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Oral calorie supplements for cystic fibrosisSmyth RL, Walters S
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SummaryUse of oral supplements to increase calorie intake in people with cystic fibrosisCystic fibrosis affects many organs, including the digestive system. It can lead to food not being absorbed as it should be and so to growth problems. Children with cystic fibrosis need more energy than children without cystic fibrosis, but often have reduced appetites. Poor diet has been linked to poor outcomes in cystic fibrosis. Therefore, calorie-fortified milks or juices are often added to the diets of children with cystic fibrosis to increase total daily calorie intake and improve weight gain. However, they are expensive and may reduce the amount of food eaten and without improving total energy intake. This review includes three randomised controlled trials with a total of 131 people. Two of the trials included only children. At 12 months the people taking supplements consumed significantly more calories than the people receiving dietary advice alone, but this outcome was only reported in one trial. There were no significant differences between people receiving supplements or dietary advice alone for any nutritional or growth measurements. This was also true for measures of body composition, lung function, adverse effects on the digestive system or people's levels of activity. Advice and monitoring appear to be enough to manage the diet of moderately malnourished children. Randomised controlled trials should look into the use of calorie supplements for acute weight loss or long-term care for adults with cystic fibrosis.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
January 26. 1998 AbstractBackgroundPoor nutrition occurs frequently in people with cystic fibrosis (CF) and is associated with other adverse outcomes. Oral calorie supplements are used to increase total daily calorie intake and improve weight gain. However, they are expensive and there are concerns they may reduce the amount of food eaten and not improve overall energy intake. ObjectivesTo establish whether in people with CF, oral calorie supplements: increase daily calorie intake; and improve overall nutritional intake, nutritional indices, lung function, survival and quality of life. To assess adverse effects associated with using these supplements. Search strategyWe searched the Cochrane CF Trials Register comprising references from comprehensive electronic database searches, handsearches of relevant journals and abstract books of conference proceedings. We contacted companies marketing oral calorie supplements. Last search: August 2008. Selection criteriaRandomised or quasi-randomised controlled trials comparing use of oral calorie supplements for at least one month to increase calorie intake with no specific intervention or additional nutritional advice in people with CF. Data collection and analysisWe independently selected the included trials, assessed methodological quality and extracted data. We contacted the authors of included trials and for two trials obtained additional information. Main resultsTwenty-one trials were identified and three, reporting results from 131 participants, were included. There were no significant differences between people receiving supplements or dietary advice alone for change in weight, height, body mass index, z score or other indices of nutrition or growth. Changes in weight (kg) at three, six and twelve months respectively were: MD 0.32 (95% CI -0.09 to 0.72); MD 0.47 (95% CI -0.07 to 1.02 ); and MD 0.16 (-0.68 to 1.00). Total calorie intake was greater in people taking supplements at 12 months, MD 265.70 (95% CI 42.94 to 488.46). There were no significant differences between the groups for anthropometric measures of body composition, lung function, gastrointestinal adverse effects or activity levels. Authors' conclusionsOral calorie supplements do not confer any additional benefit in the nutritional management of moderately malnourished children with CF over and above the use of dietary advice and monitoring alone. While nutritional supplements may be used, they should not be regarded as essential. Further randomised controlled trials are needed to establish the role of oral protein energy supplements for the short-term in people with CF and acute weight loss and also for the long-term nutritional management of adults with CF or advanced lung disease, or both. |