title: Dietary pattern and its relationship between bone mineral density in girls and boys with cystic fibrosis - preliminary report.
abstract: BACKGROUND
  Nutrition influence on cystic fibrosis (CF) patients survival is well documented and dietary therapy is one of basic elements of their treatment. Prolonged survival of CF patients might yet emerge comorbidities, which include bone mineral disease.
  
  
  OBJECTIVE
  The assessment of the dietary pattern and its relationship between bone density in boys and girls with cystic fibrosis.
  
  
  METHODS
  89 patients aged 10-18 years from 3 Polish CF Centres were included into the study. To obtain a knowledge about quality of diet, a 3-day food record was assessed and percent of recommended for CF patients intake of energy, protein, carbohydrates, fat, vitamin D3, calcium, phosphorus was counted. Bone mineral density (BMD) in lumbar spine (L1-L4) was measured and expressed as a Z-score. To assess nutritional status, anthropometric measurements was evaluated (body weight, height and BMI). Descriptive methods, Mann-Whitney test, T-Student test, Spearman correlation and one-way ANOVA were used for statistical analyses.
  
  
  RESULTS
  The patients with cystic fibrosis did not meet specific for CF nutritional guidelines. A deficiency in recommended intake was observed in energy (88%), protein (82%), calcium (78%) and vitamin D3 (71%). The intake of phosphorus was higher than recommended (142%). A nutritional status was significantly reduced, as compared with the reference group (p 0.001). Boys characterized significantly lower body weight (p=0.019) and height (p=0.036) than girls as well as worse caloric (p=0.023) and carbohydrates intake (p=0.005). However, girls had reduced vitamin D3 content in their diet (p 0.001). The bone mineral density in the whole group was reduced and Z-score amounted to -0.95 ± 1.17. Tendency to decreasing of BMD with age was observed. BMI showed important correlation with bone mineral density both in girls (p 0.001) and in boys (p=0.020).
  
  
  CONCLUSIONS
  CF patients do not follow specific for them dietary recommendations and essential differences were observed between girls and boys. Nutritional status (BMI) showed correlation with bone mineral density in CF patients. Therefore intensive nutritional therapy according to recommendations is needed. .
authors.affiliation: Cystic Fibrosis Centre Institute of Mother and Child, Kasprzaka Street 17A, 01-211 Warsaw, Poland, Telephone: (+48 22) 327-71-90, e-mail: dorota.sands@imid.med.pl.
authors.forename: Dorota
authors.initials: D
authors.lastname: Sands
authors.forename: Monika
authors.initials: M
authors.lastname: Mielus
authors.forename: Wioleta
authors.initials: W
authors.lastname: Umławska
authors.forename: Anna
authors.initials: A
authors.lastname: Lipowicz
authors.forename: Beata
authors.initials: B
authors.lastname: Oralewska
authors.forename: Jarosław
authors.initials: J
authors.lastname: Walkowiak
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D015519:Bone Density; D002136:Calcium, Dietary; D002648:Child; D003550:Cystic Fibrosis / Q000503:physiopathology*; D004435:Eating; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D009752:Nutritional Status; D012737:Sex Factors
chemical_list: D002136:Calcium, Dietary