Dietary intakes and quality of Irish adults with cystic fibrosis: Comparisons to nutrition guidelines and HEI-2020

Background With evolving Cystic Fibrosis (CF) phenotypes resulting from changes to clinical management, healthier dietary practices are warranted for many people with CF. Whilst diet composition is reported, diet quality data is lacking in CF. This study aims to evaluate dietary intakes and diet quality in adults with CF via guideline comparison and a validated diet quality index. Methods Cross-sectional study of Irish adults with CF. Demographic questionnaires and three-day food diaries were completed. Healthy Eating Index – 2020 (HEI-2020) assessed diet quality. Data was statistically analysed in SPSS®. Results Of n = 68 participants (female: 58.8 %, age: 35.2 ± 10.1 years, FEV₁%: 77.4 ± 25.1 %), 36.8 % were overweight/obese and 77.6 % pancreatic insufficient. While median (interquartile range) percentage estimated average requirement (EAR) was 110.1 (45.3) %, 50.0 % of participants were below CF energy requirements (110 % EAR). Mean percentage total energy intake (%TEI) protein (18.0 ± 3.9 %) aligned to dietary reference values (DRV). %TEI carbohydrates (44.1 ± 6.5 %) was below, and %TEI fat (37.1 ± 5.4 %), saturated fat (14.1 ± 3.3 %) and sugar (17.4 ± 5.6 %) exceeded DRV. Median vitamin A intake was adequate [936.6 (1005.2) µg], but vitamin D [3.6 (4.3) µg], E (9.6 ± 5.2 mg) and K₁ [31.1 (71.2) µg] intakes were insufficient without supplementation. Regarding Irish healthy eating guidelines, 95.6 % of participants overconsumed energy-dense nutrient poor (EDNP) foods, with 76.5 % below vegetables, salad and fruit intake guidelines. Participants’ mean HEI-2020 score (0–100) was 59.3 ± 12.4. Conclusion Findings indicate suboptimal diet quality. Despite reliance on EDNP foods, many did not achieve energy targets. Moving forward, emphasis on diet quality is of paramount importance to improve overall health in people with CF.