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Category Archives: Parents Corner

Do I really need to follow the expiration date?

by Linda Leuffgen, RD

It’s now 2015 and you see those expiration dates creeping up.

“Is expired product still safe to use?”

We get this question a lot. Our advice is not to use a medical food or low protein food product past its’ date of expiration. Let me explain why as a lot of factors go into determining an expiration date for all food; not just for Nutricia products.

First is the reliability of the packaging materials. We need to make sure the product inside that packaging is safe until the expiration date. Second is the stability of the ingredients in the product. For example, some fats go bad faster than others. We want to ensure the product you consume is fresh which is indicated by the use by date.

Another determination for expiration dates is to ensure the nutrients in the product are true to the levels marked on their label. Nutrients, especially vitamins, have a tendency to naturally break down over time; some faster than others. It is extremely important that the right amount of each nutrient is in the product since these formulas tend to make up more than 50% of your nutritional needs. We conduct extensive testing under a number of conditions to ensure that the nutrients hold up until the date of expiration.

Nutricia’s goal is to bring you the best nutritional products possible. The intent of an expiration date is to keep our consumers safe and ensure they receive the nutrition they need. Again, we cannot recommend using any of our products past their date of expiration. We suggest discussing this further with your healthcare professional if you have expired product at home and require further questions.

Nutrition Series: Calcium & Your Child’s Diet

Calcium is best known for its role in bone health. In fact, the body stores more than 99% of calcium in bones and teeth to keep them strong [1]. However, calcium also plays a critical role in many bodily functions including muscle contraction, hormone secretion and nerve transmission [2].

The body must maintain constant levels of calcium in the blood, muscles and cells in order for the body to function properly. Although the level required for this is small (less than 1% of total body calcium), if you aren’t getting enough calcium from your diet, the body will use calcium stored in bones to maintain these processes, resulting in bone loss.

Calcium intake throughout childhood and adolescence sets the stage for your little one’s lifetime bone health because the development of peak bone mass during these years will reduce the risk of fractures and Osteoporosis later in adulthood.[3]

The recommended intake of calcium for infants and children are [4]:

  • Birth-6 months: 210 mg per day
  • 7-12 months: 270 mg per day
  • 1-3 years: 500 mg per day
  • 4-8 years: 800 mg per day
  • 9-13 years: 1300 mg per day

The best sources of calcium are milk and milk products, soy products like tofu, leafy greens and of course, the extra calcium-rich sardines. For children with PKU or other inborn errors of metabolism, the best dietary source becomes medical food (formula) fortied with calcium, since the natural foods listed above are not permitted (or highly restricted) in a low protein diet.  It’s also important to get enough Vitamin D because it plays a key role in the body’s absorption of calcium.

This September, Nutricia launched new products for people over 1 year of age with Phenylketonuria (PKU) or Tyrosinemia (TYR).  PKU Periflex® Junior Plus and TYR Anamix® Next are an excellent source of both Calcium and Vitamin D.   Both products meet 100% of current daily recommended intake in 20 g of protein equivalent (PE) a day based on protein needs of an average 2 year old (male).   PKU Periflex Junior Plus and TYR Anamix Next also contain a multi-fiber mix to support digestive health and DHA to support brain and eye development (up to 2 years of an age).

Another important factor for bone health is regular exercise and weight-bearing activities. So make sure that your children get adequate calcium and Vitamin D and encourage them to be active.

 

[1] Weaver CM, Heaney RP. Calcium. In: Shils ME, Shike M, Ross AC, Caballero B, Cousins RJ. Modern Nutrition in Health and Disease. 10th ed. Baltimore, MD: Lippincott Williams & Wilkins, 2006:194-210.

[2] http://dietary-supplements.info.nih.gov/factsheets/calcium.asp. [

3] PEDIATRICS Vol. 117 No. 2 February 2006, pp. 578-585 (doi:10.1542/peds.2005-2822).

[4] Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: National Academy Press;1997.

