Counseling Boosts Energy Intake in CF

NEW YORK (Reuters Health) - Behavioral and nutritional counseling improves energy intake and promotes normal growth in toddlers and preschoolers with cystic fibrosis (CF), according to results of a small study. Toddlers and preschoolers with CF often fall short of nutritional recommendations for this disease, which leads to impaired growth. This is a major problem because adequate growth from 3 to 6 years of age is associated with better lung function later on.

In the study, four young children with CF and their families were randomly assigned to 8 weeks of behavioral and nutrition intervention (BEH) and six age-matched children with CF and their families were assigned to usual care consistent with CF Foundation guidelines on nutritional care.

The intervention included nutrition counseling to increase energy intake and child behavioral management training.

The dietary intake intervention group met the clinical benchmarks of 120 percent to 150 percent RDA for energy and 35 percent to 40 percent fat intake suggested by the 2 consensus conferences on pediatric nutrition in CF, the investigators report.

Children in the control arm, in contrast, failed to show any change in energy or fat intake over the 8-week study period, despite guideline-driven nutritional care.

However, five of the six control children and their families who chose to receive the BEH intervention after the study saw significant increases in energy and fat intake as a result.

The impact of the 8-week counseling program seems to be durable, Dr. Scott W. Powers from Cincinnati Children's Hospital and colleagues report in the journal Pediatrics, noting that children who received it maintained the clinically significant increase in energy and fat intake at 3 and 12 months after treatment.

This, they say, suggests that families are able to continue to implement the skills and knowledge provided during counseling without ongoing contact with the research team or additional booster treatment sessions.

Summing up, Powers told Reuters Health, "it also appears that the intervention has great potential for improving growth." In fact, he added, a large controlled clinical trial evaluating the impact of behavioral and nutrition treatment on growth is planned.

SOURCE: Pediatrics December 2005.