To understand Cystic Fibrosis Related Diabetes (CFRD), we must first understand Cystic Fibrosis (CF). CF, a genetic disorder, affects the mucus and sweat glands throughout the body. Those with the disease develop an abnormally thick mucus buildup, which in return, severely affects many organs, the lungs in particular. The airways become clogged, making it difficult to pull in oxygen, and causes bacterial growth which results in frequent infection. CF patients sweat more profusely, causing dehydration, fatigue, low blood pressure, increased heart rate, and mineral imbalance. Sufferers also have an enzyme imbalance, making it difficult to digest and absorb food, meaning they often are very thin.
What is CFRD?
As if the challenges associated with CF weren’t enough, now add diabetes into the mix. CFRD, a complicated disease that requires delicate treatment, has characteristics of both type 1 and type 2 diabetes, but is different from both.
CFRD can occur for various reasons. Cells of the pancreas can become damaged by the trademark mucus secretions of people with CF, thus injuring and killing insulin-producing cells. All of the cells may be killed, mimicking type 1 diabetes, or only some cells may be killed.
Infections cause insulin resistance, and CF patients may experience frequent infections. People with CF also produce more cortisol because of the constant stress CF places on the body and cortisol contributes to insulin resistance. Corticosteroids are used in treatment and, unfortunately, reduce insulin efficiency. These factors create an effect that mimics type 2.
The Big Difference- Diet
All of that being said, CFRD is its own disease entirely. Treatment may consist of typical diabetes medications, but one huge difference exists. Diet. CFRD patients not only encounter insulin deficiency, but they also suffer from the inability to gain weight. Because of this, their diet is completely different from the traditional diet recommended for people with diabetes. They must consume a diet rich in calories and fat, while compensating with insulin doses.
To learn more, I spoke with Chef Alexandra Lopukhin, a personal chef who creates meals for a client with CFRD. Chef Alex became a professional chef in 2003, obtaining certification from the Institute of Culinary Education in NYC. She now runs Your Own Gourmet, an affordable personal chef and in-home catering service.
Chef Alex works closely with her client, Suzanne, who has CFRD. Chef Alex and Suzanne create everyday meals to keep Suzanne healthy and help her gain weight, which is difficult given that she has CF.
“Suzanne’s weight gain has to come from carbs, but they have to be the right carbs so there are a lot of whole grains, nut flours, etc. I try to nudge her towards more animal proteins like chicken. Sometimes she goes for comfort food like roast chicken, mashed potatoes (only 1/2 cup at a time), and sautéed greens. Other times it’s stuff like Fried Sweet Potato and Quinoa Cakes or an arugula salad with pumpkins seeds, balsamic vinegar, and nutritional yeast,” said Chef Alex. “I also try to encourage healthy sweets, like dark chocolate and nuts.”
Healthy meal options for people with CFRD like Suzanne include Chickpea-Hiijiki Salad, Hempseed Apricot Chews, Baba Ghannouj, Mini Zucchini and Goat Cheese Tarts (olive oil crust), Eggplant with Lentils and Goat Cheese, Chicken Milanese (whole wheat panko) with arugula salad, Vegan Chocolate Tart with Salted Oat Crust, Salmon Pilaf with Green Onions, and Butternut Squash and Roasted Apple Soup.
Chef Alex was more than happy to share one of her favorite recipes – My Mother’s Roast Chicken. Chicken has fat and calories, but is low carb, so it has a good effect on glucose levels. It would be a good choice for a CFRD patient.
My Mother's Roast Chicken
- 1 whole chicken 2 1/2 to 3 1/2 pounds, giblets removed
- 1 tablespoon kosher salt
- 2 teaspoons black pepper
- 2 tablespoons garlic powder
- 2 tablespoons curry powder
- 2 tablespoons paprika
- 2 tablespoons cumin
Wash and pat dry the chicken inside out. Combine the spices in the bowl and spread them all over the chicken and inside the cavity. Don’t worry if there seems like too much spice, use all of it.
Place the chicken on the roasting rack breast side up and place a pan underneath to catch all of the drippings.
Convection Oven Method
Preheat oven to 425°F. Be sure the oven is at the right temperature before placing the bird in the oven.
Place chicken in the hot oven for seven minutes. Then reduce the temperature to 325°F and cook 10 minutes per pound or until an instant read thermometer inserted into the thickest part of the thigh reads 165°F.
Regular Oven Method
Preheat oven to 450°F. Make sure the oven has reached the correct temperature before placing the bird in the oven.
Place the chicken in the hot oven for 15 minutes, then reduce the temperature to 350°F. Cook 20 minutes per pound or until an instant-read thermometer inserted into the thigh reads 165°F.
If you do not have a roasting rack, simply slice up an onion into thick slices and place on a roasting pan. Place the chicken breast side down instead of up, then flip breast side up half way through cooking.
I can’t thank Chef Alex and Suzanne enough for giving us a deeper look into the CFRD diet. People with diabetes face a lot of dietary challenges and Suzanne has to deal with an even further complicated scenario. The good news is that Suzanne is truly beating the odds. Chef Alex explained that the typical CFRD life expectancy is late 20’s and Suzanne is in her late 30’s. She is maintaining a healthy lifestyle by carefully controlling her diet. This can be achieved with or without a chef, by following healthy guidelines and preparing delicious recipes like the roasted chicken above. Diabetic Foodie also has many recipes that would work for a CFRD diet.
ABOUT THE AUTHOR
Karyn Wofford is a type 1 diabetic who has been educating herself about health and wellness for 14 years. She has been an Emergency Medical Technician for 5 years and is now studying to become a Health and Wellness Specialist. Her aspiration in life is to bring helpful information to those seeking to be as healthy as they can be.
Disclaimer: This information is not intended to take the place of medical advice. Always discuss any dietary or lifestyle changes with your doctor first.