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Making the Most of Your Meal

Satisfaction from food or a meal is something everyone wants. Although many foods may be restricted or limited on a low protein diet, you do not have to compromise taste. Selecting the  foods you eat involves a variety of factors. We choose foods based on taste and smell, in addition to texture, sight and culture.

To make the most of your meal, begin by identifying what you crave, like spicy, sweet, crunchy or salty. This will make your meal more satisfying.Here are some tips to help you make the most of your meal.

  • Spicy: Add seasonings that can add a kick. For example, add cracked pepper, crushed red pepper or hot sauce to steamed vegetables to give a familiar item a new twist.

  • Sweet & Tangy:  Satisfy your sweet and tangy craving with grilled pineapple topped with BBQ sauce on a low protein bun. You can also add mandarin oranges and Italian dressing to a garden salad for added flavor and tang.

  • Crunchy: With a little creativity you can add a snap to any dish. Make your own salad iStock_000015639017Mediumcroutons with low protein bread. Season them in a variety of ways by using garlic powder, cayenne pepper or Italian herbs depending on your personal desire for savory or spice. Another great way to add crunch is to include raw vegetables, like cucumbers or carrots slices to a salad or sandwich.

  • Salty: Salt is among the most popular taste craving. Although highly desired, salt is an ingredient to be used in moderation. A little bit goes a long way. To satisfy your craving for salt, try slicing fresh potatoes very thin and sprinkling with garlic and a touch of sea salt. Bake them until crisp for a satisfying addition to your meal or snack.  

  • Smooth and Creamy: Create your own creamy low protein dip with your favorite seasonings for a flavorful way to enjoy Low Protein Crackers or fresh cut vegetables. You can also include a sweet treat at the end of your meal to help satisfy your need for something smooth and creamy.

Flying with Formula – Tips for your Next Trip

Flying with Formula – Tips for your Next Trip

airplane girl image

If you are planning a flying vacation, before you book, contact your airline’s customer service department to notify them of your travel requirements as soon as you can.  Airline policies regarding travelling with metabolic formula will differ so it is worth checking with a customer service representative before you arrive at the airport.

Airplane food is generally not PKU or low protein diet-friendly so you may need to pack (or purchase prior to boarding) any food or snacks you think you might need during the flight.

If you are booking an international flight you will need to order a special meal. Please note that even meals listed as low-protein or vegetarian/vegan may not be low enough in protein for the PKU diet, so explain your dietary requirements clearly.

Airline Tips

  • Always take a travel letter from your clinic explaining your medical condition, especially for international travel

  • Always pack extra PKU or metabolic formula in your carry-on bag in case of delays

  • Do not mix PKU or metabolic formula powders with liquid until you go past the security screening checkpoint

  • Keep your PKU or metabolic formula in its original sealed containers (packages, cans or sachets)

  • Take a copy of your child’s diet prescription with you

  • Take plenty of snacks for the flight

Useful PKU Traveler’s Tip

  • It may be useful to switch to a powdered PKU or metabolic formula when travelling abroad, to reduce your overall luggage weight. However, ready-to-drink pouches that don’t require mixing are also particularly convenient when traveling. Contact your dietitian for more information on these options

  • If you are traveling overseas, ask your metabolic healthcare professional team for information on where low-protein food supplies can be obtained in your destination country

  • If you are shipping your PKU or metabolic formula or food to a hotel prior to your arrival, be sure to label the box clearly with your name and arrival date on the package. Call and alert the hotel that a shipment will be arriving for you.

*Reference Source: My PKU Binder. National PKU Alliance. Chapter 11: Traveling, Page 88-89.

Amino Acid Blends

Ever wish you could just make your own formula using your favorite great tasting drink?

Well, now you can with Nutricia’s Amino Acid Blends.

This type of formula is available for PKU (PhenylAde™ Amino Acid Blend), MSUD (Complex MSD Amino Acid Blend) and GA-1 (GlutarAde™Amino Acid Blend).

