Charley Somsanguansit

February 4, 2015
UNIVERSITY OF PITTSBURGH
School of Health and Rehabilitation Sciences
Nutrition and Dietetics
NUTR 1632: Nutrition Therapy 2

Assignment: Cystic Fibrosis (25 points)

JL is a 19 year old male who you are seeing for nutrition assessment and counseling in an outpatient pulmonary clinic.
He has cystic fibrosis complicated by newly diagnosed pancreatic insufficiency with malabsorption. He is 71 inches
tall and currently weighs 140 lb. His FEV1 is 60% of that predicted. The results of his 72-hour fecal fat test revealed
a CFA (coefficient of fat absorption) of 84%. After conducting a diet interview with JL, you have determined that he
has a fair appetite and intake, he has unintentionally lost 20 lb in the past 6 months, he is not taking any supplements,
and is moderately active.
Weight in kg= 140/2.2 = 63.64kg

Height in m= 71x2.54/100 = 1.8034m

1. Calculate and assess his IBW, % IBW, %UBW, % weight change, & BMI (8 points).
IBW = 106 + (6x11) = 172lb
% IBW = 140/172 x100 = 81.4% Mild malnutrition
% UBW = 140/160 x 100 = 87.5% Mild malnutrition
% Weight change = (160 140)/160 x100 = 12.5% in 6 month severe weight loss
BMI = 63.64/1.803^2 = 19.6 Normal
2. Using the Cystic Fibrosis Consensus Formula, calculate JL's energy needs (7 points).
REE = 15.3 x 63.64kg + 679 = 1652.64kcal
TEE = 1652.64kcal x (1.6 +0.2) = 2974.75kcal
DRE = 2974.75kcal (0.93/0.84) = 3293.5kcal
3. Calculate his protein needs (in grams) (2 points).
Protein should be 15-20% of total calories
3293.5 x.15 = 494.025/4 = 123.5g protein
3293.5 x.2 = 658.7/4 = 164.7g protein
123.5-164.7g protein
4. Would you recommend a fat restriction for this patient? Provide a rationale for your answer. If "no",
how should the patient's fat malabsorption be managed (4 points)?
No, I would not recommend a fat restriction for JL. Fat provides EFA, increases palatability,
lowers CO2 production, and is high caloric dense! We can treat his fat malabsorption with
pancreatic enzyme replacements.
5. What micronutrient supplementation would you recommend for this patient (2 points)?
MVI with minerals, fat-soluble vitamin supplementation in water-soluble form
6. Please provide 2 suggestions for how the patient can increase his energy intake (2 points):
-Regularly scheduled meals and snacks
-Include nutrient dense foods