NUTRITION INTERVENTION FOR WEIGHT-GAIN IN CYSTIC-FIBROSIS - A META ANALYSIS

Objectives: A meta analysis of the literature on treatment approaches to malnutrition in cystic fibrosis (CF) was conducted to evaluate the effectiveness of oral supplementation, enteral nutrition, parenteral n utrition, and behavioral intervention on weight gain before and after treatment. Study design: Eighteen studies were reviewed: four behavior al, sir. supplement, five enteral nutrition, and three parenteral nutr ition. Results: The weighted effect size for weight gain was large for each intervention: 1.51 behavioral, 1.62 oral, 1.78 enteral, and 2.20 parenteral intervention. All interventions produced a large effect fo r weight gain in patients with CF. A univariate analysis of variance i ndicated no significant difference among the four interventions, F(3, 17) = 0.87, p > 0.05. Effect size for calorie intake was also evaluate d when data were available (N = 7 studies), yielding a sample size of three behavioral, two enteral, and two oral supplement studies. Analys is of variance indicated a significant effect for treatment, F(2,4) = 13.34, p < 0.05, with post hoc analysis indicating that the behavioral intervention had a greater effect size for calorie intake than oral s upplement. Conclusions: All interventions were effective in producing weight gain in patients with CF. Behavioral intervention appeared to b e as effective in improving weight gain in patients with CF as more in vasive medical procedures. These findings support continued research o n nutrition intervention with patients with CF including controlled cl inical trials of the interventions and long-term follow-up on the impa ct of nutrition on disease progression.