Cystic Fibrosis & Sports Nutrition

Why Nutrition Matters for Athletes with Cystic Fibrosis

People with cystic fibrosis (CF) face unique challenges that affect their ability to perform sport and exercise. Thick mucus in the lungs, pancreatic insufficiency, and chronic inflammation can lead to:

• Increased calorie expenditure
• Difficulty absorbing fatsoluble vitamins
• Frequent infections that reduce training volume

Because of these factors, a welldesigned nutrition plan is essential not only for overall health but also for sustaining performance, supporting recovery, and preventing muscle loss.

Energy Needs: Calorie Requirements

Most individuals with CF require 110130% of the standard Recommended Dietary Allowance (RDA) for calories. Active adolescents and adults can need 2,5004,000kcal/day, depending on sport intensity and body size.

Key tip: Track daily intake for at least two weeks using a food diary or app, then adjust to maintain a stable weight or achieve a gradual gain if underweight.

Macronutrient Guidelines

Carbohydrates

Carbohydrates remain the primary fuel for highintensity activities. Aim for 57g per kilogram of body weight per day, with higher amounts (up to 10g/kg) on heavy training days.

Proteins

Protein supports muscle repair and immune function. Recommendations are 1.21.5g/kg body weight daily. Include a source of highquality protein (lean meat, dairy, eggs, soy, or whey) in every meal.

Fats

Because many people with CF have pancreatic insufficiency, fat digestion can be limited. Use pancreatic enzyme replacement therapy (PERT) with every meal that contains fat.

Target 3035% of total calories from fat, focusing on unsaturated fats: olive oil, avocado, nuts, and fatty fish (omega3 EPA/DHA).

Hydration Strategies

CF patients often have salty sweat, especially in hot climates. Replace both water and electrolytes.

• Drink 500ml of fluid 30min before activity.
• Consume 150250ml every 1520min during exercise.
• Postexercise, replace 1.5L of fluid for each kilogram of body weight lost (weigh before and after).

Consider oral rehydration solutions that contain sodium (400700mg/L) and potassium (200300mg/L) for longer sessions.

Supplements Commonly Used in CF Sports Nutrition

Always discuss supplements with a CFspecialist dietitian or physician before adding them.

• Pancreatic Enzymes essential with every meal containing fat, protein, or carbs.
• FatSoluble Vitamins (A, D, E, K) highdose preparations are standard due to malabsorption.
• Creatine Monohydrate 35g daily can improve sprint performance and muscle recovery without affecting CF pathology.
• Omega3 Fatty Acids 12g EPA/DHA per day may reduce inflammation and improve lung function.
• Protein Powders (Whey or PlantBased) convenient for meeting protein goals, especially after training.
• Electrolyte Tablets useful during hot workouts to offset salt loss.

Meal Timing & Performance

PreExercise (23hours before)

Consume a carbohydraterich meal (11.5g/kg) with moderate protein and low fat to ensure gastric emptying. Example: oatmeal with banana, honey, and a scoop of whey.

During Exercise (60min)

Provide 3060g of carbs per hour via sports drinks, gels, or dried fruit. Add a pinch of salt if sweat is heavy.

PostExercise (within 30minutes)

Prioritize a 3:1 carbohydratetoprotein ratio to replenish glycogen and stimulate muscle protein synthesis. Example: chocolate milk, a smoothie with fruit, Greek yogurt, and a dash of flaxseed oil.

Evening Recovery

Include a balanced dinner with complex carbs, lean protein, and healthy fats. Finish with a vitaminD fortified dessert or a small glass of fortified milk to aid bone health.

Practical Tips for Everyday Life

• Keep portable snacks (protein bars, nuts, dried fruit) in your gym bag.
• Set reminders to take enzymes with every bite; timing matters.
• Use a digital scale to measure portion sizes accurately.
• Plan meals around training cycles increase carbs on heavy days, maintain protein consistently.
• Stay in regular contact with a CFfocused dietitian who can adjust calories as weight changes.