Which CF patients are at high risk for EFAD?

• A. Those with moderate to severe lung disease
• B. Pancreatic sufficient patients
• C. Neonates only
• D. Adults only

Answer: (A)

Essential fatty acid deficiency in cystic fibrosis is most likely when the body’s needs outpace the ability to absorb and utilize fats. Those with moderate to severe lung disease experience a higher resting energy expenditure and a more pronounced inflammatory state, which drives greater catabolic stress. This combination increases fat and essential fatty acid requirements and, if intake or absorption doesn’t keep up, EFAD is more likely to develop. In this scenario, the group with more advanced pulmonary disease is the one most at risk because their nutritional demands are greatest and their reserve can be more quickly depleted.

While fat malabsorption from pancreatic insufficiency is a known contributor to EFAD, the question highlights the impact of disease severity on risk. Neonates and adults can be affected, but the level of lung disease burden directly amplifies the risk by raising energy needs and inflammatory activity that challenge nutritional balance.