What is the primary reason EFAD occurs in CF?

• A. Pancreatic exocrine insufficiency leads to malabsorption of fat, fat-soluble vitamins
• B. High carbohydrate diet
• C. Excessively high fat absorption
• D. Increased fat consumption exceeds requirements

Answer: (A)

EFAD in cystic fibrosis occurs primarily because pancreatic exocrine insufficiency impairs fat digestion and absorption. In CF, thick secretions clog the pancreatic ducts, limiting the delivery of pancreatic lipase and other enzymes to the small intestine. Without enough lipase, dietary fats aren’t properly digested, so long-chain fatty acids and fat-soluble vitamins A, D, E, and K are poorly absorbed, leading to essential fatty acid deficiency even if fat intake is adequate. This digestion-absorption problem in CF is the driving cause, not dietary fat amount; a high carbohydrate diet, excessive fat absorption, or simply increasing fat intake beyond needs do not explain EFAD.