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Duck SA, Jansen E, Papantoni A, Sheltry A, Koinis-Mitchell D, D'Sa V, Deoni S, Moran TH, Findling RL, Mogayzel PJ, Carnell S. Parental perceptions of body weight and appetite in infants and toddlers with cystic fibrosis. Appetite 2024; 198:107357. [PMID: 38621592 PMCID: PMC11134312 DOI: 10.1016/j.appet.2024.107357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 04/01/2024] [Accepted: 04/12/2024] [Indexed: 04/17/2024]
Abstract
Nutritional status has clinical relevance and is a target of guidance to parents of children with cystic fibrosis (CF). Growth is routinely monitored in CF clinics but there is no standardized way of assessing appetitive behaviors or parents' perceptions of their children's appetite. Greater understanding of these factors could improve clinical guidance regarding parent feeding behaviors. We therefore aimed to assess parent perceptions of child weight, and parent reports of child appetite using the Baby Eating Behavior Questionnaire (BEBQ), in a sample of infants and toddlers with CF, compared with a community sample. We additionally assessed relationships of parent perceptions of child weight with parent feeding behaviors in the sample with CF. Anthropometric and questionnaire data were collected for 32 infants and toddlers with CF, as well as 193 infants and toddlers drawn from RESONANCE, a community cohort study. Parents perceived children with CF to be lower in weight than their actual weight, to a greater extent than was evident in the community sample. Parents who perceived their children with CF to be underweight vs. right weight reported greater slowness in eating on the BEBQ. Parents perceived children with CF to have greater slowness in eating and lower enjoyment of food, compared to parents of children in the community sample, independent of sample differences in child weight, age, and sex. Our results demonstrate the potential utility of the BEBQ in a clinical sample and suggest it may be helpful for clinicians to assess parents' perceptions of their child's weight and appetite to promote a fuller understanding of the child's nutritional status, facilitate appropriate feeding behaviors and alleviate unnecessary concerns.
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Affiliation(s)
- Sarah Ann Duck
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Elena Jansen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Afroditi Papantoni
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aerial Sheltry
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
| | | | - Viren D'Sa
- Department of Pediatrics, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Sean Deoni
- Department of Psychology, Social Sciences, University of Stavanger, Stavanger, Norway
| | - Timothy H Moran
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - Robert L Findling
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Peter J Mogayzel
- Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, Johns Hopkins Medicine, USA
| | - Susan Carnell
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Schumacher S, Harklau NM, Osterhaus JK, Wright BA. Overweight, understudied: The new need for weight loss modalities in CF patients. Pediatr Pulmonol 2024; 59:2021-2023. [PMID: 38629391 DOI: 10.1002/ppul.27011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/22/2024] [Accepted: 04/04/2024] [Indexed: 07/21/2024]
Affiliation(s)
- Sarah Schumacher
- Department of Pharmaceutial Care, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Nichole M Harklau
- Department of Food & Nutrition Services, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Julie K Osterhaus
- Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Brittany A Wright
- Department of Pharmaceutial Care, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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Anderson HL, Lynch V, Moore JE, Millar BC. What is the Perceived Role of the Dietitian Amongst People with Cystic Fibrosis? Results of an International survey. CAN J DIET PRACT RES 2023; 84:149-153. [PMID: 36988118 DOI: 10.3148/cjdpr-2022-044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Cystic fibrosis (CF) is a chronic condition requiring continued input from the CF dietitian as an integral part of the CF multidisciplinary team. In recent years, the longer life expectancy experienced by people with CF (PwCF) means that nutrition advice and therapy are evolving from a focus on nutrition support to prevention and management of comorbidities. Little has been reported regarding the perceived role of the CF dietitian amongst PwCF. We report the responses to 11 questions that were part of a larger international survey distributed to members of national CF charities in 2018-2019. These questions evaluated PwCFs' perspectives on (i) the importance of the CF diet, (ii) how often PwCF obtain dietary/nutritional advice from their dietitian, (iii) the perceived reliability of information given by the dietitian, (iv) other sources of CF information and their perceived reliability, and (v) how CF nutrition/diet, as well as CF-related diabetes, ranked as research priorities. There were 295 respondents from 13 countries. Almost half of the respondents (46.8%) contacted their CF dietitian on a frequent/more regular basis, compared to medical/scientific journals/medical/scientific search engines. The CF dietitian was considered a reliable source of information, as 84% of the respondents indicated that the information provided was very/generally reliable. At a time when CF care and expectations are changing rapidly, PwCF are in need of trusted and reliable information to make positive changes in lifestyle and habits. Dietitians working with PwCF should appreciate the pivotal and valued role they perform as purveyors of robust evidence-based information to this chronic disease population.
