Energy balance and the accuracy of reported energy intake in preadolescent children with cystic fibrosis

Abstract

Background: Suboptimal growth and nutritional status are common among children with cystic fibrosis (CF) and pancreatic insufficiency (PI). A better understanding of energy balance is required to improve prevention and treatment of malnutrition. Objective: Our objective was to characterize energy balance and the reporting accuracy of dietary intake in children with CF by evaluating the relations between energy intake (EI), energy expenditure (EE), fecal energy loss, nutritional status, and growth. Design: The subjects were participants of a 24-mo prospective study of children 6 -10 y of age with CF and PI. EE, EI, fecal energy loss, and anthropometric measures were obtained at baseline and at 24 mo. Results: The children (n ҃ 69) had suboptimal growth at baseline (x Ȁ SD: weight-for-age z score, Ҁ0.53 Ȁ 1.19; adjusted heightfor-age z score, Ҁ0.67 Ȁ 1.06; body mass index z score, Ҁ0.29 Ȁ 1.12), and these variables remained suboptimal at 24 mo. The median ratios of EI to EE at baseline and 24 mo were 1.15 and 1.18, respectively, which decreased to 1.09 and 1.10, respectively, when adjusted for fecal energy loss (EI ҀFL :EE). At baseline, 7% of subjects were underreporters, 64% were accurate reporters, and 23% were overreporters of energy intake; the percentages were similar at 24 mo. Conclusions: Although EI ҀFL :EE ratios were higher than expected at both baseline and 24 mo, this cohort showed only age-appropriate weight gain. Self-reported dietary intake data at the individual level should be interpreted with caution, and weight gain velocity may serve as an objective measure of long-term energy balance. J Clin Nutr 2006;84:523-30. Am

Energy expenditure: how much does it matter in infant and pediatric chronic disorders?

“…Furthermore, there may be inaccurate reporting of nutrient intake that contributes to erroneous energy balance calculations in some chronic illnesses. In children with CF, parental report of the child's energy intake may be higher than the actual amount (22). Trabulsi et al observed overreporting of actual energy intake in a quarter of their cohort of preadolescent children with CF.…”

Validity of dietary assessment methods compared with doubly labeled water in children: A systematic review and meta‐analysis

“…Sample sizes in these studies ranged from 9 to 118 participants. The studies were conducted in various countries, including the USA, 4,40,42,53,55,60,61,[63][64][65][66][67]70 Sweden, 41,43,45,54,57,62 the UK, 39,44,56,58,68,69 China, 46 Australia, 47,[49][50][51]59 the Netherlands, 52 and one as a multi-center study across two countries (Belgium and Spain). 48 The age of participants varied from 1.5 to 18 years; however, one study did not provide information on the mean or range of participants' ages.…”

“…Various methods were employed to assess total EI, with the food records being the most frequently utilized dietary assessment tool. 4,39,40,42,45,47,49,53,55,59,62,63,66,[68][69][70] These studies used imageassisted food records, 40 remote food photography methods (RFPM), 42 Tool for Energy Balance in Children (TECH), 45 and weighed food records (WFR). 49,55,69 One study used computerized 24-h recall, 48 and four studies used multiple-pass 24-h recall.…”

“…4,39,40,42,45,47,49,53,55,59,62,63,66,[68][69][70] These studies used imageassisted food records, 40 remote food photography methods (RFPM), 42 Tool for Energy Balance in Children (TECH), 45 and weighed food records (WFR). 49,55,69 One study used computerized 24-h recall, 48 and four studies used multiple-pass 24-h recall. 56,58,64,65 FFQ, 52,60 semiquantitative FFQ, 67 and diet history 54,57,69 were the other dietary assessment methods.…”

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“…Treatment involves behavioral therapy, use of nutritional supplements, and the use of enteral diet via a nasoenteral tube in an acute phase and via gastrostomy for prolonged use. 198 - 201 …”