Adult CF: Adding Calories for a Healthy Weight

People with cystic fibrosis (CF) may have trouble staying at a healthy weight. That's because people with CF require more calories than people without CF. Certain things may make it necessary for you to eat a diet high in calories. These include:

• Lung infections

• Breathing problems (requires more energy to breathe normally)

• You can’t absorb certain nutrients (malabsorption, poor digestion)

Your healthcare team or dietitian can teach you about your nutritional needs and how to meet them. People with CF should eat 3 meals and 2 to 3 snacks a day to help meet their calorie needs. It can help to add extra fat to meals and snacks to meet these needs. You may also need to take pancreatic enzymes to help your body break down food.

How can you add extra calories to your diet?

You can add extra calories to your meals and snacks with these tips:

• Don't have foods that are light, reduced-calorie, nonfat or low fat. Buy whole-milk dairy products.

• Add butter, margarine, or vegetable oil to breads, toast, crackers, or sandwiches. Also try these with potatoes, hot cereals, rice, noodles, soups, or casseroles.

• Add sour cream to potatoes, rice, pasta, or vegetables. You can also use it as a dip for veggies or chips.

• Add mayonnaise to sandwiches or crackers. Mix it in dips, salad dressings, or sauces. Eat it with meat, fish, eggs, or vegetable salads.

• Add avocado to sandwiches.

• Eat nuts or trail mix as a snack.

• Eat canned fruit in heavy syrup rather than in water or light syrup.

• Add cream cheese to fruit slices, raw vegetables, bread, toast, or crackers.

• Use heavy creams in soups, sauces, batters, custards, puddings, shakes, mashed potatoes, or cooked cereals.

• Use whipping cream on foods like pancakes, fruit, pudding, or other desserts. You can also mix it in cream soups, hot cereals, mashed potatoes, pudding, and custards.

• Add brown sugar, maple syrup, or syrup to hot cereals, cold cereals, fruits, ice cream, or puddings. Use them as a glaze on meats or vegetables.

• Add powdered milk to cereals, potatoes, cream soups, eggs, pudding, gravy, and casseroles. You can make super milk by adding 2 to 4 tablespoons of powdered milk to 1 cup of whole milk.

• Add cheese to foods like sandwiches, burgers, toast, crackers, eggs, potatoes, and noodles.

• Eat peanut butter with sandwiches, crackers, toast, fruit slices, vegetables, ice cream, or milkshakes.

• Use high-calorie drinks such as homemade milkshakes or commercial liquid nutrition supplements.

Do you need extra vitamins?

Vitamins A, D, E, and K are fat-soluble vitamins. Many people with CF don’t get enough of these vitamins from the foods they eat. That’s because they have trouble digesting and absorbing fat. When this happens, you may need to take extra vitamins. Your healthcare provider can recommend the type and amount of vitamins you should take.

Do you need extra salt?

People with CF need extra salt in their diets because they lose more salt in their sweat than other people. Add extra salt by using the saltshaker at meals. Also choose more salty foods and snacks. Some of these are chips, pretzels, fast foods, French fries, pickles, nuts, and lunch meats. Extra salt intake may be vital while exercising or being in hot weather when you are sweating. Ask your healthcare team what amount of salt is right for you.

Do you need tube feedings?

Sometimes, people with CF can’t maintain weight despite a high-calorie diet. This can happen if you have frequent infections. It may also happen if you have trouble eating enough food or your body has trouble absorbing some nutrients (malabsorption). Symptoms of malabsorption include:

• Bloating

• Passing gas (flatulence)

• Bad-smelling stools

• Belly pain

• Watery diarrhea

If you can't eat enough calories, then you may need a feeding tube. For short-term feedings, you may have a small tube inserted through the nose and into the stomach. The tube is called a nasogastric (NG) tube.

Some people with CF need calorie supplements over a long period of time. In this case, a feeding tube (gastrostomy or G-tube) is placed through the stomach wall. Your healthcare provider can help you figure out a feeding schedule that works best for you.