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Affiliation(s)
- Hannah L Anderson
- School of Biomedical Sciences, Ulster University, Londonderry, Northern Ireland, UK
| | - Veronica Lynch
- Northern Ireland Regional Adult Cystic Fibrosis Centre, Belfast, Northern Ireland, UK
| | - John E Moore
- School of Biomedical Sciences, Ulster University, Londonderry, Northern Ireland, UK
- Northern Ireland Regional Adult Cystic Fibrosis Centre, Belfast, Northern Ireland, UK
- Northern Ireland Public Health Laboratory, Belfast City Hospital, Belfast, Northern Ireland, UK
| | - Beverley C Millar
- School of Biomedical Sciences, Ulster University, Londonderry, Northern Ireland, UK
- Northern Ireland Regional Adult Cystic Fibrosis Centre, Belfast, Northern Ireland, UK
- Northern Ireland Public Health Laboratory, Belfast City Hospital, Belfast, Northern Ireland, UK
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Li S, Douglas T, Fitzgerald DA. Psychosocial needs and interventions for young children with cystic fibrosis and their families. Paediatr Respir Rev 2023:S1526-0542(23)00017-9. [PMID: 37268508 DOI: 10.1016/j.prrv.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/06/2023] [Indexed: 06/04/2023]
Abstract
This review summarises the experiences of young children and their families living with CF during the first five years of life following NBS diagnosis, as well as the options of psychosocial support available to them. We present strategies embedded within routine CF care that focus on prevention, screening, and intervention for psychosocial health and wellbeing that constitute essential components of multidisciplinary care in infancy and early childhood.
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Affiliation(s)
- Stella Li
- Department of Psychological Medicine, The Children's Hospital at Westmead, Sydney, New South Wales 2145, Australia
| | - Tonia Douglas
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland 4001, Australia; Children's Health Queensland Clinical Unit, Medical School, Faculty Medicine, University of Queensland, Australia
| | - Dominic A Fitzgerald
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; Discipline of Child and Adolescent Health, Faculty of Medicine, Discipline of Health Sciences, University of Sydney, New South Wales, Australia.
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Petropoulou A, Bakounaki G, Grammatikopoulou MG, Bogdanos DP, Goulis DG, Vassilakou T. Eating Disorders and Disordered Eating Behaviors in Cystic Fibrosis: A Neglected Issue. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9060915. [PMID: 35740852 PMCID: PMC9221629 DOI: 10.3390/children9060915] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/06/2022] [Accepted: 06/16/2022] [Indexed: 05/28/2023]
Abstract
As with the majority of chronic diseases having specific nutrition recommendations, in cystic fibrosis (CF), the emphasis placed on patients regarding their diet and ideal body weight status often increases the risk of developing disordered eating behaviors and by inference, eating disorders (EDs). Body weight appears to be an important concern for patients with CF, with many patients struggling to lose weight. Between sexes, women appear more preoccupied with dieting compared to men, but exhibit a better body image, mainly due to their preference for a lower weight. Several comorbidities appear to change these dynamics, and visibly apparent factors, including scars, ports, and tubes, and the need for supplementary oxygen supply, may also influence body image perception. Disordered eating is usually initiated during a bout of pulmonary infection, with the patient feeling unwell to eat. Regarding the prevalence of EDs, research appears conflicting on whether it is higher among individuals with a CF diagnosis or not. As for comorbidities, anxiety and depression consist of the most common psychiatric diagnoses in CF, also greatly prevalent in EDs. Despite the plethora of studies, non-specific CF tools, small samples, and lack of data regarding important outcomes, including lung health, indicate the need for more research.
