Skip to main content
NCBI home page
Journal of Applied Behavior Analysis logoLink to Journal of Applied Behavior Analysis
. 1993 Winter;26(4):435–450. doi: 10.1901/jaba.1993.26-435

Increasing calorie consumption in children with cystic fibrosis: replication with 2-year follow-up.

L J Stark 1, L G Knapp 1, A M Bowen 1, S W Powers 1, E Jelalian 1, S Evans 1, M A Passero 1, M M Mulvihill 1, M Hovell 1
PMCID: PMC1297869  PMID: 8307828

Abstract

Three mildly malnourished children with cystic fibrosis and their parents participated in a behavioral group-treatment program that focused on promoting and maintaining increased calorie consumption. Treatment included nutritional education, gradually increasing calorie goals, contingency management, and relaxation training, and was evaluated in a multiple baseline design across four meals. Children's calorie intake increased across meals, and total calorie intake was 32% to 60% above baseline at posttreatment. Increased calorie consumption was maintained at the 96-week follow-up (2 years posttreatment). The children's growth rates in weight and height were greater during the 2 years following treatment than the year prior to treatment. Increases in pace of eating and calories consumed per minute were also observed 1 year posttreatment. These findings replicated and extended earlier research supporting the efficacy of behavioral intervention in the treatment of malnutrition in children with cystic fibrosis.

