Protein diet - phenylalanine - low (PKU)
This document is part of the ACI Diet Specifications for Adult Inpatients. It is not to be used for patient education.
Aim
To provide a diet extremely low in phenylalanine, in order to reduce a high blood level to the desired range of 2-10mg/dL.
Characteristics
The diet eliminates all foods containing significant levels of protein (meat, poultry, fish, milk, yoghurt, cheese, eggs, nuts, seeds, legumes and peanut butter). Recommended foods are phenylalanine-free formula / medical formula to provide adequate protein (e.g. Easiphen, Lophlex, Phenyl-Free, Phenex) plus fruits, vegetables, and low-protein bread or cereal products.
Indications
Phenylketonuria.
Nutritional adequacy
This is a highly restrictive diet, and is not nutritionally complete. Depending on the type of special metabolic formula used, the suggested food plan may need a multivitamin and a calcium supplement.
Precautions
Must only be used when ordered by a physician and under the supervision of a dietitian. A dietitian will establish the daily phenylalanine level permitted from foods in the diet.
Paediatrics
Not suitable for use in paediatrics.
Specific menu planning guidelines
| Allowed | Not allowed | |
|---|---|---|
| Hot main dishes | None | - |
| Sauces, gravies | None | - |
| Starchy vegetables / pasta / rice | All starchy vegetables Low-protein pasta Rice | Regular pasta |
| Vegetables | All others | Legumes |
| Soups | Low-protein soups (e.g. clear tomato soup made with water) | Meat-based soups |
| Sandwiches | None | - |
| Salads, dressings | Green salad All dressings | Cheese, meat, fish, egg, baked beans, peanut butter |
| Breads, cereals | Low-protein bread Rice Bubbles®, Corn Flakes®, Coco Pops® | All others |
| Spreads | All others | Peanut butter |
| Hot breakfast choices | None | - |
| Fruit | All fruit | - |
| Yoghurt | - | All yoghurt |
| Desserts | Jelly | Milk-based desserts |
| Milk and cheese | Non-dairy creamer | Milk and cheese |
| Beverages | Tea, coffee Fruit juice, soft drink, cordial | Milk, Milo® Beverages containing aspartame |
| Biscuits | Low-protein biscuits only | Commercial biscuits |
| Miscellaneous | Special metabolic formula Low-protein dishes (e.g. pasta) Low-protein biscuits Cream, sugar, hard lollies | Nuts Aspartame |
References
- Poustie VJ, Wildgoose J. Dietary interventions for phenylketonuria. Cochrane Database of Sys Rev 2010;(1):CD001304.
- Food Standards Australia New Zealand. NUTTAB 2006 Online version:foods that contain phenylalanine. [accessed 10 June 2010]
- American Dietetic Association. Nutrition care manual. Chicago: ADA; 2009. [accessed 10 June 2010].
- Mahon LK, Escott-Stump S. Krause’s food and nutrition therapy. 12th ed. St Louis: Saunders Elsevier; 2008.
- Maher AK, editor; Iowa Dietetic Association. Simplified diet manual. 10th ed. Ames: Blackwell; 2007.
- Dolan BE, Koch R, Bekins C, Schuett V. Diet intervention guidelines for adults with untreated PKU.