Dietary management practices in phenylketonuria across European centres.
BACKGROUND
Dietary phenylalanine restriction is the cornerstone of phenylketonuria (PKU) management. However, there are no European consensus guidelines for its optimal dietary care.


METHODS
Detailed information on the routine dietary management of PKU was obtained from 10 European centres using structured questionnaires. Each centre was represented by one dietitian/nutritionist or physician (European Nutritionist Expert Panel).


RESULTS
All centres screened for PKU within the first 10 days of life. PKU prevalence was highest in Turkey. The training, roles and responsibilities of dietitians and nutritionists varied widely; in some centres dietitians were responsible for managing the diet, while in others this was performed by a physician. There were marked differences in target blood phenylalanine concentrations, the dosages of protein substitutes, systems for allocating daily phenylalanine allowance, and the definition of foods that could be eaten without restriction ('free foods'). Eighty percent (n=8/10) of centres encouraged breastfeeding together with protein substitute in infants with PKU.


CONCLUSIONS
Important differences exist among centres across Europe in the dietary management of PKU, and in support systems designed to assist patients in managing their diets. Further studies are needed to compare different dietary treatments with the aim of identifying best practice to optimise phenylalanine control and dietary adherence.
Ahring
Kirsten
K
Center for PKU, Kennedy Institute, Glostrup, Denmark.
Bélanger-Quintana
Amaya
A
Dokoupil
Katharina
K
Gokmen Ozel
Hulya
H
Lammardo
Anna Maria
AM
MacDonald
Anita
A
Motzfeldt
Kristina
K
Nowacka
Maria
M
Robert
Martine
M
van Rijn
Margreet
M
D001942:Breast Feeding; D004032:Diet / Q000592:standards; D004044:Dietary Proteins / Q000008:administration & dosage / Q000378:metabolism; D005060:Europe; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening; D010649:Phenylalanine / Q000008:administration & dosage* / Q000097:blood*; D010661:Phenylketonurias / Q000097:blood / Q000175:diagnosis / Q000178:diet therapy*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011787:Quality of Health Care; D011795:Surveys and Questionnaires
D004044:Dietary Proteins; D010649:Phenylalanine