nutrition

Question

Dear expert team,
I have a question about nutrition in CF. In general it is said, that the increased calory need in CF should be covered especially with an increased intake of fat. But: increased fat intake means of course also a more intensive repletion. Now it is known for years, (only the german society for nutrition (DGE) does not seem to know this...), that for healthy people the intake of (healty) fats should not count for "fat-makers" - as it is postulated very often- but rather the carbohydrates count as "hunger-makers" (due to the reaction of the insulin) and therefore serve as a "fat-maker".
Is there not the inversion of the argument right for CF patients: eat more carbohydrates? And as a consequence get more hunger? And as a consequence: eat more? Problems could occur of course with diabetes, but for non-diabetic CF patients this would probably be the easy variant to come to a better weight?

Answer

Hello,
we asked our expert in nutrion Ellen Althaus per mail and she gave the following answer:
"The nutrition in CF should be rich of fat, as hereby the required calory rich nutrition can be fullfilled the best. Fats provide furthermore essential fatty acids and fat-soluble vitamins A, D, E and K. Fats have the greates energy density. 1g of fat provides the body with 9 Kcals, while 1 g of carbohydrates and protein provide the body only with 4 Kcals each per gram.
An example: one large spoon of oil has about 110 kcal, 45 g bread about 90 kcal. For many people it is easier to add a spoon of oil to a hot meal than to eat one more slice of bread. In case one likes to achieve a calory rich nutrition via a high carbohydrate intake and a smaller amount of fat, the proportions/amounts would have to be larger. And this can only hardly be achieved. In addition very large amounts (also carbohydrates) can replete for a long time and therefore intermediate meals fall out.
It is for sure favorable to eat carbohydrate rich meals as an intermediate meal. That could be fruit or a sweat (probably this contains also fat) and can enhance the apetite until the next main meal.
In the daily nutrition carbohydrates and proteins play a great role, but without an enhanced intake of fat it is hard to cover the calory need."

Many greeting from the ECORN-CF team,
Annette Pfalz

18.01.2011