(P13-071-25) Relationship Between Added Sugar Intake and Metabolic Outcomes in Adults With Cystic Fibrosis Using CFTR Modulator Therapy

Objectives: Cystic fibrosis transmembrane receptor (CFTR) modulator therapy has changed the life course of people with cystic fibrosis (CF). Prior to the widespread use of highly effective modulator therapy (HEMT), we found significant links among added sugar intake, body fat distribution, and insulin resistance in adults with CF. The aim of this study was to assess the relationships of added sugar intake with these metabolic endpoints in a new cohort of adults with CF, the majority of whom are taking CFTR modulator therapies.

Methods: This is a cross-sectional analysis of an ongoing longitudinal study. Thirty-five clinically stable adults with CF are included in this analysis. Body composition was assessed by dual-energy X-ray absorptiometry, glycemic endpoints by oral glucose tolerance test, and habitual dietary intake by 3-day food records and NDSR software. Statistical analyses included Pearson correlations and linear regression analyses with age and sex as covariates. Added sugar intake was adjusted per 1000 kcal.

Results: A total of 83% (n = 29/35) of subjects were using a CFTR modulator, mean BMI was 24.7 ± 3.6kg/m² and mean fasting plasma glucose was 102.3 ± 13.2mg/dL. Mean added sugar intake was 54.2 ± 35.5g (12.9 tsp)/day, representing 9.4 ± 5.3% of total kcal intake. A total of 62.1% (n = 18) of participants consumed ≤10% of their daily calories from added sugar. Added sugar intake was significantly positively correlated with percentage body fat (r = 0.38, p = 0.04) and significantly inversely correlated with lean mass (r = −0.40, p = 0.03). However, when adjusted for age and sex, statistical significance was lost (% body fat: β= 0.11 ± 0.13, p=0.38; lean mass: β= −0.00 ± 0.00, p=0.21).

Conclusions: In this cohort of adults with CF, most on HEMT, over half reported habitual consumption of added sugar below the daily recommended amount of 10% of kcal, suggestive of improvements of diet quality in this population. Added sugar intake was not independently associated with body composition and glucose metabolic outcomes, which contrasts with our previous findings prior to widespread CFTR modulator use. Assessment of additional dietary factors potentially impacting body composition and metabolic risk in people with CF receiving CFTR modulators are needed.

Funding Sources: Cystic Fibrosis Foundation, National Institutes of Health