Calcium, iron, sodium chloride (salt) and zinc play significant roles in your body. Deficiencies in any of these minerals can cause everything from bone disease to anemia.
Calcium
Why do I need it? Calcium helps build strong (hard) bones and teeth, keeps your nerves and muscles working correctly and helps your blood clot. If you do not get enough calcium from food or suppleLike vitamins, minerals also help with normal growth, function and maintenance of good health. Individuals with cystic fibrosis can be deficient in these minerals.e too much calcium from your bones, you are at risk for breaking them. You could break ribs during chest physical therapy, while coughing or break a bone during a fall.
How do I get it? It is found in dairy products, some green vegetables and almonds. Calcium supplements are available. Your body can absorb only about 500 mg of calcium at a time, so spread your calcium sources throughout the day.
How much do I need? The CF Foundation recommends that you get the amount of calcium listed below. The amount of calcium listed is the total amount from your diet plus any supplement you use. The results of your of your dual-energy X-ray absorptiometry (DEXA) scan may show that you need more calcium. Check with your CF dietitian.
| Age | Calcium (mg) |
| 0 to 12 months | 210–260 |
| 1 to 3 years | 700 |
| 4 to 8 years | 1,000 |
| 9 years and older | 1,000–1,300 |
Iron
Why do I need it? Iron is responsible for carrying oxygen from the lungs to all the cells in the body. If you don’t have enough iron in your blood cells, you will have anemia, which can make you feel tired, cold, dizzy and irritable. Iron deficiency is common in CF.1
How do I get it? There are two forms of iron in food -- heme and nonheme. Heme iron is found in animal protein such as beef and beef liver. Nonheme iron is found in non-animal protein foods such as lima beans, kidney beans, lentils, dark green vegetables and enriched and fortified cereals. The body is better able to absorb heme iron, but both types of iron are important for overall health. Nonheme iron and iron supplements are absorbed better if taken with a vitamin C source such as orange juice or another vitamin C-rich food.
How much do I need? There are no specific recommendations for daily iron intake for people who have CF. Most people can get enough iron from food, but sometimes an iron supplement is needed. Your CF care team can determine if you are anemic by conducting a blood test and determine whether you need an iron supplement.
| Food | Iron (mg) |
| Heme iron | |
| Beef liver (3 oz.) | 5.3 |
| Beef (3 oz.) | 2.6 |
| Chicken (3 oz.) | 1.1 |
| Nonheme iron | |
| Total® cereal (1 cup) | 13.5 |
| Farina cereal (1 cup) | 12.0 |
| Cheerios® (1 cup) | 8.4 |
| Kidney beans (1/2 cup) | 2.6 |
| Spinach (1/2 cup) | 2.4 |
Sodium Chloride (Salt)
Why do I need it? Sodium chloride is also called salt. Salt plays an important role in maintaining fluid balance in the body, which means keeping the right amount of water in the right places. Salt also helps muscles contract. Not getting enough salt can interfere with growth; reduce appetite; and cause stomach pain, weakness, muscle cramps, nausea and headache. People with CF lose a lot of salt in their sweat, so they must eat more salty foods, especially during hot, humid weather.
How do I get it? Table salt is the best source, along with foods that are processed with salt, such as bacon and pickles. Fresh foods such as meats, chicken, fish, fruits, vegetables, rice and pasta have very little salt; but they are high in salt when they are processed into canned and boxed soups, vegetables, pastas and frozen dinners. Make sure to read food labels and use the saltshaker to add extra salt.
How much do I need? No one is sure how much salt people with CF need; the usual recommendation is to eat salty foods and use the saltshaker freely at meals and snacks. People with CF who play or exercise outside in hot weather may want to add 1/8 teaspoon of salt to 1 1/2 cups (12 ounces) of a sports drink, such as Gatorade®. Infants with CF should get 1/8 teaspoon of salt daily until they are 6 months old. Parents then should increase it to a 1/4 teaspoon of salt daily. It is important not to use too much salt, so ask your care team if you have any questions.
Zinc
Why do I need it? Zinc has many important daily functions in the body, from growth and healing to taste and appetite. Zinc helps you fight infection, heal wounds and develop sexually. Zinc also helps the liver release vitamin A into the blood. A deficiency in zinc has been linked to lower pulmonary function and bone disease in individuals with CF.1
How do I get it? The best food sources are oysters, beef and beef liver. Other good sources include high-protein foods such as turkey, cheese and milk. Many breakfast cereals are fortified with zinc. All forms of multivitamin supplements designed for people with CF have zinc, but not all over-the-counter multivitamins do. Look at the label of the multivitamin you are taking and make sure it contains zinc.
How much do I need? There are no specific recommendations for daily zinc intake for people who have CF.
REFERENCES
1 Leonard, Amanda. Cystic Fibrosis Nutrition: Outcomes, Treatment Guidelines, and Risk Classification. In: Diet and Exercise in Cystic Fibrosis. San Diego, CA: Academic Press; 2015:27-34.