Short-term clinical, nutritional, and functional effects of continuous elemental enteral alimentation in children with cystic fibrosis

Bertrand, Jean‐Marie; Morin, Claude; Lasalle, R; Patrick, J.; Coates, Allan L.

doi:10.1016/s0022-3476(84)80586-7

Cited by 79 publications

(32 citation statements)

References 29 publications

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“…This approach has been widely accepted and used to assess nutritional status in a variety of populations including pediatric patients in hospital settings. For example, AMA and AFA were used as outcome measures to evaluate nutritional interventions in children with cancer (4) and CF (5) and for the assessment of nutritional status in sick children (6 -8). Another common application in children is to predict and compare fat and lean mass in different populations with large sample sizes (9 -13) or to interpret the nutritional status of populations with regard to normal reference curves (14,15) in research settings.…”

mentioning

confidence: 99%

Evaluation of Arm Anthropometry for Assessing Pediatric Body Composition: Evidence from Healthy and Sick Children

Chomtho

Fewtrell

Jaffé³

et al. 2006

Pediatr Res

109

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Arm anthropometry is used as a proxy of body composition in clinical and field research but its validity has not been established in children. To address this issue, mid-upper arm circumference (MUAC) and triceps skinfold thickness (TS) were measured in 110 healthy children aged 4.4 -13.9 y (55 boys) and 49 cystic fibrosis (CF) patients aged 8.1-13.4 y (22 boys). Reference values were arm and whole-body fat mass (FM) and fat-free mass (FFM) measured by dual x-ray absorptiometry and four-component model, respectively. Arm fat area (AFA), MUAC, and TS correlated well with arm FM (r ϭ 0.84 -0.92) and total FM (r ϭ 0.78 -0.92). Arm muscle area (AMA) and MUAC correlated well with arm FFM (r ϭ 0.68 -0.82) and total FFM (r ϭ 0.60 -0.86). After adjusting for age, sex, and height, arm anthropometry correlated strongly with FM but weakly with FFM. AFA, MUAC, and TS explained 67, 63, and 61% of variability in total FM in healthy children and 70, 72, and 63% in CF. AMA and MUAC explained only 24 and 16% of variability in total FFM in healthy children and 33 and 28% in CF. Arm anthropometry is useful for predicting FM and ranking healthy children and patients for fatness. It has poorer success in predicting regional or total FFM. A rm anthropometry has been used as a proxy of body composition in both clinical and field research settings for decades. The cross-sectional AMA and AFA were introduced for the assessment of nutritional status of children in community settings (1,2) and proposed to be better than direct skinfold thickness and arm circumference measurements (3). This approach has been widely accepted and used to assess nutritional status in a variety of populations including pediatric patients in hospital settings. For example, AMA and AFA were used as outcome measures to evaluate nutritional interventions in children with cancer (4) and CF (5) and for the assessment of nutritional status in sick children (6 -8). Another common application in children is to predict and compare fat and lean mass in different populations with large sample sizes (9 -13) or to interpret the nutritional status of populations with regard to normal reference curves (14,15) in research settings. Despite the evolution of body composition measurement techniques, arm anthropometry is still popular because it is inexpensive and noninvasive, and can be measured without difficulty in almost any situation, especially in clinical settings where time and patients' tolerance is limited. However, the validity of this simple method for assessing body composition has not been established.The value of arm muscle and fat area as proxies for lean and fat mass relies on the theoretical assumptions that i) the arm is cylindrical in form, ii) the subcutaneous fat is evenly distributed around a circular core of muscle, and iii) TS accurately separates fat and lean components of the arm and represents twice the thickness of subcutaneous fat in the arm (2). These assumptions inevitably predispose the method to some inaccuracy. Although a few studies ha...

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confidence: 99%

Evaluation of Arm Anthropometry for Assessing Pediatric Body Composition: Evidence from Healthy and Sick Children

Chomtho

Fewtrell

Jaffé³

et al. 2006

Pediatr Res

109

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“…Assessments of pulmonary function varied: most showed no significant change in relation to predicted values [9,10,37,42]; one group reported no decline (which could be interpreted as improvement) [39] and one group did find an improvement, with fewer pulmonary infections [41], Notable features of almost all the trials were spontaneous comments made by patients and parents, of improvements of appetite, energy and well being.…”

Section: Nutritional Interventionmentioning

confidence: 98%

“…Other techniques are formula feeding via the nasogastric [36][37][38] and nasojejunal routes, gastrostomy [39,40] and intravenous feeding [41,42].…”

Section: Nutritional Interventionmentioning

confidence: 99%

“…Using these various forms of supplemen tary nutrition, many workers [9,10,[36][37][38][39]41] have demonstrated positive changes which have included significant increases in weight, height, body fat, lean body mass and muscle mass, at least in the relatively short term. Assessments of pulmonary function varied: most showed no significant change in relation to predicted values [9,10,37,42]; one group reported no decline (which could be interpreted as improvement) [39] and one group did find an improvement, with fewer pulmonary infections [41], Notable features of almost all the trials were spontaneous comments made by patients and parents, of improvements of appetite, energy and well being.…”

Section: Nutritional Interventionmentioning

confidence: 99%

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Nutritional Management of Cystic Fibrosis

Goodchild¹

1987

Digestion

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“…Palatability of supple¬ mental diets and the invasive nature of these interventions are major draw¬ backs and can affect life-style. 8,9 In recent years there has been a grow¬ ing tendency to use invasive nutrition programs, such as total parenteral nu¬ trition and intragastric feedings, to maintain weight in patients with CF. We therefore conducted a study to establish whether a noninvasive nutrition inter¬ vention program, consisting of a nonrestricted fat diet, emphasizing a high energy intake and administration of an optimal pancreatic enzyme replacement dosage, could enhance the nutritional and pulmonary status of patients with CF.…”

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confidence: 99%