Practices in prescribing protein substitutes for PKU in Europe: No uniformity of approach

Mol Genet Metab. 2015 May;115(1):17-22. doi: 10.1016/j.ymgme.2015.03.006. Epub 2015 Mar 26.

Abstract

Background: There appears little consensus concerning protein requirements in phenylketonuria (PKU).

Methods: A questionnaire completed by 63 European and Turkish IMD centres from 18 countries collected data on prescribed total protein intake (natural/intact protein and phenylalanine-free protein substitute [PS]) by age, administration frequency and method, monitoring, and type of protein substitute. Data were analysed by European region using descriptive statistics.

Results: The amount of total protein (from PS and natural/intact protein) varied according to the European region. Higher median amounts of total protein were prescribed in infants and children in Northern Europe (n=24 centres) (infants <1 year, >2-3g/kg/day; 1-3 years of age, >2-3 g/kg/day; 4-10 years of age, >1.5-2.5 g/kg/day) and Southern Europe (n=10 centres) (infants <1 year, 2.5 g/kg/day, 1-3 years of age, 2 g/kg/day; 4-10 years of age, 1.5-2 g/kg/day), than by Eastern Europe (n=4 centres) (infants <1 year, 2.5 g/kg/day, 1-3 years of age, >2-2.5 g/kg/day; 4-10 years of age, >1.5-2 g/kg/day) and with Western Europe (n=25 centres) giving the least (infants <1 year, >2-2.5 g/kg/day, 1-3 years of age, 1.5-2 g/kg/day; 4-10 years of age, 1-1.5 g/kg/day). Total protein prescription was similar in patients aged >10 years (1-1.5 g/kg/day) and maternal patients (1-1.5 g/kg/day).

Conclusions: The amounts of total protein prescribed varied between European countries and appeared to be influenced by geographical region. In PKU, all gave higher than the recommended 2007 WHO/FAO/UNU safe levels of protein intake for the general population.

Keywords: Glycomacropeptide; Phenylketonuria; Protein substitute; l-Amino acid supplements.

MeSH terms

  • Adult
  • Amino Acids / administration & dosage*
  • Caseins / administration & dosage*
  • Child
  • Child, Preschool
  • Dietary Proteins / administration & dosage*
  • Dietary Supplements*
  • Europa
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Peptide Fragments / administration & dosage*
  • Phenylalanine
  • Phenylketonurias / diet therapy*
  • Surveys and Questionnaires
  • Türkei
  • World Health Organization

Substances

  • Amino Acids
  • Caseins
  • Dietary Proteins
  • Peptide Fragments
  • caseinomacropeptide
  • Phenylalanine