Create Your Own PKU Formula with PhenylAde MTE Amino Acid Blend

PhenylAde™ MTE Amino Acid Blend for PKU

It’s simple, this style of medical food is just the amino acid (protein) part of your formula . It is virtually tasteless and ordorless. You simply MIX-IT-IN to the drink of your choice.

Seriously, it is that easy. So, yes wishes can come true!

Example:

Love drinking sports drink while you exercise or play soccer?

Why not turn that sports drink into your PKU formula and get some post workout phenyalanine-free (for PKU) protein at the same time.

Other examples:

Mix  with lemonade, iced tea, fruit punch, orange drink or anything you think it would taste good with.

There are no rules, expect you want the drink you choose to be protein-free or very, very low in in protein. You can even mix Amino Acid Blend into ready to eat foods like applesauce and tomato sauce.

Mix-It-In---Convenience-Store

Lastly, if you or your child love your current formula but have a hard time with that last serving to meet your full daily diet prescription.

Talk to your metabolic healthcare professional about adding a scoop of Amino Acid Blend to increase the medical food protein content without adding volume.

For more information about PhenylAde Amino Acid Blend (for PKU), Complex MSD Amino Acid Blend (for MSUD) or GlutarAde GA-1 Amino Acid Blend (for GA-1) visit www.Medicalfood.com or 800-605-0410 to request a sample.

 

Please note:  PhenylAde Amino Acid Blend, Complex MSD Amino Acid Blend and GlutarAde GA-1Amino Acid Blend are medical foods intened for use under medical supervision.  Please consult a metabolic healthcare professional prior to making any changes to your metabolic diet. 
PhenylAde & GlutarAde are trademarks of Nutricia North America.

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 12 years and is often seen at patient events around the country.

Why can’t I just follow a low protein diet?

The simplest answer is because you need protein.  Following a low protein diet without formula could lead to protein deficiency. You may also lack energy and develop an array of secondary health problems.

PKU formula  provides phenylalanine-free protein.  Since all natural food, with the exception of pure fat and sugar, contain some PHE, you must watch your total food intake. If you only eat foods that are low in protein you body may not get enought daily protein.  In addition, eating larger portions of foods that are ‘lower’ in protein can still add up to up more phenylalanine than you can tolerate in a day, resulting in high blood PHE levels.

Formula allows you to take in PHE-free protein and calories to help you meet your daily needs.   PKU formula can also help you feel less hungry.   Controling hunger is important becasue despite your best efforts to only eat low protein, excess hunger may lead you to consume some foods that are higher in protein or larger portions.

Don’t forget – drinking PKU formula also provides a balance of all the other amino acids (building blocks of protein) you need plus tyrosine which is an essential amino acid (needed from food) for those with PKU.

If you are currently not drinking formula and only watching what you eat, assess the reasons why you are not going ‘all in’ on your PKU diet.

  • Are you uncertain if your insurance covers formula or have you been denied in the past?
  • Do you recall from childhood hating your formula and not wanting to drink it?
  • Just stopped re-ordering for no good reason at all?

If any of these ring a bell, let Nutricia help you.

We offer a complimentary samples and a staff of trained coverage specialist that can help navigate your insurance to see if you have coverage and help find a local supplier.

Don’t delay – getting back on track and including PKU formula in your diet will be one decision you will not regret.

Request a free PKU product sample at www.medicalfood.com


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 My PKU Toolkit: A Transition Guide to Adult PKU Management.

At what age should I introduce solid foods?

At what age should I introduce solid foods?Feeding child

The American Academy of Pediatrics (AAP) currently recommends gradually introducing solid foods when a baby is about 6 months old.1

**Always consult your metabolic healthcare professional before introducing new foods or changing your child’s low protein diet.

How do I know if my baby is ready to eat solids?

The following tips may help2

  • Is your baby’s tongue-thrust reflex gone or diminished?
    This reflex prevents infants from choking on foreign objects, but also causes them to push food out of their mouths. Ask your pediatrician or metabolic dietitian.
  • Can your baby support his/her own head?
    To eat solid food, an infant needs good head and neck control and should be able to sit up unassisted in a high chair.
  • Is your baby interested in food?
    A 6-month-old baby who stares and grabs at your food at dinnertime is clearly ready for some variety.

