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Natural Protein Intake in Children with Phenylketonuria: Prescription vs. Actual Intakes

dc.contributor.authorPinto, A
dc.contributor.authorDaly, A
dc.contributor.authorCésar Rocha, J
dc.contributor.authorAshmore, C
dc.contributor.authorEvans, S
dc.contributor.authorIlgaz, F
dc.contributor.authorHickson, M
dc.contributor.authorMacDonald, A
dc.date.accessioned2023-12-22T15:22:57Z
dc.date.available2023-12-22T15:22:57Z
dc.date.issued2023
dc.description.abstractIn phenylketonuria (PKU), an important component of the UK dietary management system is a 50 mg phenylalanine (Phe)/1 g protein exchange system used to allocate the Phe/natural protein intakes according to individual patient tolerance. Any foods containing protein ≤ 0.5 g/100 g or fruits/vegetables containing Phe ≤ 75 mg/100 g are allowed without measurement or limit. In children with PKU, we aimed to assess the difference between the prescribed natural protein intake and their actual consumed intake, and to calculate the natural protein/Phe intake from foods given without measurement or restriction. Over a 6-month duration, three one-day diet diaries were collected every month by caregivers of children with PKU at the beginning of a follow-up study. Dietary intakes of Phe, as well as natural and total protein intakes, were calculated using Nutritics® (v5.09). Weekly blood Phe spots were collected by caregivers. The target blood Phe level was ≤360 μmol/L for ages up to 12 years and ≤600 μmol/L for ages ≥12 years. Sixteen early treated children (69% females) with PKU were recruited. The median age was 11 years (range: 9-13), and most had classical PKU (n = 14/16). A median of 18 (range 12-18) one-day diaries and 22 blood spots were analysed for each subject over 6 months. The median prescribed natural protein was 6 g/day (range: 3-27), but when calculated, the actual median intake from all foods consumed was 10 g/day (range: 4-37). The median prescribed Phe was 300 mg/day (range: 150-1350), but the actual median intake was 500 mg/day (range: 200-1850). The median difference between the prescribed and actual natural protein daily intakes was +4 g/day (range: -2.5 to +11.5), with a median percentage increase of 40% for natural protein/Phe intake (p < 0.001). The median blood Phe level was 250 μmol/L (range 20-750), with 91% of blood Phe levels within the target range. Only one patient (11 years) had less than 75% of their blood Phe levels within the target range. The UK Phe exchange system provides flexibility in the dietary management of PKU. With this method, the actual natural protein intake was 167% higher than the prescribed amount. Although this led to a variable daily protein intake, the majority of children (n = 15/16) experienced no deterioration in their metabolic control.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationNutrients . 2023 Nov 23;15(23):4903pt_PT
dc.identifier.doi10.3390/nu15234903pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4766
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherMDPIpt_PT
dc.subjectHCC Ept_PT
dc.subjectChildpt_PT
dc.subjectDietpt_PT
dc.subjectFemalept_PT
dc.subjectFollow-Up Studiespt_PT
dc.subjectMalept_PT
dc.subjectHumanspt_PT
dc.subjectPhenylalaninept_PT
dc.subjectPhenylketonurias*pt_PT
dc.subjectPrescriptionspt_PT
dc.titleNatural Protein Intake in Children with Phenylketonuria: Prescription vs. Actual Intakespt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue23pt_PT
oaire.citation.startPage4903pt_PT
oaire.citation.titleNutrientspt_PT
oaire.citation.volume15pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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