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Nutrition studies in treated infants and children with phenylketonuria: vitamins, minerals, trace elements

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Abstract

Chemically defined or elemental medical foods provide the majority of protein equivalent in the diets of children treated for phenylketonuria (PKU). Because of the restricted intake of high biologic value protein, children with PKU often have lower than normal plasma concentrations of ferritin and zinc. Few reported studies are available on vitamin status of children with PKU undergoing treatment. This report addresses intakes of iron, zinc and vitamin A and their plasma concentrations in children ingesting either a low phenylalanine (Phe) casein hydrolysate or a Phe-free L-amino acid mix. With significantly greater than recommended mean intakes of iron and low to recommended mean intakes of zinc, individual plasma ferritin concentrations were often in the deficient (<12 ng/ml) or marginal (12<20 ng/ml) range; plasma zinc concentrations were usually normal when patients received an L-amino acid mix. When L-amino acids were the source of protein equivalent for infants, 48% of plasma retinol concentrations were in the marginal (20<30 µg/dl) or deficient range (<20 µg/dl) in spite of most vitamin A intakes being greater than Recommended Dietary Allowance for age. Some hypothetical reasons for low concentrations of plasma ferritin and retinol are discussed.

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Abbreviations

Phe :

phenylalanine

PKU :

phenylketonuria

RBP :

retinol binding protein

RDA :

Recommendend Dietary Allowance

References

  1. Acosta PB, Wenz E (1971) Nutrition in phenylketonuria. In: Bickel H, Hudson FP, Woolf L (eds) Phenylketonuria and some other amino acid disorders. Thieme, Stuttgart, pp 181–196

    Google Scholar 

  2. Acosta PB, Fernhoff PM, Warshaw HS, et al (1981) Zinc and copper status of treated children with phenylketonuria. JPEN 5:406–409

    CAS  Google Scholar 

  3. Acosta PB, Greene C, Yannicelli S, et al (1993) Nutrition studies in treated infants with phenylketonuria. Intl Pediatr 8:63–73

    Google Scholar 

  4. Acosta PB, Stepnick-Gropper S, Clarke-Sheehan N, et al (1987) Trace element status of PKU children ingesting an elemental diet. JPEN 11: 287–292

    CAS  Google Scholar 

  5. Bei L, Wood RJ, Rosenberg IH (1986) Glucose polymer increases jejunal calcium, magnesium, and zinc absorption in humans. Am J Clin Nutr 44: 244–247

    PubMed  CAS  Google Scholar 

  6. Bezkorovainy A (1980) Biochemistry of nonheme iron. Plenum Press, New York, pp 127–206

    Google Scholar 

  7. Casey CE, Walravens PA, Hambidge KM (1981) Availability of zinc: loading tests with human milk, cow’s milk and infant formulas. Pediatrics 68: 394–396

    PubMed  CAS  Google Scholar 

  8. Cook JD, Noble NL, Morck TA, et al (1983) Effect of fiber on nonheme iron absorption. Gastroenterology 85: 1354–1358

    PubMed  CAS  Google Scholar 

  9. Food and Nutrition Board (1989) Recommended dietary allowances 10th edn., National Academy of Sciences, National Research Council, Washington, DC

    Google Scholar 

  10. Greger JL, Snedeker SM (1986) Effect of dietary protein and phosphorus levels on the utilization of zinc, copper and manganese by adult males. J Nutr 110:2243–2253

    Google Scholar 

  11. Goldberg L, Smith JP (1960) Vitamin A deficiencies in relation to iron overloading in the rat. J Pathol Bacteriol 8: 173–180

    Article  Google Scholar 

  12. Harzer G, Kauer H (1982) Binding of zinc to casein. Am J Clin Nutr 35: 981–987

    PubMed  CAS  Google Scholar 

  13. Ingenbleek Y, Young V (1994) Transthyretin (prealbumin) in health and disease: nutritional implications. Ann Rev Nutr 14:495–533

    Article  CAS  Google Scholar 

  14. Kelsay JL, Jacobs R, Prather ES (1979) Effect of fiber from fruits and vegetables on metabolic responses of human subjects. III. Zinc, copper and phosphorus balances. Am J Clin Nutr 32: 2307–2311

    PubMed  CAS  Google Scholar 

  15. Lukaski HC, Klevay LM, Bolonchuk WW, et al (1982) Influence of dietary lipids on iron, zinc and copper retention in trained athletes. Fed Proc 41: 275 (Abstr)

    Google Scholar 

  16. Mead JF (1984) The non-eicosanoid functions of the essential fatty acids. J Lipid Res 25:1517–1521

    PubMed  CAS  Google Scholar 

  17. Meadows NJ, Grainger SL, Ruse W, et al (1983) Oral iron and the bioavailability of zinc. BMJ 287:1013–1014

    Article  PubMed  CAS  Google Scholar 

  18. Mejia LA, Hodges RE, Arroyave C, et al (1977) Vitamin A deficiency and anemia in Central American children. Am J Clin Nutr 30:1175–1184

    Google Scholar 

  19. Mejia LA, Hodges RE, Rucker RB (1979) Role of vitamin A in the absorption, retention and distribution of iron in the rat. J Nutr 109:129–137

    PubMed  CAS  Google Scholar 

  20. Mills CF (1985) Dietary interactions involving the trace elements. Ann Rev Nutr 5:173–193

    Article  CAS  Google Scholar 

  21. Monsen ER, Cook JD (1976) Food iron absorption in human subjects. IV. The effects of calcium and phosphate salts on the absorption of nonheme iron. Am J Clin Nutr 29:1142–1148

    PubMed  CAS  Google Scholar 

  22. Roodenburg AJC, West CE, Yu S, Beynen AC (1994) Comparison between time-dependent changes in iron metabolism of rats as induced by marginal deficiency of either vitamin A or iron. Br J Nutr 71:687–699

    Article  PubMed  CAS  Google Scholar 

  23. Shenton A, Wells FE, Addison GM (1983) Prealbumin as an indicator of marginal malnutrition in treated phenylketonuria: a preliminary report. J Inherited Metab Dis 6: [Suppl 2]: 109–110

    Article  Google Scholar 

  24. Sidransky H, Sarma DS, Bongiorno M, Verney E (1968) Effect of dietary tryptophan on hepatic polyribosomes and protein synthesis in fasted mice. J Biol Chem 243:1123–1132

    PubMed  CAS  Google Scholar 

  25. Sievers E, Oldigs HD, Dorner K, et al (1988) Trace element overload in PKU — Diet? Pediatr Res 24:270 (Abstract)

    Article  Google Scholar 

  26. Solomons NW, Jacob RA (1981) Studies on the bioavailability of zinc in man. IV. Effect of heme and nonheme iron on the absorption on zinc. Am J Clin Nutr 34:475–481

    PubMed  CAS  Google Scholar 

  27. Valberg LS, Flanagan PR, Chamberlain MJ (1984) Effects of iron, tin and copper on zinc absorption in humans Am J Clin Nutr 40:536–541

    PubMed  CAS  Google Scholar 

  28. Van Dokkum W, Cloughley FA, Hulshof KFAM, et al (1983) Effect of variations in fat and linoleic acid intake on the calcium, magnesium and iron balance of young men. Ann Nutr Metab 27:361–369

    Article  PubMed  Google Scholar 

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Acosta, P.B. Nutrition studies in treated infants and children with phenylketonuria: vitamins, minerals, trace elements. Eur J Pediatr 155 (Suppl 1), S136–S139 (1996). https://doi.org/10.1007/PL00014231

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