Improved Eating Behaviour and Nutrient Intake in Noncompliant Patients with Phenylketonuria after Reintroducing a Protein Substitute: Observations from a Multicentre Study

Nutrients

Sarah Firman¹  Yusof Rahman¹  Benjamin Green²  Rebecca Stratton²  Gary Hubbard²  Charlotte Dawson³  Louise Robertson³  Sarah Adam⁴  Alison Cozens⁵  Carolyn Dunlop⁵  Claire Nicol⁶  Fiona Jenkinson⁶  Sandra Adams⁶ 

[1] Guy’s and St Thomas’ Hospital, London SE1 9RT, UK;Medical Affairs, Nutricia Advanced Medical Nutrition, Wiltshire BA14 0XQ, UK;Queen Elizabeth Hospital, Birmingham B15 2TH, UK;Royal Hospital for Children, Glasgow G51 4TF, UK;Royal Hospital for Sick Children, Edinburgh EH9 1LF, UK;Royal Victoria Infirmary, Newcastle NE1 4LP, UK;

关键词: phenylketonuria;    PKU;    compliance;    noncompliance;    micronutrient;    nutrient intake;    eating behaviour;    nutritional status;    mood;   

DOI  :  10.3390/nu11092035

来源: DOAJ

【 摘 要 】

Noncompliance is widespread in adults with PKU and is associated with adverse metabolic, nutritional and cognitive abnormalities. Returning to the PKU diet is important for this at-risk population, yet for many this is challenging to achieve. Strategies that ease the return to the PKU diet, while offering nutritional and cognitive advantages, are needed. Twelve PKU adults (33.7 ± 2.6 years), who had been noncompliant for 4.5 years (range: 1 to 11 years), took 33 g of a low-volume, nutrient-enriched, protein substitute daily for 28 days. Outcomes of eating behaviour, nutrient intake and mood were assessed at entry (baseline, days 1−3) and after the intervention period (days 29−31). At baseline, intakes of natural protein and estimated phenylalanine were high (66.4 g and 3318.5 mg, respectively) and intakes of calcium, magnesium, iron, zinc, iodine and vitamin D were below country-specific recommendations. With use of the experimental protein substitute, natural protein and estimated phenylalanine intake declined (p = 0.043 for both). Fat and saturated fat intakes also decreased (p = 0.019 and p = 0.041, respectively), while energy and carbohydrate intake remained unchanged. Micronutrient intake increased (p ≤ 0.05 for all aforementioned) to levels well within reference nutrient intake recommendations. Blood vitamin B₁₂ and vitamin D increased by 19.8% and 10.4%, respectively. Reductions in anxiety and confusion were also observed during the course of the study yet should be handled as preliminary data. This study demonstrates that reintroducing a low-volume, nutrient-enriched protein substitute delivers favourable nutritional and possible mood benefits in noncompliant PKU patients, yet longer-term studies are needed to further confirm this. This preliminary knowledge should be used in the design of new strategies to better facilitate patients’ return to the PKU diet, with the approach described here as a foundation.

【 授权许可】

Unknown