Energy balance and the accuracy of reported energy intake in preadolescent children with cystic fibrosis.
BACKGROUND
Suboptimal growth and nutritional status are common among children with cystic fibrosis (CF) and pancreatic insufficiency (PI). A better understanding of energy balance is required to improve prevention and treatment of malnutrition.


OBJECTIVE
Our objective was to characterize energy balance and the reporting accuracy of dietary intake in children with CF by evaluating the relations between energy intake (EI), energy expenditure (EE), fecal energy loss, nutritional status, and growth.


METHODS
The subjects were participants of a 24-mo prospective study of children 6-10 y of age with CF and PI. EE, EI, fecal energy loss, and anthropometric measures were obtained at baseline and at 24 mo.


RESULTS
The children (n = 69) had suboptimal growth at baseline (x +/- SD: weight-for-age z score, -0.53 +/- 1.19; adjusted height-for-age z score, -0.67 +/- 1.06; body mass index z score, -0.29 +/- 1.12), and these variables remained suboptimal at 24 mo. The median ratios of EI to EE at baseline and 24 mo were 1.15 and 1.18, respectively, which decreased to 1.09 and 1.10, respectively, when adjusted for fecal energy loss (EI(-FL):EE). At baseline, 7% of subjects were underreporters, 64% were accurate reporters, and 23% were overreporters of energy intake; the percentages were similar at 24 mo.


CONCLUSIONS
Although EI(-FL):EE ratios were higher than expected at both baseline and 24 mo, this cohort showed only age-appropriate weight gain. Self-reported dietary intake data at the individual level should be interpreted with caution, and weight gain velocity may serve as an objective measure of long-term energy balance.
Trabulsi
Jillian
J
Division of Gastroenterology, The Children's Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. trabulsi@email.chop.edu
Schall
Joan I
JI
Ittenbach
Richard F
RF
Olsen
Irene E
IE
Yudkoff
Marc
M
Daikhin
Yevgeny
Y
Zemel
Babette S
BS
Stallings
Virginia A
VA
D000886:Anthropometry; D002648:Child; D002657:Child Development; D015362:Child Nutrition Disorders / Q000209:etiology / Q000517:prevention & control*; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000150:complications / Q000378:metabolism*; D002149:Energy Intake / Q000502:physiology*; D004734:Energy Metabolism / Q000502:physiology*; D005243:Feces / Q000737:chemistry; D005260:Female; D006128:Growth / Q000502:physiology*; D006801:Humans; D007408:Intestinal Absorption; D008137:Longitudinal Studies; D008297:Male; D009751:Nutritional Requirements; D009752:Nutritional Status; D011446:Prospective Studies; D015430:Weight Gain / Q000502:physiology