Shifting Nutrition Paradigms: Changing Attitudes Towards Diet and Body Perceptions Among People With CF in the Era of Highly Effective Modulators.

Abstract

People with cystic fibrosis (PwCF) have historically been counselled to eat a high-energy, high-fat diet to prevent malnutrition. The widespread availability of novel drug therapy has led to increased weight and body composition changes in this population, necessitating dietary and lifestyle changes to promote optimal health and well-being. The objective of our study was to understand the attitudes, perspectives, and practices related to nutrition issues in the context of elexacaftor-tezacaftor-ivacaftor (ETI) use. Semi-structured interviews were conducted with PwCF on topics of body image, perceptions of nutrition status, dietary changes, and CF care team relationships in the context of ETI. Interviews were analysed by two independent coders using inductive thematic analysis. Ten adult PwCF were interviewed. Participants were predominantly white (80%), and half were female. Body mass index ranged from 18.9 to 37.1 kg/m². Three global themes were identified: finding balance, a new normal, and working together. Participants discussed pre and post-ETI diet experiences, body image changes and perceptions, and interactions with CF care teams and other mechanisms of support. Perspectives on nutrition status changes on ETI were diverse in our sample and reflect participants' adjustment to a redefined standard of health and nutrition in this new era of CF care. Findings indicate opportunities for partnership strategies with the CF care team, and for providing updated educational resources and personalised nutritional counselling to support the individual needs of PwCF as they navigate dietary and health behaviour changes.