What should I know about first foods?

Until now your baby is only used to liquids so it is essential that the first foods offered are a smooth, runny purée. First solids should be bland, easy to swallow and easy to digest. Your baby can progress to a thicker purée once they become used to the runny texture.

What types of food should I offer?

Check with your metabolic dietitian which foods are best for your baby.  Most parents begin with rice cereal mixed with formula and gradually introduce other foods. Homemade purées are inexpensive and easy to make. Fruit and vegetables can be cooked in a small amount of water until soft and then puréed using a hand blender or food processor. Ready-to-eat first foods and baby cereals are also available in the grocery store. Once you have introduced single purees to your baby you can try mixing different combinations for variety e.g. sweet potato and carrot, or apple and pear.

How much should I give my baby to eat?

At first, only offer very small amounts (about 1-2 teaspoons at a single meal). Gradually more food can be offered. When your baby is taking a reasonable amount of solids at a single meal (about 6-10 teaspoons) you can introduce solids at a second meal in the day and then at a third.

Suitable Low Protein Baby Foods2

6-8 Months Old

  • Apple sauce
  • Very small pieces of soft fruit
  • Some cereals
  • Soft cooked vegetables such as carrots or squash

9-12 Months Old

FRUITS

Fresh

  • Wash thoroughly.
  • Remove skins and seeds.
  • Cut into small, bite-size pieces or thin sticks (i.e. quarter grapes).
  • At one year, include unpeeled ripe fruits, berries, pears and nectarines.

Frozen/Canned

  • Look for fruits packed in their own juices.
  • Avoid fruits canned in heavy syrup.
  • Frozen fruits are soothing to teething gums.

Dried

  • Pitted or seedless prunes, apples, apricots, peaches, and dates.
  • Avoid raisins, which can cause choking.

Examples: Apple, Apricot, Avocado, Banana, Berry Grape, Kiwi, Mango, Melon, Nectarine, Orange, Papaya, Peach, Pear, Plum.

VEGETABLES2

Vegetables can be served hot or cold, but all will need to be cooked.

Fresh

  • Wash thoroughly.
  • Raw vegetables are difficult to chew, swallow, and digest.
  • Cook until tender and easily pierced with a fork.
  • Cut into small pieces, long thin strips, or grate.

Canned or Jarred

  • Be careful of the amount of sodium, choose low sodium if possible.
  • Rinse the can or jar before opening.
  • Can be served directly from the can, cut to appropriate size.

Frozen

  • Must be cooked until tender and cut to appropriate size.

**Be sure to discuss PHE or protein tracking an your child’s daily allowance prior to proving any new foods.

References:
1. American Academy of Pediatrics Web Site. Web. 03 Mar. 2010. http://www.aap.org/
2. Eat Right Stay Bright. Guide for Hyperphenylalanemia. L Bernstein and C Freehauf. Chapter 1. Pages 56-58

Eating Out on a Low Protein Diet

Although it can be easier to prepare low protein meals at home, this can restrict your work and social activities. Fortunately, many eating places are beginning to realize that an increasing number of people follow “special diets”.

Many of the larger restaurant chains state that they will try and cater for customers on a special diet whenever possible. To get further information from a particular company contact their Customer Service helpline or check their website.

RESTAURANT TIPS

  • Try and give advanced notice to the restaurant whenever possible
  • When explaining your diet, try not to get caught up in a long list of “I can’t have” foods
  • Offer a few ideas of possible dishes you can eat and recipes if necessary
  • Ask if you can bring in your own low protein products such as pasta or pizza bases if this is suitable

EATING ON THE GO
1. Cafes/sandwich shops

Small cafes that make things up from scratch can prove useful (especially if they get to know you!).  Ask if nutritional information is available to find out ingredients /protein content of items.