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Affiliation(s)
- Anastasia Petropoulou
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, 57400 Thessaloniki, Greece; (A.P.); (G.B.)
| | - Georgia Bakounaki
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, 57400 Thessaloniki, Greece; (A.P.); (G.B.)
| | - Maria G. Grammatikopoulou
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, 57400 Thessaloniki, Greece; (A.P.); (G.B.)
- Department of Rheumatology and Clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 40500 Larissa, Greece;
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Medical School, Aristotle University of Thessaloniki, Agiou Pavlou 76, 56429 Thessaloniki, Greece;
| | - Dimitrios P. Bogdanos
- Department of Rheumatology and Clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 40500 Larissa, Greece;
| | - Dimitrios G. Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Medical School, Aristotle University of Thessaloniki, Agiou Pavlou 76, 56429 Thessaloniki, Greece;
| | - Tonia Vassilakou
- Department of Public Health Policy, School of Public Health, University of West Attica, Athens University Campus, 196 Alexandra’s Avenue, 11521 Athens, Greece
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Effects of Exercise on Nutritional Status in People with Cystic Fibrosis: A Systematic Review. Nutrients 2022; 14:nu14050933. [PMID: 35267909 PMCID: PMC8912872 DOI: 10.3390/nu14050933] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/10/2022] [Accepted: 02/16/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Physical exercise is an important part of regular care for people with cystic fibrosis (CF). It is unknown whether such exercise has beneficial or detrimental effects on nutritional status (body composition). Thus, the objective of this review was to evaluate the effect of exercise on measures of nutritional status in children and adults with CF. METHODS Standardized reporting guidelines for systematic reviews were followed and the protocol was prospectively registered. Multiple databases were utilized (e.g., PubMed, Scopus, and CINHAL). Two reviewers independently reviewed titles/abstracts and then the full text for selected studies. RESULTS In total, 924 articles were originally identified; data were extracted from 4 eligible studies. These four studies included only children; pulmonary function ranged from severe to normal, and the majority of participants were at or below their recommended weight. Exercise training did not worsen nutritional status in any study; two studies that included resistance exercise reported an increase in fat-free mass. Three of the four studies also reported increased aerobic capacity and/or muscle strength. CONCLUSIONS Exercise training can produce positive physiologic changes in children with CF without impairing their nutritional status. In fact, resistance exercise can help improve body mass. Much less is known about how exercise may affect adults or those who are overweight.
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Carnovale V, Iacotucci P, Terlizzi V, Colangelo C, Ferrillo L, Pepe A, Francalanci M, Taccetti G, Buonaurio S, Celardo A, Salvadori L, Marsicovetere G, D’Andria M, Ferrara N, Salvatore D. Elexacaftor/Tezacaftor/Ivacaftor in Patients with Cystic Fibrosis Homozygous for the F508del Mutation and Advanced Lung Disease: A 48-Week Observational Study. J Clin Med 2022; 11:1021. [PMID: 35207295 PMCID: PMC8876133 DOI: 10.3390/jcm11041021] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/04/2022] [Accepted: 02/15/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Elexacaftor/tezacaftor/ivacaftor (ETI) is the newest cystic fibrosis transmembrane conductance regulator (CFTR) modulator drug approved for the treatment of patients with cystic fibrosis (pwCF) aged ≥6 years with at least one copy of the F508del mutation (F) in the CFTR gene or another mutation that is responsive to treatment with ETI. This study determined the effectiveness and safety of ETI in a cohort of severely affected pwCF with an F/F genotype. METHODS Retrospective observational study in F/F pwCF treated for 48 weeks, enrolled in an ETI managed access program available to subjects with advanced lung disease (ppFEV1 < 40). Twenty-six patients from three centres were included. The main outcomes included lung function, sweat chloride concentration (SCC), nutrition, frequency of pulmonary exacerbations (PEx), CFQ-R, and safety. RESULTS ppFEV1 improved by 12.06 (95%CI 8.54, 15.57) from baseline after 4 weeks of treatment with ETI, 15.32 (11.3, 19.34) after 24 weeks, and 14.48 (10.64, 18.32) after 48 weeks. The increase in FEV1 was accompanied by a decrease in SCC, improvement of BMI, and noticeable reduction in PEx. An overall good safety profile was observed. CONCLUSIONS In F/F pwCF with advanced lung disease with an F/F genotype, ETI was safe and associated with clinical improvement.
