Nutrition Essentials Improving your PKU diet through balanced nutrition

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1 Nutrition Essentials Improving your PKU diet through balanced nutrition

2 Sharon L Ernst, MPH, RD, CSP, FAND Associate Professor Chief Metabolic Dietitian Division of Medical Genetics Department of Pediatrics University of Utah July 12, 2014

3 Your Book of Life Diabetes Obesity High cholesterol Hyperphe Hypertension Clean Water DNA Clean air Micronutrients Physical activity Macronutrients

4 Indianapolis 500

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6 What s on your plate?

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10 Foods commonly seen on diet records Foods Amt. Protein (g) Goldfish cracker, original 15 pieces PHE (mg) Ritz crackers 3 pieces Potato chips 5 pieces Fruit Roll-Ups 1 piece M&M plain candy 5 pieces Calories Values from Singh, Rani. pkufoodlist, second edition, 2011

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14 Fiber Dietary fibers are found naturally in the plants we eat. They do not breakdown in the stomach when eaten, instead they pass through the system undigested. Two types: Soluble fibers Insoluble fibers

15 Soluble Fibers Attract water in the body and slows digestion. This delays emptying time in the stomach and makes you feel full. Slower stomach emptying may help control blood glucose levels and have a beneficial effect on insulin sensitivity. Help lower LDL ( bad ) cholesterol by interfering with the absorption of dietary cholesterol. Sources: Oatmeal, oat cereal, oat bran, lentils, apples, oranges, pears, strawberries, blueberries, cucumbers, celery, carrots, beans, dried peas, nuts, flaxseed, psyllium.

16 Insoluble Fibers Have a laxative effect and add bulk to the diet, helping to prevent constipation. They do not dissolve in water and pass through relatively intact, so they speed up the passage of food and waste in the gut. Sources whole grains and vegetables. Whole wheat and grains, wheat bran, corn bran, seeds, nuts, barley, couscous, brown rice, bulgur, zucchini, celery, broccoli, cabbage, onions, tomatoes, carrots, cucumbers, dark leafy vegetables, raisins, grapes, and fruit.

17 Fiber Content of Some Fruits Food Amt. Wt. (g) PRO (g) PHE (mg) Pear 1 small Blueberries, fresh/frozen ½ cup Orange, fresh ½ cup Raisins, dark ½ cup Banana 1 med Apples, raw slices ½ cup Fiber (g) Peaches, fresh ½ cup Strawberries, fresh ½ cup Plum, fresh 1 med Orange juice ½ cup

18 Fiber Content of Some Vegetables Food Amt. Wt. (g) PRO (g) PHE (mg) Fiber (g) Beans, green or yellow Carrots, raw, chopped Corn, cooked or canned ½ cup ½ cup ½ cup Onions, raw ½ cup Potatoes, raw chopped Summer squash, raw Tomatoes, raw, diced ½ cup ½ cup ½ cup

19 Probiotics Probiotics are small organisms that help maintain the natural balance of organisms (microflora) in the intestines.

20 Prebiotics Non-digestible compounds that pass through the upper GI tract and stimulate growth of advantageous bacteria Examples Acacia gum Inulin Jerusalum artichoke, jicama, chicory root Dandelion greens Raw garlic, leek, onion, asparagus, wheat bran, banana

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23 Omega-3 fatty acid alpha-linolenic acid-essential fatty acid Fats and oils (walnut, wheat germ) Nuts and seeds (chia, flaxseed) Vegetables (soybean oil) EPA and DHA Human milk Shellfish and fish Or, can make from linolenic acid

24 Omega-6 fatty acid (essential fatty acid) Linoleic acid Seeds, nuts, grains, vegetable oils (safflower, grape seed, sunflower, corn, soybean, walnut, sesame)

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32 Antioxidants Helps reduce harmful substances that may cause cell damage, inflammation, heart disease and cancer. Lycopene, vitamin E, vitamin A, vitamin C, beta-carotene Food sources: citrus fruits (oranges, grapefruit, limes), tomatoes, squash, carrots, spinach, and more

33 Fruits and vegetables Fruit or vegetable Citrus fruits Tomatoes, Peppers, Potatoes, Eggplant Broccoli, Cauliflower, Cabbage Berries, Apricots, Apples, Plums, Pears Garlic, Onions, Leeks, Chives, Green Onions, Asparagus Cantaloupe, Pumpkins, Watermelon, Squash Benefits Vitamin C, folic acid, lutein Antioxidants and vitamin C Antioxidants, Vitamins C, E, and K Antioxidants, Vitamins E and C Selenium and Antioxidants Beta-carotene and soluble fiber

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39 Water Medical food or formula Limit sugar containing beverages Fruit and vegetables (85% water): Apricots, berries, cantaloupe, oranges, peaches, pineapple, watermelon, broccoli, carrots, cauliflower, celery, cucumber, eggplant, lettuce.

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43 Your Tree of Life

44 Bonneville Salt Flats

45 Thank you

Laura Kim, MGH Dietetic Intern March 17, 2015

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