Cargando…

Suitability and Allocation of Protein-Containing Foods According to Protein Tolerance in PKU: A 2022 UK National Consensus

Introduction: 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...

Descripción completa

Detalles Bibliográficos
Autores principales: Gama, Maria Inês, Adam, 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9736047/
https://www.ncbi.nlm.nih.gov/pubmed/36501017
http://dx.doi.org/10.3390/nu14234987
_version_ 1784846925108871168
author Gama, Maria Inês
Adam, 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
author_facet Gama, Maria Inês
Adam, 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
author_sort Gama, Maria Inês
collection PubMed
description Introduction: 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.
format Online
Article
Text
id pubmed-9736047
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-97360472022-12-11 Suitability and Allocation of Protein-Containing Foods According to Protein Tolerance in PKU: A 2022 UK National Consensus Gama, Maria Inês Adam, 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 Nutrients Article Introduction: 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. MDPI 2022-11-24 /pmc/articles/PMC9736047/ /pubmed/36501017 http://dx.doi.org/10.3390/nu14234987 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gama, Maria Inês
Adam, 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
Suitability and Allocation of Protein-Containing Foods According to Protein Tolerance in PKU: A 2022 UK National Consensus
title Suitability and Allocation of Protein-Containing Foods According to Protein Tolerance in PKU: A 2022 UK National Consensus
title_full Suitability and Allocation of Protein-Containing Foods According to Protein Tolerance in PKU: A 2022 UK National Consensus
title_fullStr Suitability and Allocation of Protein-Containing Foods According to Protein Tolerance in PKU: A 2022 UK National Consensus
title_full_unstemmed Suitability and Allocation of Protein-Containing Foods According to Protein Tolerance in PKU: A 2022 UK National Consensus
title_short Suitability and Allocation of Protein-Containing Foods According to Protein Tolerance in PKU: A 2022 UK National Consensus
title_sort suitability and allocation of protein-containing foods according to protein tolerance in pku: a 2022 uk national consensus
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9736047/
https://www.ncbi.nlm.nih.gov/pubmed/36501017
http://dx.doi.org/10.3390/nu14234987
work_keys_str_mv AT gamamariaines suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT adamsarah suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT adamssandra suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT allenheather suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT ashmorecatherine suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT baileysarah suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT cochranebarbara suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT daleclare suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT dalyanne suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT desousagiana suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT donaldsarah suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT dunlopcarolyn suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT ellertoncharlotte suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT evanssharon suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT firmansarah suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT fordsuzanne suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT freedmanfrancine suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT frenchmoira suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT gafflisa suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT gribbenjoanna suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT grimsleyanne suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT herlihyide suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT hillmelanie suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT khanfarzana suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT mcstravicknicola suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT millingtonchloe suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT morannicola suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT newbycamille suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT nguyenpatty suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT purvesjanet suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT pintoalex suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT rochajuliocesar suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT skeathrachel suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT skeltonamy suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT tapleysimon suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT woodallalison suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT youngcarla suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus
AT macdonaldanita suitabilityandallocationofproteincontainingfoodsaccordingtoproteintoleranceinpkua2022uknationalconsensus