Full text

PDF
435

Images in this article

446Figure 3
on p.446

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allan J. D., Mason A., Moss A. D. Nutritional supplementation in treatment of cystic fibrosis of the pancreas. Am J Dis Child. 1973 Jul;126(1):22–26. doi: 10.1001/archpedi.1973.02110190018004. [DOI] [PubMed] [Google Scholar]
  2. Bell L., Durie P., Forstner G. G. What do children with cystic fibrosis eat? J Pediatr Gastroenterol Nutr. 1984;3 (Suppl 1):S137–S146. doi: 10.1097/00005176-198400031-00021. [DOI] [PubMed] [Google Scholar]
  3. Boland M. P., Patrick J., Stoski D. S., Soucy P. Permanent enteral feeding in cystic fibrosis: advantages of a replaceable jejunostomy tube. J Pediatr Surg. 1987 Sep;22(9):843–847. doi: 10.1016/s0022-3468(87)80651-6. [DOI] [PubMed] [Google Scholar]
  4. Bowman B. H., Mangos J. A. Current concepts in genetics. Cystic fibrosis. N Engl J Med. 1976 Apr 22;294(17):937–938. doi: 10.1056/NEJM197604222941707. [DOI] [PubMed] [Google Scholar]
  5. Brook C. G. Determination of body composition of children from skinfold measurements. Arch Dis Child. 1971 Apr;46(246):182–184. doi: 10.1136/adc.46.246.182. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Buchdahl R. M., Fulleylove C., Marchant J. L., Warner J. O., Brueton M. J. Energy and nutrient intakes in cystic fibrosis. Arch Dis Child. 1989 Mar;64(3):373–378. doi: 10.1136/adc.64.3.373. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Corey M., Levison H., Crozier D. Five- to seven-year course of pulmonary function in cystic fibrosis. Am Rev Respir Dis. 1976 Dec;114(6):1085–1092. doi: 10.1164/arrd.1976.114.6.1085. [DOI] [PubMed] [Google Scholar]
  8. Dalzell A. M., Shepherd R. W., Dean B., Cleghorn G. J., Holt T. L., Francis P. J. Nutritional rehabilitation in cystic fibrosis: a 5 year follow-up study. J Pediatr Gastroenterol Nutr. 1992 Aug;15(2):141–145. doi: 10.1097/00005176-199208000-00007. [DOI] [PubMed] [Google Scholar]
  9. Daniels L., Davidson G. P., Cooper D. M. Assessment of nutrient intake of patients with cystic fibrosis compared with healthy children. Hum Nutr Appl Nutr. 1987 Jun;41(3):151–159. [PubMed] [Google Scholar]
  10. Dodge J. A. Nutritional requirements in cystic fibrosis: a review. J Pediatr Gastroenterol Nutr. 1988;7 (Suppl 1):S8–11. doi: 10.1097/00005176-198811001-00003. [DOI] [PubMed] [Google Scholar]
  11. Durie P. R., Pencharz P. B. A rational approach to the nutritional care of patients with cystic fibrosis. J R Soc Med. 1989;82 (Suppl 16):11–20. [PMC free article] [PubMed] [Google Scholar]
  12. Fomon S. J., Haschke F., Ziegler E. E., Nelson S. E. Body composition of reference children from birth to age 10 years. Am J Clin Nutr. 1982 May;35(5 Suppl):1169–1175. doi: 10.1093/ajcn/35.5.1169. [DOI] [PubMed] [Google Scholar]
  13. Gurwitz D., Corey M., Francis P. W., Crozier D., Levison H. Perspectives in cystic fibrosis. Pediatr Clin North Am. 1979 Aug;26(3):603–615. doi: 10.1016/s0031-3955(16)33752-x. [DOI] [PubMed] [Google Scholar]
  14. Kraemer R., Rüdeberg A., Hadorn B., Rossi E. Relative underweight in cystic fibrosis and its prognostic value. Acta Paediatr Scand. 1978 Jan;67(1):33–37. doi: 10.1111/j.1651-2227.1978.tb16273.x. [DOI] [PubMed] [Google Scholar]
  15. Lester L. A., Rothberg R. M., Dawson G., Lopez A. L., Corpuz Z. Supplemental parenteral nutrition in cystic fibrosis. JPEN J Parenter Enteral Nutr. 1986 May-Jun;10(3):289–295. doi: 10.1177/0148607186010003289. [DOI] [PubMed] [Google Scholar]
  16. Levy L. D., Durie P. R., Pencharz P. B., Corey M. L. Effects of long-term nutritional rehabilitation on body composition and clinical status in malnourished children and adolescents with cystic fibrosis. J Pediatr. 1985 Aug;107(2):225–230. doi: 10.1016/s0022-3476(85)80130-x. [DOI] [PubMed] [Google Scholar]
  17. Luder E., Kattan M., Thornton J. C., Koehler K. M., Bonforte R. J. Efficacy of a nonrestricted fat diet in patients with cystic fibrosis. Am J Dis Child. 1989 Apr;143(4):458–464. doi: 10.1001/archpedi.1989.02150160084017. [DOI] [PubMed] [Google Scholar]
  18. MacDonald A., Holden C., Harris G. Nutritional strategies in cystic fibrosis: current issues. J R Soc Med. 1991;84 (Suppl 18):28–35. [PMC free article] [PubMed] [Google Scholar]
