Table 3.
Dietary recommendations for CFRD
| Nutrient | Type 1 and type 2 diabetes | CFRD |
|---|---|---|
| Calories | As needed for growth, maintenance, or reduction diets | 1.2–1.5 times DRI for age; individualized based on weight gain and growth |
| Carbohydrate | Individualized. Monitor carbohydrates to achieve glycemic control; choose from fruits, vegetables, whole grains and fiber-containing foods, legumes, and low-fat milk. Sugar alcohols and nonnutritive sweeteners are safe within U.S. Food and Drug Administration–established consumption guidelines. | Individualized. Carbohydrates should be monitored to achieve glycemic control. Artificial sweeteners should be used sparingly due to lower calorie content. |
| Fat | Limit saturated fat to <7% of total calories; intake of trans fat should be minimized; limit dietary cholesterol to <200 mg/day. Consume two or more servings per week of fish high in n-3 polyunsaturated fatty acids. | No restriction on type of fat. High fat necessary for weight maintenance. Aim for 35–40% total calories. |
| Protein | 15–20% of total calories; reduction to 0.8–1.0 g/kg with nephropathy | Approximately 1.5–2.0 times the DRI for age; no reduction for nephropathy |
| Sodium | <2,300 mg/day for blood pressure control | Liberal, high salt diet, especially in warm conditions and/or when exercising |
| Vitamins, minerals | No supplementation necessary unless deficiency noted | Routine supplementation with CF-specific multivitamins or a multivitamin and additional fat-soluble vitamins A, D, E, and K |
| Alcohol | If consumed, limit to a moderate amount; one drink per day for women and two or less drinks per day for men. | Consult with physician because of the higher prevalence of liver disease in CF and possible use of hepatotoxic drugs. |
| Special circumstances | ||
| Gestational diabetes mellitus | Restricted calories/carbohydrate for weight and blood glucose control | No calorie or carbohydrate restriction; adequate kcals for weight gain |
| IGT | Weight loss of 5–10% recommended; low-fat diet | No weight loss. Spread carbohydrates throughout the day; consume nutrient-dense beverages. |
DRI, daily recommended intake.