Resultado de intervenção nutricional em crianças e adolescentes com fibrose cística / Results of nutritional intervention in children and adolescents with cystic fibrosis

Objetivo: poucos estudos têm verificado longitudinalmente a evoluçäo do estado nutricional de pacientes com fibrose cística. O objetivo deste estudo foi acompanhar a evoluçäo do estado nutricional, composiçäo corporal e consumo de energia, macro e micronutrientes ingeridos por crianças e adolescentes, mediante intervençäo nutricional, no Ambulatório de Fibrose Cística/Pneumologia Pediátrica, do Departamento de Pediatria da UNIFESP.Métodos: a casuística constituiu-se de 18 pacientes, sendo 13 do sexo masculino e 5 do feminino, faixa etária de 0,3 a 18,4 anos. Realizaram-se 3 avaliaçöes: no momento 1 (M1: pré-intervençäo nutricional), no M2, após 6 meses, e no M3, após 12 meses. Foram analisados nos 3 momentos: o escore Z de peso/idade (P/I), peso/estatura (P/E) e estatura/idade (E/I) e o cálculo do registro alimentar de 3 dias. No M1 e M3, verificou-se a composiçäo corporal (antropometria). A conduta nutricional foi hipercalórica, hiperprotéica e houve adequaçäo de macro e micronutrientes.Resultados: observou-se aumento significante do escore Z de E/I (M1=-1,07; M2=-0,69; M3=-0,50) e de massa magra após a intervençäo nutricional, sem melhora no escore Z de P/E e massa gorda. Verificou-se aumento no consumo energético nos M2 (139 por cento) e M3 (132 por cento) em relaçäo ao M1 (106 por cento). Houve considerável aumento no consumo de proteína, cálcio, ferro e vitamina C pelos pacientes. A presença de anemia ocorreu em 44,4 por cento (8/18) dos pacientes.Conclusäo: o aumento no escore Z de E/I e massa magra ocorreu devido a adequaçäo no consumo de energia, após a intervençäo nutricional. Näo houve melhora significante no escore Z de P/E e massa gorda, em funçäo do ganho de estatura e de massa magra

[Results of nutritional intervention in children and adolescents with cystic fibrosis]. / Resultado de intervenção nutricional em crianças e adolescentes com fibrose cística.

OBJECTIVE: Few studies have verified longitudinally the evolution of the nutritional status of patients with cystic fibrosis. The objective of this study is to follow the evolution of the nutritional status, body composition and energy consumption, macronutrients and micronutrients ingested by children and adolescents by means of nutritional interventions at the Clinic of Cystic Fibrosis/Pediatric Pneumology of the Department of Pediatrics of Universidade Federal de São Paulo. METHODS: 18 patients were involved in this study, thirteen males and five females with ages ranging from 0.3 to 18.4 years. We performed three evaluations: evaluation 1 (M1--prenutritional intervention), M2 after 6 months, and M3 after 12 months. In these three instances we verified: the z score for weight/age, weight/height and height/age and the calculation of a 3-day diet record. We verified the body composition (anthropometry) in M1 and M3. The nutritional interventions were hypercaloric, hyperproteic, with adequate amount of ingested macronutrients and micronutrients. RESULTS: We observed an increase in the z score for height/age (M1=-1.07; M2=-0.69; M3=-0.50) and fat-free mass after the nutritional interventions, without improvement in the z score for weight/height and fat mass. We verified an increase in the energy intake during M2 (139%) and M3 (132%) compared to M1 (106%). Remarkable increase in the intake of protein, calcium, iron and vitamin C by the patients was found. The occurrence of anemia was found in 44% (8/18) of the patients. CONCLUSION: The improvement of the z score in height/age and fat-free mass was probably due to the increase in energy consumption after the nutritional intervention. A significant improvement in the z score for weight/height and fat mass was not found, probably due to a gain in height and fat-free mass.