Special Low Protein Foods in the UK: An Examination of Their Macronutrient Composition in Comparison to Regular Foods.

Georgina Wood,Anita Macdonald,Júlio César Rocha,Kiri Pointon-Bell,Sharon Evans

doi:10.3390/nu12061893

Georgina Wood, Anita Macdonald + Show 3 more

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Special low protein foods (SLPFs) are essential in a low phenylalanine diet for treating phenylketonuria (PKU). With little known about their nutritional composition, all SLPFs on UK prescription were studied (n = 146) and compared to equivalent protein-containing foods (n = 190). SLPF nutritional analysis was obtained from suppliers/manufacturers. Comparable information about regular protein-containing foods was obtained from online UK supermarkets. Similar foods were grouped together, with mean nutritional values calculated for each subgroup (n = 40) and percentage differences determined between SLPFs and regular food subgroups. All SLPF subgroups contained 43–100% less protein than regular foods. Sixty-three percent (n = 25/40) of SLPF subgroups contained less total fat with palm oil (25%, n = 36/146) and hydrogenated vegetable oil (23%, n = 33/146) key fat sources. Sixty-eight percent (n = 27/40) of SLPF subgroups contained more carbohydrate, with 72% (n = 105/146) containing added sugar. Key SLPF starch sources were maize/corn (72%; n = 105/146). Seventy-seven percent (n = 113/146) of SLPFs versus 18% (n = 34/190) of regular foods contained added fibre, predominantly hydrocolloids. Nine percent of SLPFs contained phenylalanine > 25 mg/100 g and sources of phenylalanine/protein in their ingredient lists. Stricter nutritional composition regulations for SLPFs are required, identifying maximum upper limits for macronutrients and phenylalanine, and fat and carbohydrate sources that are associated with healthy outcomes.

Highlights

In phenylketonuria (PKU), the only UK treatment option is a rigorous low phenylalanine diet that is essential to prevent neurotoxicity and irreversible brain damage [1]
“dietary foods for special medical purposes” [6]. It gives no guidance on the source, amount or even quality of the carbohydrate and fat added to Special low protein foods (SLPFs) [6]
As a consequence of protein removal, it is expected that lower protein foods will contain higher amounts of carbohydrate and possibly fat [4,10,11], but there is no research describing the nutritional composition of UK SLPFs

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Introduction

In phenylketonuria (PKU), the only UK treatment option is a rigorous low phenylalanine diet that is essential to prevent neurotoxicity and irreversible brain damage [1]. Special low protein foods (SLPFs) are an integral part of dietary treatment They contribute essential energy (up to 50% of intake), variety and bulk, helping to improve or maintain. Nutrients 2020, 12, 1893 metabolic control and growth [3,4,5] Given their importance in a low protein diet, their nutritional profile and food labelling should receive the same care and attention as regular foods. The composition and labelling of SLPFs is regulated by European Commission (EC) legislation on “dietary foods for special medical purposes” [6]. It gives no guidance on the source, amount or even quality of the carbohydrate and fat added to SLPFs [6]. As a consequence of protein removal, it is expected that lower protein foods will contain higher amounts of carbohydrate and possibly fat [4,10,11], but there is no research describing the nutritional composition of UK SLPFs

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