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Ideal dose of protein substitute intake

Ideal dose of protein substitute intake. What do protein substitues do ?. provide 21 amino acids help growth lower phenylalanine levels some provide vitamins and minerals. How much do we give?. School of Thought 1. UK advocate generous quantities of protein substitute.

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Ideal dose of protein substitute intake

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  1. Ideal dose of protein substitute intake

  2. What do protein substitues do? • provide 21 amino acids • help growth • lower phenylalanine levels • some provide vitamins and minerals

  3. How much do we give?

  4. School of Thought 1 UK advocate generous quantities of protein substitute

  5. School of Thought 2 children with PKU don’t need big doses of protein substitute

  6. Aim To investigate if a lower dose of protein substitute can achieve the same or better control when compared to the dosage recommended by the UK

  7. Who did we study? • 25 children • 2-10y (median 6y) • 13 girls; 12 boys • dietary treatment: - 5.5 x 50 mg phenylalanine exchanges - median protein equivalent intake: 2.2 g/kg/day

  8. Dosages of protein substitute • High dose - 2 g/kg/day protein equivalent • Low dose - 1.2 g/kg/day protein equivalent

  9. 7 week study Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7

  10. Week 1 Control normal dose of protein substitute

  11. Week 1 Control day 5 6 7 morning night

  12. Week 2 and 3 High

  13. Week 2 and 3 High Low

  14. Week 3 day 5 6 7 1 2 3 4 Morning Night

  15. Weighed food record

  16. Week 4 and 5 Control normal dose of protein substitute

  17. Week 5 Control 5 6 7 morning night

  18. Week 6 and 7 High Low

  19. Week 7 day 5 6 7 1 2 3 4 Morning Night

  20. Same food menu as week 3

  21. Subject 1 girl 5y 5½exchanges

  22. Subject 2 girl 6y 6 exchanges

  23. Subject 3 girl 7 y 7 exchanges

  24. Change in morning blood phenylalanine concentrations

  25. Median change in blood phenylalanine concentrations a.m. p.m.

  26. What are the reasons for differences in change in blood phe levels? • age: no correlation • exchanges: no correlation • PKU mutations • calorie intake

  27. What are the reasons for differences in change in blood phe levels? • age: no correlation • exchanges: no correlation • PKU mutations: coming soon • calorie intake

  28. Reduction in calorie intake

  29. Summary • lower dosages of protein substitute increased plasma phenylalanine concentrations • in some children, it led to very poor phe control • individual differences may be due to severity of PKU • calories contributed by protein substitute is important

  30. Benefits UK • evidence to justify dosage of protein substitute given • important to justify prescription costs None UK countries • should help improve dietary control

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