Table 3

Dietary recommendations for CFRD

NutrientType 1 and type 2 diabetesCFRD
CaloriesAs needed for growth, maintenance, or reduction diets1.2–1.5 times DRI for age; individualized based on weight gain and growth
CarbohydrateIndividualized. 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.
FatLimit 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.
Protein15–20% of total calories; reduction to 0.8–1.0 g/kg with nephropathyApproximately 1.5–2.0 times the DRI for age; no reduction for nephropathy
Sodium<2,300 mg/day for blood pressure controlLiberal, high salt diet, especially in warm conditions and/or when exercising
Vitamins, mineralsNo supplementation necessary unless deficiency notedRoutine supplementation with CF-specific multivitamins or a multivitamin and additional fat-soluble vitamins A, D, E, and K
AlcoholIf 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 mellitusRestricted calories/carbohydrate for weight and blood glucose controlNo calorie or carbohydrate restriction; adequate kcals for weight gain
    IGTWeight loss of 5–10% recommended; low-fat dietNo weight loss. Spread carbohydrates throughout the day; consume nutrient-dense beverages.
  • DRI, daily recommended intake.