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Affiliation(s)
- Vincenzo Carnovale
- Cystic Fibrosis Centre, Adult Unit, Department of Translational Medical Science, University of Naples “Federico II”, 80131 Naples, Italy; (P.I.); (L.F.); (S.B.); (A.C.); (L.S.); (N.F.)
| | - Paola Iacotucci
- Cystic Fibrosis Centre, Adult Unit, Department of Translational Medical Science, University of Naples “Federico II”, 80131 Naples, Italy; (P.I.); (L.F.); (S.B.); (A.C.); (L.S.); (N.F.)
| | - Vito Terlizzi
- Cystic Fibrosis Centre, Department of Paediatric Medicine, Anna Meyer Children’s University Hospital, 50139 Florence, Italy; (V.T.); (M.F.); (G.T.)
| | - Carmela Colangelo
- Cystic Fibrosis Centre, Hospital San Carlo, 85100 Potenza, Italy; (C.C.); (A.P.); (G.M.); (M.D.); (D.S.)
| | - Lorenza Ferrillo
- Cystic Fibrosis Centre, Adult Unit, Department of Translational Medical Science, University of Naples “Federico II”, 80131 Naples, Italy; (P.I.); (L.F.); (S.B.); (A.C.); (L.S.); (N.F.)
| | - Angela Pepe
- Cystic Fibrosis Centre, Hospital San Carlo, 85100 Potenza, Italy; (C.C.); (A.P.); (G.M.); (M.D.); (D.S.)
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Postgraduate School of Pediatrics, University of Salerno, 84081 Baronissi, Italy
| | - Michela Francalanci
- Cystic Fibrosis Centre, Department of Paediatric Medicine, Anna Meyer Children’s University Hospital, 50139 Florence, Italy; (V.T.); (M.F.); (G.T.)
| | - Giovanni Taccetti
- Cystic Fibrosis Centre, Department of Paediatric Medicine, Anna Meyer Children’s University Hospital, 50139 Florence, Italy; (V.T.); (M.F.); (G.T.)
| | - Serena Buonaurio
- Cystic Fibrosis Centre, Adult Unit, Department of Translational Medical Science, University of Naples “Federico II”, 80131 Naples, Italy; (P.I.); (L.F.); (S.B.); (A.C.); (L.S.); (N.F.)
| | - Assunta Celardo
- Cystic Fibrosis Centre, Adult Unit, Department of Translational Medical Science, University of Naples “Federico II”, 80131 Naples, Italy; (P.I.); (L.F.); (S.B.); (A.C.); (L.S.); (N.F.)
| | - Laura Salvadori
- Cystic Fibrosis Centre, Adult Unit, Department of Translational Medical Science, University of Naples “Federico II”, 80131 Naples, Italy; (P.I.); (L.F.); (S.B.); (A.C.); (L.S.); (N.F.)
| | - Giovanni Marsicovetere
- Cystic Fibrosis Centre, Hospital San Carlo, 85100 Potenza, Italy; (C.C.); (A.P.); (G.M.); (M.D.); (D.S.)
| | - Michele D’Andria
- Cystic Fibrosis Centre, Hospital San Carlo, 85100 Potenza, Italy; (C.C.); (A.P.); (G.M.); (M.D.); (D.S.)
| | - Nicola Ferrara
- Cystic Fibrosis Centre, Adult Unit, Department of Translational Medical Science, University of Naples “Federico II”, 80131 Naples, Italy; (P.I.); (L.F.); (S.B.); (A.C.); (L.S.); (N.F.)
| | - Donatello Salvatore
- Cystic Fibrosis Centre, Hospital San Carlo, 85100 Potenza, Italy; (C.C.); (A.P.); (G.M.); (M.D.); (D.S.)
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