  19. MacDonald A., Kelleher J., Littlewood J. M. A normal fat diet for cystic fibrosis: is a dietitian still needed? Scand J Gastroenterol Suppl. 1988;143:157–159. doi: 10.3109/00365528809090238. [DOI] [PubMed] [Google Scholar]
  20. Mansell A. L., Andersen J. C., Muttart C. R., Ores C. N., Loeff D. S., Levy J. S., Heird W. C. Short-term pulmonary effects of total parenteral nutrition in children with cystic fibrosis. J Pediatr. 1984 May;104(5):700–705. doi: 10.1016/s0022-3476(84)80947-6. [DOI] [PubMed] [Google Scholar]
  21. Matthews L. W., Drotar D. Cystic fibrosis--a challenging long-term chronic disease. Pediatr Clin North Am. 1984 Feb;31(1):133–152. doi: 10.1016/s0031-3955(16)34541-2. [DOI] [PubMed] [Google Scholar]
  22. O'Loughlin E., Forbes D., Parsons H., Scott B., Cooper D., Gall G. Nutritional rehabilitation of malnourished patients with cystic fibrosis. Am J Clin Nutr. 1986 May;43(5):732–737. doi: 10.1093/ajcn/43.5.732. [DOI] [PubMed] [Google Scholar]
  23. O'Rawe A., McIntosh I., Dodge J. A., Brock D. J., Redmond A. O., Ward R., Macpherson A. J. Increased energy expenditure in cystic fibrosis is associated with specific mutations. Clin Sci (Lond) 1992 Jan;82(1):71–76. doi: 10.1042/cs0820071. [DOI] [PubMed] [Google Scholar]
  24. Ramsey B. W., Farrell P. M., Pencharz P. Nutritional assessment and management in cystic fibrosis: a consensus report. The Consensus Committee. Am J Clin Nutr. 1992 Jan;55(1):108–116. doi: 10.1093/ajcn/55.1.108. [DOI] [PubMed] [Google Scholar]
  25. SHWACHMAN H., KULCZYCKI L. L. Long-term study of one hundred five patients with cystic fibrosis; studies made over a five- to fourteen-year period. AMA J Dis Child. 1958 Jul;96(1):6–15. doi: 10.1001/archpedi.1958.02060060008002. [DOI] [PubMed] [Google Scholar]
  26. Sanders M. R., Rebgetz M., Morrison M., Bor W., Gordon A., Dadds M., Shepherd R. Cognitive-behavioral treatment of recurrent nonspecific abdominal pain in children: an analysis of generalization, maintenance, and side effects. J Consult Clin Psychol. 1989 Apr;57(2):294–300. doi: 10.1037//0022-006x.57.2.294. [DOI] [PubMed] [Google Scholar]
  27. Shepherd R. W., Holt T. L., Thomas B. J., Kay L., Isles A., Francis P. J., Ward L. C. Nutritional rehabilitation in cystic fibrosis: controlled studies of effects on nutritional growth retardation, body protein turnover, and course of pulmonary disease. J Pediatr. 1986 Nov;109(5):788–794. doi: 10.1016/s0022-3476(86)80695-3. [DOI] [PubMed] [Google Scholar]
  28. Shepherd R. W., Thomas B. J., Bennett D., Cooksley W. G., Ward L. C. Changes in body composition and muscle protein degradation during nutritional supplementation in nutritionally growth-retarded children with cystic fibrosis. J Pediatr Gastroenterol Nutr. 1983;2(3):439–446. doi: 10.1097/00005176-198302030-00008. [DOI] [PubMed] [Google Scholar]
  29. Singer L. T., Nofer J. A., Benson-Szekely L. J., Brooks L. J. Behavioral assessment and management of food refusal in children with cystic fibrosis. J Dev Behav Pediatr. 1991 Apr;12(2):115–120. [PMC free article] [PubMed] [Google Scholar]
  30. Stark L. J., Bowen A. M., Tyc V. L., Evans S., Passero M. A. A behavioral approach to increasing calorie consumption in children with cystic fibrosis. J Pediatr Psychol. 1990 Jun;15(3):309–326. doi: 10.1093/jpepsy/15.3.309. [DOI] [PubMed] [Google Scholar]
  31. Tomezsko J. L., Stallings V. A., Scanlin T. F. Dietary intake of healthy children with cystic fibrosis compared with normal control children. Pediatrics. 1992 Oct;90(4):547–553. [PubMed] [Google Scholar]
  32. Vaisman N., Clarke R., Pencharz P. B. Nutritional rehabilitation increases resting energy expenditure without affecting protein turnover in patients with cystic fibrosis. J Pediatr Gastroenterol Nutr. 1991 Nov;13(4):383–390. doi: 10.1097/00005176-199111000-00008. [DOI] [PubMed] [Google Scholar]
  33. Wood R. E., Boat T. F., Doershuk C. F. Cystic fibrosis. Am Rev Respir Dis. 1976 Jun;113(6):833–878. doi: 10.1164/arrd.1976.113.6.833. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Applied Behavior Analysis are provided here courtesy of Society for the Experimental Analysis of Behavior

RESOURCES