Diet and exercise can considerably relieve the symptoms of cystic fibrosis. NHS Direct says that both of these elements can be managed at home with the assistance of the gp and cystic fibrosis specialists. Eating an appropriate diet in order to achieve and maintain a good weight is viewed as essential for maintaing good lung function and in helping to withstand infection.
Feeding Babies with Cystic Fibrosis.
Breast milk is the best option for most babies with cystic fibrosis. The Cystic Fibrosis Trust says that "research shows that babies with cystic fibrosis grow well on breast milk and it should be encouraged wherever possible". Infant formula milks are also suitable for babies with cystic fibrosis and will enable most babies to gain weight satisfactorily. For those babies who do not gain weight on infant formula milk, using a nutrient dense infant formula or concentrating the formula milk is recommended. Increasing the concentration of formula milk should only be done under the supervision of a dietitian as too much milk powder can cause diarrhoea and vomiting.
It is best to feed babies with cystic fibrosis on demand. Parents are advised to contact the dietitian if their baby is only taking small quantities of milk. Cow's milk should not be given until the baby is one year old.
Most babies with cystic fibrosis will need a pancreatic enzyme supplement to help with digesting food. The hospital will prescribe the dosage that should be given. It is recommended that the granules should be mixed with a little milk or fruit puree and given from a spoon at the start of the feed.
There is no need to start weaning until the baby is six months old. At this stage, the solids given should be smooth purees- commercial first stage weaning foods can also be used. Between seven and nine months finger foods (fingers of buttered toast, soft cooked vegetables, slices of peeled fruit). At this stage babies should be taking solids three times daily and about 500-600ml of infant formula or follow-on formula or breast feeding three or four times a day.
Babies with cystic fibrosis will also need vitamin supplements to compensate for the loss of vitamins A, D and E. Vitamins A and D are usually given together in a liquid medicine. Vitamin E is given as a separate liquid.
The doctor may prescribe a salt solution for those babies that are losing too much salt through their sweat. Extra salt should not be added to a baby's breast or bottle milk nor should it be added to baby food.
Diet for Children with Cystic Fibrosis.
Children with cystic fibrosis should be encouraged to eat a "normal" diet but this should contain a higher than normal level of protein and calories. The Cystic Fibrosis Trust makes the following recommendations with regard to an appropriate diet-
In addition the child will need to continue taking vitamin supplements and pancreatic enzyme supplements. Salt solution may be prescribed during periods of hot weather
More detail can be found in the Eating well factsheet (pdf document) produced by the Cystic Fibrosis Trust
Diet for Adults with Cystic Fibrosis.
Adults with cystic fibrosis often require between 20 and 50% more calories each day than people without cystic fibrosis. Fat is the richest source of energy and is also a good source of essential fatty acids and fat-soluble vitamins. People should use unsaturated fats as they are healthier than lard or butter. Cooking should be done with olive oil or rapeseed oil.
Oily fish contain a high level of essential omega 3 fats and should be included in the diet. These include salmon, herring, sardines, mackerel, pilchards, trout, kippers and fresh tuna.
Many of the points outlined above for children also apply to adults.
Vegetarians should replace meat or fish with a variety of protein sources such as soya mince or other meat substitutes, beens, seeds, lentil, tofu, nuts, cheese or eggs. NHS Direct says "a vegan diet is not advised for people with cystic fibrosis".
People should eat three meals a days interspersed with several high calorie snacks.
Some fruit and vegetables should be eaten each day but it is important that people do not fill themselves up with fruit and vegetables at the expense of higher calorie foods.
Calcium rich foods are important for maintaining strong and healthy bones. Dairy products such as full cream milk, cheese, full cream yoghurts and dairy ice cream are the best sources of calcium. Other sources include baked beans, tinned fish with bones and white bread.
Men should consume no more than 3 or 4 units of alcohol per day. Women should restrict themselves to 2 or 3 units per day. This is to avoid putting additional strain on the liver. Binge drinking should also be avoided.
Additional information can be found on the Eating Well for Adults factsheet (pdf document) produced by the Cystic Fibrosis Trust.
Exercise and Cystic Fibrosis.
Exercise is recognised as being very beneficial for people with cystic fibrosis as it can help to prevent lung damage, improve lung function and airway clearance, increase bone density and prevent bone loss.
Ideally people should exercise for 20-30 minutes three times per week. However it is recognised that some people's level of tolerance may not be up to this and their exercise regimes may be adjusted accordingly. Any exercise is better than none at all.
People should try and find an activity which they enjoy and can incorporate intop their lifestyle.
Aerobic exercise is recommended as it makes people breathe harder. Forms of aerobic exercise include running, soccer, swimming, tennis and cycling.
NHS Direct recommends that parents of children with CF should inform the school that exercise is to be encouraged as the school may not be aware that exercise is good for children with CF.
Dehydration should be avoided during exercise by drinking plenty of water. Taking salt tablets will compensate for salt loss through sweating.
Exercise should not cause weight loss if the person is eating a good diet. Exercise converts excess fat to muscle. People who are concerned about weight loss are advised to discuss these concerns with their dietitian.