Oral nutritional supplements in patients with cystic fibrosis: research results

Vers V. Zarubina; Зарубина Вера В.; Olga V. Vysokolova; Высоколова Ольга В.; Mariya A. Mukhina; Мухина Мария А.; Elena E. Yakushina; Якушина Елена Е.; Тatiana N. Kekeeva; Кекеева Татьяна Н.; Irina P. Vitkovskaya; Витковская Ирина П.

doi:10.17816/medjrf636590

Oral nutritional supplements in patients with cystic fibrosis: research results

Authors: Zarubina V.V.¹, Vysokolova O.V.¹, Mukhina M.A.¹, Yakushina E.E.¹, Kekeeva Т.N.¹, Vitkovskaya I.P.²^,3
Affiliations:
1. Morozov Children's Municipal Clinical Hospital
2. Russian Research Institute of Health
3. The Russian National Research Medical University named after N.I. Pirogov
Issue: Vol 30, No 6 (2024)
Pages: 604-615
Section: Original Research Articles
URL: https://journals.rcsi.science/0869-2106/article/view/292637
DOI: https://doi.org/10.17816/medjrf636590
ID: 292637

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Abstract

BACKGROUND: The nutritional status of patients with cystic fibrosis significantly affects their survival and the function of all organs, particularly the lungs. Due to increased protein and energy needs, these patients often require high-calorie and high-protein oral nutritional supplements (ONS).

AIM: To assess the tolerability, efficacy, and safety of the ONS containing whey protein and soy lecithin.

MATERIALS AND METHODS: The data of 14 patients with mixed form of cystic fibrosis and nutritional deficiencies, aged between 6 and 16 years, were analyzed. Five patients received ONS containing whey protein and soy lecithin (Fresubin Protein®) as monotherapy (Group 1), four patients received the same therapeutic food together with emulsion of medium-chain triglycerides (Group 2), and five patients received ONS balanced in protein, fat, and carbohydrates (control group). The dynamics between percentile and Z-Scores of body mass index (BMI) at the beginning and at the end of the study period (day 180±2) were used as the main efficacy parameter of the investigated food. Body fat and lean body mass were assessed by caliperometry as additional efficacy parameters.

RESULTS: All patients showed an increase in Z-Score and BMI percentile from baseline while taking ONS containing whey protein and soy lecithin both as monotherapy and in combination with medium-chain triglyceride emulsion. There were no statistically significant differences from the control group (p >0.05). However, Group 1 (100% of patients) demonstrated positive changes in muscle mass gain, as evidenced by caliperometry data, which was statistically significant (p <0.05) compared with the control group (20%). In Group 2, muscle gain was observed in 75% of the patients (p >0.05).

CONCLUSION: These findings suggest that protein-enriched ONS not only increase BMI but also contribute to muscle mass gain in patients with cystic fibrosis. New therapeutic approaches are needed, such as the inclusion of high-protein ONS in the diet to prevent muscle mass loss, along with the monitoring of body composition to improve control of disease progression.

Keywords

cystic fibrosis, nutritional support, oral nutritional supplements, malnutrition, whey protein

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MD, Cand. Sci. (Medicine), Associate Professor

Russian Federation, Moscow; Moscow

References

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