Protein status in phenylketonuria: A scoping review.

Sarah J Firman, Radha Ramachandran, Kevin Whelan, Oliver C Witard, Majella O'Keeffe

Journal: Clinical nutrition (Edinburgh, Scotland) 2022;41(4):894-922

PMID: 35289300

Abstract

BACKGROUND & AIMS

The physical and functional outcomes of lifelong treatment with a phenylalanine restricted diet for the management of Phenylketonuria (PKU) remain unknown. Given that the mainstay of dietary management consists of modifying the sources of ingested protein, various aspects of body protein status could be compromised.

OBJECTIVES

To examine the existing evidence regarding the protein status of people with PKU and identify nutritional and lifestyle variables that influence protein status.

ELIGIBILITY CRITERIA

Studies reporting anthropometric, biochemical and/or functional measurements of body protein status in people with PKU were eligible.

SOURCE OF EVIDENCE

MEDLINE (Ovid), Embase (Ovid), CENTRAL, Web of Science and Scopus, and conference abstracts.

RESULTS

Seventy studies were included in the review. The majority of studies assessing protein status based on anthropometric measurements observed no differences between people with PKU and controls, although deficits in muscle mass were reported within PKU cohorts. Findings for biochemical assessment of protein status were mixed and limited studies assessed protein status using functional measures. Factors such as participant age, sex, metabolic control, protein source, type of protein substitute, and pharmacological treatments were found to modulate protein status of people with PKU.

CONCLUSIONS

Findings were inconclusive regarding body protein status in people with PKU. The relationship between diet and protein status outcomes remains unclear and further research is warranted to determine the impact of dietary regimens on physical and functional outcomes, and to understand the best clinical assessments to reliably monitor the protein status in people with PKU.

Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Address: Department of Nutritional Sciences, King's College London, London, United Kingdom; Department of Nutrition and Dietetics, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Adult Inherited Metabolic Diseases, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.; Adult Inherited Metabolic Diseases, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.; Department of Nutritional Sciences, King's College London, London, United Kingdom.; Department of Nutritional Sciences, King's College London, London, United Kingdom; Centre for Human and Applied Physiological Sciences, King's College London, London, United Kingdom.; Department of Nutritional Sciences, King's College London, London, United Kingdom; School of Food and Nutritional Sciences, University College Cork, College Road, Cork, Ireland. Electronic address: [email protected].
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