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Nutritional regimen with mucoviscidosis

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Nutritional regimen with mucoviscidosis

Mucoviscidosis is a widely prevalent genetic disorder. In Poland, it affects approximately one in 4,000 newborns, as per data from the Central Statistical Office in 2020. Around 90 children with this condition were born worldwide. This illness is characterized by a severe course and there is no possibility of complete cure. However, it requires intensive treatment aimed at reducing the progression of the disease, alleviating its symptoms, and prolonging the patient's life. The treatment is multistage and includes m.. a. appropriately planned pharmacotherapy, physiotherapy, or surgical interventions. Given the altered metabolic processes, dietary therapy also plays a significant role in the treatment of mucoviscidosis.

Table of Contents

1. Mycobacteriosis is delineated by:

Mucoviscidosis is a genetic disorder characterized by dysfunction in the secretory glands, resulting in the production of dense and sticky mucus. It primarily affects the digestive and respiratory systems. The gene responsible for its occurrence is situated on chromosome number seven and is inherited in a recessive manner, which implies that for the progeny to fall ill, both parents must be carriers, possessing a damaged copy of the gene. The manifestation of the disease is not gender-specific.

2. Cystic Fibrosis - Diagnostic Methods and Symptoms

Since 2009, newborn screenings for cystic fibrosis have been performed in Poland, which entails taking a blood sample from each newborn. The analysis of the sample allows for a highly reliable confirmation or exclusion of the presence of cystic fibrosis. This program also enables the detection of other genetic conditions. In case of a positive screening result, a test for chloride concentration in sweat is conducted, which confirms the final diagnosis. Many cases of cystic fibrosis are diagnosed in childhood, however, some cases may not exhibit symptoms until adolescence or adulthood. Common symptoms of this disease include coughing, shortness of breath, frequent respiratory infections, and digestive issues.

3. Genetic Malady of Mucoviscidosis - Progression and Implications

Mucoviscidosis is an inherited disorder that arises from a mutation in the gene responsible for coding the CFTR protein, resulting in a deficiency of this protein or its modified form. The CFTR protein regulates the transport of chlorine and sodium ions between cells, which is essential for the proper functioning of secretions in the body. In the lungs, an excess of secretions can lead to disruptions in fluid transport and predispose the lungs to infections. Meanwhile, in the pancreatic ducts, an excess of secretions can lead to blockage and ultimately digestive disorders. In extreme cases, mucoviscidosis can lead to the development of cirrhosis of the liver, diabetes, and infertility.

4. Cystic fibrosis treatment – an intricate and multifaceted process

The treatment process of cystic fibrosis is highly intricate and requires interdisciplinary medical, psychological, physiotherapeutic, and dietetic care. Within this process, physiotherapeutic techniques are utilized to remove secretions from the lungs, necessitating the patient's placement in an appropriate position to facilitate expectoration. Additional support for this process is provided through clapping or vibrating techniques (often employing machines or specialized cameras). It is also recommended that patients engage in daily physical activities tailored to their abilities, such as swimming, running, cycling, or aerobics, to improve airflow through the lungs and enhance respiration. Throughout the course of the disease, medications are administered in the form of inhalations to expand the bronchi and dilute the remaining secretions. However, due to the heightened susceptibility to bacterial infections in certain patients, prolonged use of antibiotics is required. This, however, may lead to negative consequences, such as the development of antibiotic resistance, the occurrence of allergic reactions to antibiotics, and the weakening of the human natural microflora.

5. Mycobacteriosis - appropriate diet

Appropriate nutrition is a crucial component of the treatment of mycobacteriosis in infants, who should be breastfed like healthy children (if possible). The diet should be high in energy, protein, and fat, as well as certain nutrients such as chlorine and sodium. Due to the increased risk of malnutrition in patients with mycobacteriosis, it is recommended to increase the caloric intake by 20-50% compared to the requirement of a healthy person of the same weight and height. In special cases, it may be necessary to follow a diet with twice the caloric content. Furthermore, patients with mycobacteriosis should consume large amounts of protein (about 20% of the total energy requirement) and fat (35-40% of the total energy requirement). In patients with pancreatic disorders, pancreatic enzyme preparations should be used to ensure effective digestion of fat. Additionally, the diet should pay attention to the intake of certain vitamins and minerals, such as calcium, iron, zinc, and selenium. To prevent deficiencies of these nutrients, supplementation of vitamins and minerals and the use of special high-calorie preparations containing a lot of calories in a small amount are recommended.

6. What should the appropriate diet for cystic fibrosis patients look like?

Patients should eat regularly; in addition to the 4-5 main meals, smaller snacks should be planned during the day. They should be based primarily on high-calorie products with high energy density, such as fatty cocoa, full-fat creams, vegetable oils, butter, nut creams and nuts, jams, fruit, baked goods, cheese and rice. Soups and sauces should be thickened with cream or added with oil. All thermal processing methods are allowed, including frying. Meals should be salted during preparation or directly on the plate. It is also possible to use salty snacks, such as nuts, crackers, savory cheeses and cookies. The diet should be as varied and attractive as possible for the patient. It is worth considering the use of high-calorie dietary supplements to provide the body with additional energy. They are available in the form of cocktails that can be consumed as independent snacks or added to meals, such as pudding, creams or pancakes.

7. Concise compendium

Adequate nutrition plays a critical role in managing cystic fibrosis. Maintaining an appropriate nutritional status by adhering to a high-energy, high-protein, and high-fat diet contributes to improved disease course, prognosis, and a reduction in the risk of complications.
Source

Burdacka K. et al., Metody fizjoterapii stosowane w leczeniu mukowiscydozy – przegląd literatury, „Physiotherapy Review” 2020, 24(3), epub.
Ciborowska H., Rudnicka A., Dietetyka. Żywienie zdrowego i chorego człowieka, Warszawa 2015, 552–554.
Nowak J. K., Walkowiak J., Mazurek H., Mukowiscydoza, Żywienie i leczenie żywieniowe dzieci i młodzieży, pod red. Szajewskiej H., Horvath A., Kraków 2017, 217–227.
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Rządowy program badań przesiewowych noworodków w Polsce na lata 2019–2022, gov.pl/web/zdrowie/program-badan-przesiewowych-noworodkow-w-polsce-na-lata-2019-2022 (10.10.2022).
Turck D. et al., ESPEN-ESPGHAN-ECFS guidelines on nutrition care for infants, children, and adults with cystic fibrosis, „Clinical nutrition” 2016, 35(3), 557–577.