve lung function in people with CF. In a three-year controlled trial, people with CF engaged in a home exercise program, during which they exercised for a minimum of 20 minutes, three times weekly, and attained a heart rate of approximately 150 beats per minute. A slower decline in lung function was observed in these people compared with non-exercisers.1 Those who exercised also tended to feel better about themselves, had more energy, and/or experienced less chest congestion.
People with CF are usually unable to digest food completely and therefore need to consume more calories than a healthy person of similar size and weight. Current guidelines recommend calorie intakes 20 to 50% above the recommended daily allowance.
Children with CF lose a large amount of salt in their sweat and thus should be encouraged to salt their food liberally. In case of fever, an additional 2 to 4 grams (1/2 to 1 teaspoon) should be added to the daily diet.
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People with CF tend to have insufficient pancreas function. Supplementation with pancreatic enzymes will often lead to improved digestion, especially of fats. The current recommendation for people with cystic fibrosis is to supplement with pancreatic enzymes at meals. Amounts should not exceed 10,000 IU of lipase per day per 2.2 pounds body weight or 500 to 1,000 lipase units per gram of dietary fat consumed, as larger amounts may damage the large intestine. A double-blind trial found enteric-coated microsphere enzyme preparations to be superior to enteric-coated capsules for reduction of abdominal pain and improvement of digestion.Because pancreatin is rapidly emptied from the stomach during digestion, people taking these enzymes may obtain better results by spreading supplementation throughout the meal.
The fat malabsorption associated with CF often leads to a deficiency of fat-soluble vitamins. Oral supplementation of these nutrients is considered crucial to maintaining good nutritional status. Current recommendations for supplementation are as follows: vitamin A, 5,000 to 10,000 IU/day; vitamin D, 1,000 to 2,000 IU/day; vitamin E, 100 to 300 IU/day; and vitamin K, 5 mg every three days. Of the water-soluble vitamins, only vitamin B12 is poorly absorbed in cystic fibrosis, and taking pancreatic enzymes helps prevent B12 deficiencies.
The impaired digestion of fats in people with CF often leads to a deficiency of essential fatty acids. This deficiency may in turn lead to lowered immune function, which makes people with CF more susceptible to respiratory infection. This deficiency may be reversed by supplementation with corn oil (1 gram per 2.2 pounds body weight per day),safflower oil (1 gram per 2.2 pounds body weight per day), linoleic acid (7.7 grams per day), and eicosapentaenoic acid (EPA from fish oil) (2.7 grams per day). EPA supplementation was particularly effective. In a double-blind trial, six weeks of supplementation with 2.7 grams of EPA per day led to a reduction in sputum and improvement in lung function in children with chronic respiratory infection due to CF.
Taurine is an amino acid and a component of bile acids, which are important for proper fat digestion. Some, but not all, investigators have reported improvement in fat digestion among people with CF when they supplemented with 30 mg taurine per 2.2 pounds of body weight daily. Greater improvement was seen in people with the worst maldigestion.
The malabsorption produced by CF may adversely affect mineral absorption as well. Blood concentrations of zinc were low in a group of children with CF. One child with CF was reported to have a severe generalized dermatitis that resolved upon correction of zinc and fatty acid deficiencies by using a formula containing zinc (about 3 mg per day) and medium chain triglycerides (amount not reported).[REF] In a double-blind trial, supplementation with 30 mg of zinc per day for one year significantly decreased the number of days that children with CF needed antibiotics to treat respiratory infections. The beneficial effect of zinc was more pronounced in children who had low or low–normal plasma zinc levels than in those who had higher levels.
1. Schneiderman-Walker J, Pollock SL, Corey M, et al. A randomized controlled trial of a 3-year home exercise program in cystic fibrosis. J Pediatr 2000;136:304-10.
Last Review: 05-29-2015
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