Possible snack ideas

-Salad
-Fruit
-Tomatoes on toast*
-Chips*
-Jacket potato* and butter

2. Fast food outlets

Some larger, well known fast food chains, provide nutritional content leaflets  for customers in the shop or online access nutrition information.

Possible snack ideas

-Salad (if available)
-Chips*
-Onion rings*
-Hash browns*
– Most veggie burgers are NOT suitable, as they are high in protein.

3. Cafeterias at work or school

Some cafeterias can be quite flexible so it is worth asking if they can cook or re-heat some of your low protein foods. If the cafeteria food choices are limited it may be easier to take a packed lunch in.

Possible snack ideas

-Salad/vegetables
-Fruit
-Baked Potato (avoid mashed potato as it is likely to contain milk)
 *Weigh out as usual

Note: Each condition may vary in tolerance for specific foods that contain protein, even if low in protein. Always speak with your metabolic dietitian or healthcare provider before adding new foods or changing your metabolic diet in any way.

5-A-Day the Low Protein Way

For those following a low protein diet for a medical reason, FRUITS and VEGETABLES are a very important part of the diet. The good news is fruits and veggies are good for you and it is recommended to have a least 5 servings a day. The best of all they are typically naturally low in protein and a good source of vitamins and antioxidants. Antioxidants are chemical compounds (natural) found in food that keep cells within your body strong and work to fight off illness.

Here are some quick tips for eating 5 A Day the Low Protein Way

  • Included a tossed green salad as part of your dinner and lunch
  • Keep celery and carrot sticks pre-cut so they are available for a quick snack
  • Add fresh berries to your low protein cereal (Shop Loprofin Low Protein Cereal Now)
  • Roast vegetables in advance for quick eating and reheating during the week
  • Don’t leave home without it! It = An apple!
  • Enjoy canned fruit cocktal (packed in juice) as an evening snack or when summer fruit is out of season
  • Try something tropical like guava, pineapple, mango or papaya diced on a salad
  • Add fruit to your formula and blend for a PKU formula (or any other metabolic condition) smoothie
  • Freeze grapes for a cold, bite size treat

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.

Exploring Exotic Fruits and Vegetables

Exploring Exotic Fruits and Vegetables

You can tell summer is approaching by the increased variety of fruit and produce at your local supermarket. Exploring new fruits and vegetables can add excitement and variety to a low protein diet. Most fruits and vegetables are naturally low in protein and can be included in meal plans that limit phenylalanine or other amino acids.

Many fruits and vegetables we consume today were once considered exotic, but are now readily available. By exploring new items, you can open the door to new low protein foods, recipes and improved nutrition. Fruits and vegetables are a good source of fiber and other nutrients needed to maintain a healthy diet. Below are some of our favorite fruits and vegetables that can spark your culinary imagination, increase fiber intake and add a new twist to an ordinary low protein meal.

Star Fruit (Carambola) 1 medium (91g) Protein 0.9g PHE 33.7mg LEU 70mg Fiber 2.5g Kcal 28
Star Fruit, also known as Carambola, is a juicy tropical fruit grown in Thailand and throughout Southeast Asia. It is also grown domestically in Hawaii and Florida, so it is readily available at your local grocery store. This exotic fruit is both fun and nutritious. When you slice through the yellow shiny skin, it resembles a 5 pointed star and is packed with fiber and vitamin C. Add it to a fruit salad or enjoy it sliced for a sweet, crisp, and refreshing low protein snack.

Figs. 1 medium (50g) Protein 0.4g PHE 9mg LEU 17mg Fiber 1.4g Kcal 39
Figs are a great way to add flavor and fiber to a meal. Figs are sweet in taste and can be diced and tossed into a salad or made into a spread to add flavor and excitement to low protein bread or scones. Besides the delicious, sweet taste, one medium fig contains 1.4 grams of fiber, an abundance of minerals and only 9mg of PHE. They can be found fresh in season or dried all year round.

