Suitability and allocation of protein-containing foods according to protein tolerance in PKU: a 2022 UK national consensus.
Author
Gama, Maria InêsAdam, Sarah
Adams, Sandra
Allen, Heather
Ashmore, Catherine
Bailey, Sarah
Cochrane, Barbara
Dale, Clare
Daly, Anne
De Sousa, Giana
Donald, Sarah
Dunlop, Carolyn
Ellerton, Charlotte
Evans, Sharon
Firman, Sarah
Ford, Suzanne
Freedman, Francine
French, Moira
Gaff, Lisa
Gribben, Joanna
Grimsley, Anne
Herlihy, Ide
Hill, Melanie
Khan, Farzana
McStravick, Nicola
Millington, Chloe
Moran, Nicola
Newby, Camille
Nguyen, Patty
Purves, Janet
Pinto, Alex
Rocha, Júlio César
Skeath, Rachel
Skelton, Amy
Tapley, Simon
Woodall, Alison
Young, Carla
MacDonald, Anita
Publication date
2022-11-24Subject
Diet & nutrition
Metadata
Show full item recordAbstract
ntroduction: There is little practical guidance about suitable food choices for higher natural protein tolerances in patients with phenylketonuria (PKU). This is particularly important to consider with the introduction of adjunct pharmaceutical treatments that may improve protein tolerance. Aim: To develop a set of guidelines for the introduction of higher protein foods into the diets of patients with PKU who tolerate >10 g/day of protein. Methods: In January 2022, a 26-item food group questionnaire, listing a range of foods containing protein from 5 to >20 g/100 g, was sent to all British Inherited Metabolic Disease Group (BIMDG) dietitians (n = 80; 26 Inherited Metabolic Disease [IMD] centres). They were asked to consider within their IMD dietetic team when they would recommend introducing each of the 26 protein-containing food groups into a patient’s diet who tolerated >10 g to 60 g/day of protein. The patient protein tolerance for each food group that received the majority vote from IMD dietetic teams was chosen as its tolerance threshold for introduction. A virtual meeting was held using Delphi methodology in March 2022 to discuss and agree final consensus. Results: Responses were received from dietitians from 22/26 IMD centres (85%) (11 paediatric, 11 adult). For patients tolerating protein ≥15 g/day, the following foods were agreed for inclusion: gluten-free pastas, gluten-free flours, regular bread, cheese spreads, soft cheese, and lentils in brine; for protein tolerance ≥20 g/day: nuts, hard cheeses, regular flours, meat/fish, and plant-based alternative products (containing 5−10 g/100 g protein), regular pasta, seeds, eggs, dried legumes, and yeast extract spreads were added; for protein tolerance ≥30 g/day: meat/fish and plant-based alternative products (containing >10−20 g/100 g protein) were added; and for protein tolerance ≥40 g/day: meat/fish and plant-based alternatives (containing >20 g/100 g protein) were added. Conclusion: This UK consensus by IMD dietitians from 22 UK centres describes for the first time the suitability and allocation of higher protein foods according to individual patient protein tolerance. It provides valuable guidance for health professionals to enable them to standardize practice and give rational advice to patients.Citation
Gama MI, Adam S, Adams S, Allen H, Ashmore C, Bailey S, Cochrane B, Dale C, Daly A, De Sousa G, Donald S, Dunlop C, Ellerton C, Evans S, Firman S, Ford S, Freedman F, French M, Gaff L, Gribben J, Grimsley A, Herlihy I, Hill M, Khan F, McStravick N, Millington C, Moran N, Newby C, Nguyen P, Purves J, Pinto A, Rocha JC, Skeath R, Skelton A, Tapley S, Woodall A, Young C, MacDonald A. Suitability and Allocation of Protein-Containing Foods According to Protein Tolerance in PKU: A 2022 UK National Consensus. Nutrients. 2022 Nov 24;14(23):4987. doi: 10.3390/nu14234987Type
ArticleAdditional Links
http://www.mdpi.com/journal/nutrientsPMID
36501017Journal
NutrientsPublisher
MDPIae974a485f413a2113503eed53cd6c53
10.3390/nu14234987