(P14-084-23) Young Children With Cystic Fibrosis Have Worse Diet Quality Compared to a Nationally Representative Sample and May Be Influenced by Their Home Food Environment

Objectives: (1) To examine diet quality and growth among young children initiating cystic fibrosis(CF) transmembrane conductance regulator(CFTR) modulator therapy for 24 weeks,(2) compare diet quality scores with national averages and (3) explore home environment and dietary pattern relations. We hypothesized higher diet quality would be associated with greater improvements in growth and children with CF would have worse diet quality.

Methods: Children 2-5 years with CF were recruited from the USA and Canada. Height, weight and BMI were measured in triplicate and averaged. Z-scores were calculated using CDC reference data. Intake was measured via 3-day weighted food records. The Healthy Eating Index(HEI) was generated using the USDA scoring system for each record day and averaged. Outcomes were assessed before treatment, 12 and 24 weeks after beginning medication. Mixed longitudinal models and correlations were used.

Results: Participants(2.8±1.3 years, mean±SD, 42% male) who completed food records at baseline were included(n=17) and had significant increases in weight-for-age z-score(WAZ) at 12(0.17±0.3, p=0.003) and 24 weeks(0.28±0.3, p< 0.001) following therapy. There was no significant change in height-for-age z-score(HAZ), BMI-for-age z-score(BMIZ) or head circumference-for-age z-score(HCZ) at 12 or 24 weeks. HEI total and individual components did not change over 24 weeks, but baseline scores were lesser in children with CF for total HEI, total vegetables, greens and beans, total fruit, whole fruit, whole grains, total dairy, total protein, sea and plant protein, fatty acids(all p< 0.05) and greater for refined grains. Medicaid status was inversely associated with sea and plant protein scores(r=-0.55, p=0.03), number of adults in the house was positively correlated with fatty acid(r=0.62, p=0.01) and saturated fatty acid scores(r=0.60, p=0.01), and number of children was negatively correlated with refined grain scores(r=-0.71, p=0.002).

Conclusions: CF diet recommendations are changing as a result of CFTR modulator therapy and examining diet patterns among children is important. These data indicate relatively stable, but poor diet quality among children with CF. Medicaid status and the number of children and adults residing in the home may affect diet quality.

Funding Sources: Vertex Pharmaceutics & Center for Human Phenomic Science, CHOP