Walters S
University of Birmingham, Edgbaston, UK.
J Hum Nutr Diet. 2001 Apr;14(2):83-91. doi: 10.1046/j.1365-277x.2001.00274.x.
Good nutritional status in cystic fibrosis (CF) is associated with improved clinical status and survival. In some conditions where dietary and pharmacological treatment are important (e.g. diabetes), a combination of eating disorders and failure of treatment compliance has been reported. Cases of eating disorders have been reported in CF. Societal pressures on young women to remain slim may compromise optimum clinical management as women are content to remain underweight.
To determine whether women have different perception of their weight than men with CF and whether this manifests in different nutritional behaviour.
Confidential postal questionnaire to 1870 adults with CF in 1994 known to the Association of Cystic Fibrosis Adults (UK). Participants were asked their own weight and height, and their perception of their weight. Very underweight was defined as < 85% ideal body weight, underweight as 85-94%, normal weight as 95-104%, overweight as 105-114% and very overweight as 115% and over.
A significantly higher proportion of women than men who are very underweight (29% vs. 11%) or underweight (41% vs. 15%) saw themselves as being of normal weight or overweight. Conversely, a significantly higher proportion of men than women who were normal weight (42% vs. 19%) saw themselves as underweight. All P-values < 0.01. A significantly higher proportion of people who perceived themselves to be underweight were taking oral or enteral food supplements compared with those who did not (77% vs. 30%, P < 0.05). Multiple logistic regression showed that perception of self as underweight was the strongest predictor of taking oral or enteral food supplements (adjusted odds ratio 2.42), even after adjustment for age, sex, overall severity score, body mass index, and seeing a dietitian in the last year.
Young women with CF tend to overestimate their weight, and young men with CF underestimate their weight when compared with their actual body weight. Perception of self as underweight is reflected in nutritional behaviour, being a significantpredictor of taking oral and enteral food supplements. People working with young patients with CF should be aware of these sex differences in weight perception, and work with young women and young men with CF to achieve a realistic perception of body weight and realistic nutritional goals. There is a need for further research into body image, weight perception, eating behaviour and adherence to pancreatic enzyme supplementation and oral and enteral food supplementation in young patients with CF.
囊性纤维化（CF）患者良好的营养状况与临床状况改善及生存率提高相关。在一些饮食和药物治疗很重要的疾病（如糖尿病）中，曾有饮食失调与治疗依从性差并存的报道。CF患者中也有饮食失调的病例报告。社会对年轻女性保持苗条的压力可能会影响最佳临床管理，因为女性甘愿体重偏低。
确定CF女性患者与男性患者对自身体重的认知是否不同，以及这是否体现在不同的营养行为上。
1994年向英国囊性纤维化成人协会登记的1870例成年CF患者邮寄保密问卷。询问参与者的体重、身高以及他们对自己体重的认知。体重极低定义为低于理想体重的85%，体重偏低为85% - 94%，正常体重为95% - 104%，超重为105% - 114%，极度超重为115%及以上。
体重极低（29%对11%）或体重偏低（41%对15%）的女性中，认为自己体重正常或超重的比例显著高于男性。相反，体重正常的男性（42%对19%）认为自己体重偏低的比例显著高于女性。所有P值均<0.01。与未这样认为的人相比，认为自己体重偏低的人服用口服或肠内营养补充剂的比例显著更高（77%对30%，P<0.05）。多因素logistic回归显示，自我认知为体重偏低是服用口服或肠内营养补充剂的最强预测因素（调整后的优势比为2.42），即使在对年龄、性别、总体严重程度评分、体重指数以及过去一年是否看过营养师进行调整后也是如此。
与实际体重相比，CF年轻女性往往高估自己的体重，而CF年轻男性则低估自己的体重。自我认知为体重偏低反映在营养行为上，是服用口服和肠内营养补充剂的重要预测因素。治疗CF年轻患者的人员应意识到体重认知方面的这些性别差异，并与CF年轻女性和男性合作，以实现对体重的现实认知和现实的营养目标。有必要进一步研究CF年轻患者的身体形象、体重认知、饮食行为以及对胰酶补充剂和口服及肠内营养补充剂的依从性。
