Resultado de intervenção nutricional em crianças e adolescentes com fibrose cística

Abstract

ResumoObjetivo: poucos estudos têm verificado longitudinalmente a evolução do estado nutricional de pacientes com fibrose cística. O objetivo deste estudo foi acompanhar a evolução do estado nutricional, composição corporal e consumo de energia, macro e micronutrientes ingeridos por crianças e adolescentes, mediante intervenção nutricional, no Ambulatório de Fibrose Cística/Pneumologia Pediátrica, do Departamento de Pediatria da UNIFESP.Métodos: a casuística constituiu-se de 18 pacientes, sendo 13 do sexo masculino e 5 do feminino, faixa etária de 0,3 a 18,4 anos. Realizaram-se 3 avaliações: no momento 1 (M1: pré-intervenção nutricional), no M2, após 6 meses, e no M3, após 12 meses. Foram analisados nos 3 momentos: o escore Z de peso/idade (P/I), peso/ estatura (P/E) e estatura/idade (E/I) e o cálculo do registro alimentar de 3 dias. No M1 e M3, verificou-se a composição corporal (antropometria). A conduta nutricional foi hipercalórica, hiperprotéica e houve adequação de macro e micronutrientes.Resultados: observou-se aumento significante do escore Z de E/I (M1=-1,07; M2=-0,69; M3=-0,50) e de massa magra após a intervenção nutricional, sem melhora no escore Z de P/E e massa gorda. Verificou-se aumento no consumo energético nos M2 (139%) e M3 (132%) em relação ao M1 (106%). Houve considerável aumento no consumo de proteína, cálcio, ferro e vitamina C pelos pacientes. A presença de anemia ocorreu em 44,4% (8/18) dos pacientes.Conclusão: o aumento no escore Z de E/I e massa magra ocorreu devido a adequação no consumo de energia, após a intervenção nutricional. Não houve melhora significante no escore Z de P/E e massa gorda, em função do ganho de estatura e de massa magra.J Pediatr (Rio J) 2002; 78 (2): 161-70: fibrose cística, intervenção nutricional, energia e nutrientes, estado nutricional, composição corporal. AbstractObjective: few studies have verified longitudinally the evolution of the nutritional status of patients with cystic fibrosis. The objective of this study is to follow the evolution of the nutritional status, body composition and energy consumption, macronutrients and micronutrients ingested by children and adolescents by means of nutritional interventions at the Clinic of Cystic Fibrosis/Pediatric Pneumology of the Department of Pediatrics of Universidade Federal de São Paulo.Methods: 18 patients were involved in this study, thirteen males and five females with ages ranging from 0.3 to 18.4 years. We performed three evaluations: evaluation 1 (M1-prenutritional intervention), M2 after 6 months, and M3 after 12 months. In these three instances we verified: the z score for weight/age, weight/height and height/age and the calculation of a 3-day diet record. We verified the body composition (anthropometry) in M1 and M3. The nutritional interventions were hypercaloric, hyperproteic, with adequate amount of ingested macronutrients and micronutrients.Results: we observed an increase in the z score for height/age (M1=-1.07; M2=-0.69; M3=-0.50) and fat-free mass after the nutritional interventions, without i...

Difficulties experienced by the mothers of people with cystic fibrosis

“…9 Various studies have been undertaken in Paraná addressing cystic fibrosis, either in isolation or in the context of Neonatal Screening. The majority of these address epidemiological [10][11] or nutritional 12 aspects, associated health problems, 13 diagnostic tests 14 and evaluation of the Neonatal Screening Program. 15 Only two studies were identified addressing the importance of the organization of support for those with cystic fibrosis and the intersubjectivity in the context of the family.…”

Associação entre o estado nutricional e a ingestão dietética em pacientes com fibrose cística

“…One study demonstrated a significant increase in the Z score for H/A after a nutritional intervention, through which CF patients reached a caloric intake of 132% of the RDA. (25) The importance of nutritional status in CF patients is well-known and has been widely documented. The present study shows evidence of the association between caloric intake and nutritional status, indicating that dietary profile is a predictor of height in these patients.…”

Perfil nutricional, clínico e socioeconômico de pacientes com fibrose cística atendidos em um centro de referência no nordeste do Brasil

“…(6) The problems of malnutrition presented by CF patients are multifactorial and can be attributed to the energy imbalance caused by chronic respiratory disease, poor nutrient absorption caused by pancreatic insufficiency, changes in enterohepatic circulation of biliary salts and antibiotic therapy, as well as to the possibility of being aggravated by anorexia caused by gastroesophageal reflux or cough, increased metabolism, especially in the presence of infections, and psychosocial stress. (7,8) The objective of this study was to describe the nutritional, clinical and socioeconomic (11) for individuals under 5 years of age, and of the National Center for Health Statistics, (12) for those above 5 years of age. Those presenting a Z score < −1 for any evaluated indicator were considered to have nutritional deficit, whereas those presenting a Z score ≥ −1 SD were considered to present normal nutritional status.…”