Jicama. 1 cup (130g) Protein 0.9g PHE 20mg LEU 33mg Fiber 6g Kcal 49
Jicama is an often forgotten low protein food. It is a root vegetable that is native to Mexico and Central America. It has a crisp texture and when sliced open resembles a raw potato, but with much less PHE. Complete a summer meal with sliced Jicama, chili powder and a splash of lime juice for a crunchy side dish at your next barbeque. Check out Celebrity Chef, Bobby Flay’s recipe for Jicama Slaw that can be found on the food network website at www.foodnetwork.com.

Kiwi Fruit. 1 medium (76g) Protein 0.8g PHE 21mg LEU 43mg Fiber 2.6g Kcal 46
Kiwi Fruit is a good example of an exotic fruit that has become more available in local food markets. Also known as Chinese Gooseberry, once native to China, Kiwi is now grown in New Zealand, Israel, Italy and domestically in California. This little green fruit makes a great addition to fruit salads and can be diced and tossed over greens to add flavor to a salad.

Mango. 1/2 cup (83g) Protein 0.4g PHE 14mg LEU 26 Fiber 1.5g Kcal 54
Some call mango the king of tropical fruits. We call it a great low protein snack. Mango can range in colors but all have a sweet, soft texture when ripe. You can be creative with this fruit and add to low protein rice, splash with spicy seasonings or chop into a salad.

The following recipe was created by Chef Birch DeVault, MEd, Department Chair of Culinary Arts at Johnson & Wales University, Denver, CO

JICAMA AND MANGO SALAD

NUTRITION:
Per Serving: 1/8th recipe Protein: 1.4g PHE: 37mg LEU: 53mg Kcal: 125

Ingredients:

  • 2 small (730g) jicama, peeled, cut into julienne strips
  • 3 cups (495g) mango, peeled, sliced
  • 1 each (14g) jalapeno, seeded, diced fine
  • 1 each (80g) red onion, peeled, minced
  • 1 clove (3g) garlic, minced
  • 1.5 fl oz orange juice
  • 1 fl oz lemon juice
  • 2 each (152g) kiwi, peeled, sliced
  • 2 tablespoons (27g) olive oil
  • To Taste salt and pepper
  • 1/2 cup (8g) cilantro – chopped

Method of Preparation:

  1. Mix garlic, orange and lemon juice, cilantro and olive oil. Season with salt and pepper.
  2. Add remaining ingredients, toss lightly.
  3. Divide in 8 servings and Enjoy!

Click here to view More Low Protein Recipes

Nutrition information obtained from the following sources: USDA nutrient database; Low Protein Food List for PKU by Virginia Schuett; The Food Processor, ESHA Research; MSUD Foodlist, Emory University; Manufacturer’s packaging. Household measurements are approximate, for greater accuracy use a gram scale.

What is PKU?

What is PKU?

If you have PKU or your child with phenylketonuria is older, you may think this is a silly question, but even though you are living with and managing this metabolic condition on a daily basis, you may not completely understand what PKU is or be able to explain it to others.

There are some terms that you may or may not be familiar with. Learning these key terms will help you better understand or better explain why you follow a special low protein diet.

Art: In “medical terms’ Phenyketonuria (PKU) is an autosomal recessive genetic disorder that results in incomplete phenylalanine metabolism.

But in “REAL TERMS” what does this mean?

Let’s break it down:
Autosomal: a chromosome other than an X or Y sex chromosome
Recessive: a trait that appears only when a gene has been inherited from both parents
Genetic: hereditary characteristic that you get from your parents
Disorder: an abnormal condition
Phenylalanine: an essential amino acid (must be consumed, the body doesn’t make it) commonly referred to as “PHE”
Metabolism: the process in which your body breaks down particular substances

So in REAL TERMS:
PKU is an inherited genetic disorder that prevents the full breakdown of phenylalaine.

Did you know: (image) When phenylalanine builds up in the blood it is excreted in the urine as phenyketones. That is how this condition became known as PhenyKetonUria or PKU for short.


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 also found in a book written by Sandy with the help of others titled: My PKU Toolkit: A Transition Guide to Adult PKU Management.

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.