Tag: nutrition

High Calorie Meal-Time Make-Over


By JULIE MATEL, RD, Stanford University CF Care Centre

cool-hunter-mcdonalds-fashion-makeover-1One of the challenges of living with cystic fibrosis is consuming enough calories to meet growth and weight gain goals. People with CF need 20 to 50 percent more calories than people without CF. For active teens and adults this can be as many as 3000 to 5000 calories: whereas someone without CF might require 2000 calories per day. Why so many calories?
People with CF may not absorb all of the calories from their food, even when taking enzymes with all meals and snacks. People
with CF may need more calories to breathe and to fight infections. Getting enough calories can feel like an insurmountable task
for people with CF. Below are some tips that may help.
1. Be an informed consumer
• Read labels
when you shop find the brand with the highest
amount of calories per serving. For example, one brand of
ice cream may have as many as 300 calories per ½ cup serving
versus 130 calories per serving in another brand!
2. Be consistent
• Avoid skipping meals.
Missing breakfast, for example can
leave you short calories for the day.
• Aim for three meals plus two to three snacks per day.
Eating multiple times during the day makes it more likely to
get the nutrition and calories you need.
• Bed-time snack.
Make this a routine. Choose comfort
foods such as whole milk and cookies or granola with full-fat
yogurt as a snack to look forward to before bed
3. Make your calories count
• Choose calorie dense foods
at meal and snack times.
• Avoid beverages between meals and snacks,
such as juice or soda. These can hinder appetites. Consume water between
meals and snacks instead.
4. Look for creative ways to add calories.
Below are some high calorie ideas:
* Trail mix in place of chips
* Muffins or croissants instead of plain bread
* Whole milk or half-and-half in place of low-fat milk
*Add cheese or guacamole or mayonaise to burgers and sandwiches
*Add crumbled bacon to rice, soup, pasta, eggs, or
* Include a milkshake or smoothie each
day as a snack
* Add peanut butter or whole-fat yogurt
to fruits
* Butter all toast, bread and sandwiches thickly with salted butter

Continue reading “High Calorie Meal-Time Make-Over”

Bowel movements are a good indicator of health

Much to the chagrin and embarrassment of CF patients everywhere, bowel movements are an important part of our lives. In many ways our bowel movements serve as a benchmark that lets us know how things are going, so to speak, with our digestive systems. Cystic fibrosis patients with pancreatic insufficiency should be especially aware of all things related to their digestive process, and be able to identify what’s normal for them and what isn’t.

When the pancreas is too blocked by mucus, it can’t deliver the enzymes necessary to break down the foods we eat, particularly proteins and fats. As a result, people with CF may have more frequent bowel movements because they are not absorbing the protein and fat that they are eating. As if that weren’t embarrassing enough, CF patients are also prone to flatulence (gas). Their gas and BMs can be particularly foul-smelling as the result of proteins and fats not being absorbed by the body.

So how can a person with CF determine what’s a normal BM and what isn’t? Consider these three factors:

1) Color

2) Condition

3) Quantity


Brown is generally the “preferred” color of healthy stool, though there may be different variations on that theme.

The liver excretes bile salts into the stool, giving it a normal brown color. Obstruction to the flow of bile out of the liver (you may see the word “cholestasis”), or liver infections like viral hepatitis, may produce clay-colored stools .

Black, tarry stools with a foul odor can be the result of eating certain foods, taking iron supplements, or possibly from internal bleeding. Foods that are dark blue or black in color may also cause black stools. Examples of foods and minerals causing dark stools include: black licorice, blueberries, iron supplements, lead, Pepto Bismol (contains bismuth.)

Green , leafy vegetables contain chlorophyll which could be coloring the stool green . Another possibility is that the stool has passed too quickly through the large intestine and has not yet had all of the bile absorbed. Sometimes newborns have green colored stools, and this is perfectly normal.

Patients with cystic fibrosis often have gall bladder issues, which can cause the stools to appear orange. This is because bile, which normally helps process fats in foods may not be excreted adequately. Stools are usually orange if they contain a lot of oil and fat that the bile salts have not had enough time to break down. A lack of bile (because of bile blockage such as gall stones) can also cause stools to appear orange. Orange, greasy stools are particularly foul-smelling, and may be difficult to control.


Healthy stools should be uniform in shape and consistency. They should sink and not float. Floating stool is evidence that you are not absorbing enough fat from your food.

Loose, watery stools may indicate a stomach virus, especially if they are concurrent with vomiting. In young children especially, it’s important not to let diarrhea lead to dehydration. Dehydration as a result of lost water through the stools may also contribute to intestinal blockage. If the small intestine, which usually adds water to digested food, is unable to do so, the fecalization process cannot take place and the stool can back up into the upper gastrointestinal system.

Stools that are difficult and painful to pass are often the result of not enough fiber in the diet. Patients with cystic fibrosis have to strike a delicate balance between having just enough BMs to prevent bowel obstruction, but not so many that they lose water and vital nutrients.


Cystic fibrosis patients are encouraged to eat several small meals throughout the day instead of 3 large ones, as a way to avoid painful bloating and stomach pains. This means that for some people, going to the bathroom 6 times a day is just part of life. Some patients with cystic fibrosis are very regular in their bathroom habits, and can accurately predict which foods will go through more quickly than others. Usually it’s the foods that are high in fat content that cause a person to use toilet shortly after eating.

One of the earliest signs of cystic fibrosis is a condition called meconium ileus. Approximately 20% of cystic fibrosis will be diagnosed at birth because of mecomium ileus. Meconium is the material present in the intestines of a newborn. In meconium ileus, intestinal obstruction results from the impaction of thick, tenacious meconium in the small bowel.