Posted by:  Linda Leuffgen, RD

Medical Affairs Associate for Nutricia North America

 

 

Metabolic Disorders – Talking to your young child

What to say to your child

While your child is not old enough to manage their metabolic disorder alone, it is valuable for them to begin to better understand their diet and treatment. When speaking with your child about their metabolic disorder, the following tips may be helpful:

  • Use simple examples to explain ideas
    For example, when explaining to your child why their metabolic diet is important, it may be helpful to relate the diet to that of a food allergy. Speak with your metabolic team who will also have information about books to read to your child to help him or her understand special diets.
  • Let your child know they can say “no”
    If you haven’t already, teach your child to ask you before eating unfamiliar foods, and that it is OK to say no to anyone who offers food that is unfamiliar or off limits.
  • Tell your child it isn’t his or her fault
    A child may not understand why he or she has metabolic disorder when others do not, and may think that he or she did something to ‘deserve’ it. Explain to your child that everyone is born with different qualities, such as hair and eye color, and a metabolic disorder is something that people are born with, not something that anyone causes. Reinforce to your child that he or she is special, and that this special way of eating is to keep him or her healthy.
  • Stay positive.
    Sending the right message about foods and treatment is important. It is better to talk about off-limit foods as “high-protein,” “no,” “red” or “stop” foods rather than “bad” or “naughty” foods. Help your child accept and manage their metabolic disorder as he or she grows. Never say anything negative about the food or formula to your child. This special way of eating is to keep him or her healthy.
  • You’re not alone
    Talk to your child about other people you know who are on a special diet, even if they are adults, so your child knows that he or she is not the only one on a special diet.   Get involved!   Go to a local metabolic or National event.

Click here to view upcoming events and metabolic support groups across the nation.

 

*Reference Source:Adapted from – My PKU Binder. National PKU Alliance. Chapter 5: Ages 3 to 6 Years, Page 41.

Types of Formula

Did you know that there are over 60 different PKU formula world-wide?

Whether you have been drinking the same formula and maintaining excellent dietary control or if you are reading this in a effort to learn more to return to the PKU diet plan, understanding the ‘Types’ of formulas is a great way to get started and stay in the loop of what formulas are available.

Types of PKU Medical Food

The Drink – PKU Formula in a powdered form that you mix with water. This type of medical food typically provides a balance of fat, carbohydrate, phenylalanine-free protein, vitamins and minerals. Often it contains a good amount of calories to aid satiety and help people with higher caloric needs. Examples from Nutricia include Periflex Junior, Periflex Advanced and PhenylAde Essential.

The Low Fat Formula – This type of formula is a growing segment of the PKU marketplace. Since PKU is diet for life, as people age their calorie needs sometimes lessen. Older people with PKU often have a wider array of low protein foods they will eat which makes them less reliant on formula for satiety. Low or reduced fat formulas typically have less calories and are lower in volume so you can drink less to meet your daily PHE-free protein needs, which can aid adherence and help keep levels in check. Examples from Nutricia include Xphe Maxamum, Lophlex Powders (also in Liquid) PhenylAde40, and PhenylAde60.

The Ready to Drink – PKU formula that is pre-mixed and ready to drink is in high demand. Everyone leads busy lives and don’t want their formula needs to slow them down. This segment is growing just as fast as you can drink one of these single serve units. The ready to drink formulas are often low in fat, calories and volume. For example, PKU Lophlex LQ provides 20 g of protein equivalent (PE) in only  4.2 fl oz. Ready-to-Drink (RTD) PKU formula are quick and easy to drink so you so you can get on with your day.

The Fortifier – Concentrated phenylalnine-free amino acid powder that can be added to any low protein food or drink you already enjoy. It can also be added to ‘Drink’ formula to increase protein content without added formula. Examples for Nutricia include PhenylAde Amino Acid Blend and PhenylAde MTE Amino Acid Blend (Minerals & Trace Elements)

The Tablets – Not everyone has an easy time drinking their formula. But the importance of consuming medical food (formula) and the consequences of not are is well known. For this reason there are formulas that are in tablet form. You would need to ingest quite a few to meet your full daily phe-free protein needs, but for some this is a better alternative than drinking formula.  You can choose to just replace 1 serving of liquid formula per day with tablets.  Example, just 12 tablets of Phlexy-10 Tablets replace 10 g PE of liquid formula. Talk to your metabolic professional if you are struggling with formula to see if a tablet or a combination of formula and tablets will work for you.


Posted by: Sandy Simons, MA, RD, CHES

Sandy is a Registered Dietitian and Certified Health Education Specialist. She received her graduate training at Columbia University’s Teacher College in New York. She has been working on the industry side of metabolic nutrition for the past 11 years and is often seen at patient events around the country. This post is based on an excerpt from a book written by Sandy with the help of others titled: My PKU Toolkit: A Transition Guide to Adult PKU Management.