NUCDF. National Urea Cycle Disorders Foundation Conference Presentation Eating for Life. July 20, 2013

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Eating for Life What I Eat to Optimize Health Debra Geary Hook, MPH, RD Eating for Life - Outline Purpose of the modified diet Why are foods excluded from the diet? How our body uses fuel from foods Basics of UCD Diet Use of Medical Foods & Formula Eating for Life Nutrients that help us grow and stay healthy UCD Super Meals Power Nutrients Making everything work "Food is about pleasure, about community, about family and spirituality, about our relationship to the natural world and about expressing our identity." Michael Pollan So where does the UCD diet fit? Foundation www.cureucd.org 1

Why are foods excluded from the diet? (purpose of the diet) Reduction of nitrogen waste Where do we get this waste? Protein Where do we get this protein? Protein Major Fuel Sources for the body Sugar Fat Protein Alcohol Foundation www.cureucd.org 2

Keeping things in balance Calories In Which foods are excluded from the diet? All high protein foods! Calories Out What is left? What is left? Foundation www.cureucd.org 3

Common Questions 1 st asked Where is the protein in the diet? Couldn t I just follow a vegetarian diet? My UCD Plate Low Protein Starch My UCD Plate Low Protein Fruit Vegetables Vegetables Protein Starch Special Formula Protein Fruit Foundation www.cureucd.org 4

UCD Formulas - How are formulas chosen? What is the age of the child or adult? (feeding skills) What are the calorie needs? What are the protein needs? How good is the appetite? UCD Formulas - How are formulas chosen? Formulas for Infants Few non-formula foods are used Many non-formula foods are used But we are afraid to ask? Must we use formula? Foundation www.cureucd.org 5

4 year old female carrier OTC Breakfast ½ cup corn flakes ½ banana 4oz orange juice Lunch ½ cup white rice 1/3 cup carrots 4 oz orange juice Dinner 1/3 cup broccoli ½ cup mashed potatoes 4 oz apple juice Snacks 20 Gold Fish Cracker 1 small orange 15 cheetos 1712 calories 22.6 grams protein Typical Diet Looks good at first glance.but Analysis of Amino Acid Content Amino Acid mg % Requirement Tryptophan 11.79 10% Threonine 19.65 4% Isoleucine 32.750 7% Leucine 30.13 3% Lysine 61.57 7% Methionine 26.2 6% Phenylalanine 940.61 115% Histidine 23.58 7% Valine 52.4 9% Poor Protein Quality Analysis of Amino Acid Content Amino Acid mg % Requirement Tryptophan 198.328 165% Threonine 604.97 126% Isoleucine 784.8 178% Leucine 1404.024 143% Lysine 932.6 101% Methionine 317 72% Phenylalanine 1540.6 188% Histidine 379.26 119% Adding 2 grams protein Valine 1030.3 184% from formula Foundation www.cureucd.org 6

Must I have medical foods? Medical Foods can Make A HUGE Difference in Your Health Breakfast 413 calories 13 grams protein 506 calories 3.6 grams protein Breakfast Foundation www.cureucd.org 7

Dinner 647 calories 12 grams protein Dinner Making Choices 615 calories 4.5 grams protein What do I eat? Foundation www.cureucd.org 8

High Low High Low Let s place them in order Breafast High Protein 8 ounces whole milk ( 8 grams protein) 1 cup cheerios (3 grams protein) 1 medium banana (1.2 grams protein) Total: 12.2 grams protein Moderate Protein 8 ounces mocha mix (0.8 grams protein) 1 cup froot loops (1.4 gram protein) 1 medium banana (1.2 grams protein) Total: 3.4 grams protein Moderate-High Protein 8 ounces mocha mix (0.8 grams protein) 1 cup cheerios (3 grams protein) 1 medium banana (1.2 grams protein) Total: 5 grams protein Very Low Protein 8 ounces beverage ( 0.95 grams protein ) 1 cup Loprofin Cereal Loops ( 0.14 grams protein) 1 medium banana (1.2 grams protein) Total: 2.29 grams protein High Low Foundation www.cureucd.org 9

Let s place them in order 1 ear = 4.4 grams Find a formula 1 = 1.2 grams Starting the Diet as an Adult Formula ½ cup =.4 grams 22 = 4 grams Remove high protein food items Increase fruits and vegetables Replace starches with low protein items Rice Cereal Fruits and Vegetables Develop food menus with meat alternatives Low Protein Foods and Starches ½ cup =.5 grams Infant to Toddler Diet Foundation www.cureucd.org 10

How do we improve the UCD diet? Excellent Vitamin D Source Deep Color Fruits & Vegies Numerous products on the market Probiotics Omega 3 Fatty Acids Eicosanoids Have Different Effects A group of hormone-like compounds Regulates blood pressure, childbirth, clotting, immune responses, inflammatory responses, & stomach secretions Omega-6 eicosanoids; Archidonic acid increase blood clotting increase inflammatory responses Omega-3 eicosanoids, DHA, EPA decrease blood clotting reduce heart attack excess may cause hemorrhagic stroke Eicosanoid has different effect on different tissues 7/17/2013 33 Foundation www.cureucd.org 11

Power Food (having a healthy gi track) Bugs in our Foods its a good thing Power Nutrient Bugs Prebiotic food sources: artichokes banana garlic onions shallots leeks asparagus Bug Food Probiotic food sources: fermented milk products yogurts with added probiotics fermented soy products supplements (vitamin D the sunshine vitamin) Strong bones Supports immune system USDA Super Foods Wild blueberries Blueberries Cranberries Artichoke hearts Blackberries Prunes Raspberries Strawberries Red Delicious Apple Granny Smith Apple Sweet Cherry Black Plum Russet Potato Plum Gala Apple colorful Vit D Infants 0-12 months: 400 IU (5 mcg/day) Children 1-3 years: 600 IU (15 mcg/day) 4-8 years: 600 IU (15 mcg/day) Older children and adults 9-70 years: 600 IU (15 mcg/day) > 70 years: 800 IU (20 mcg/day) New Super Foods Hot Chia seeds Hemp protein powder Seaweed Dates Chili Peppers Super UCD Foods Foundation www.cureucd.org 12

UCD Diets Part of our Global Community Vegetables What are people eating around the world? UCD Diet Project What are you eating? Send a picture or two which shows what you are eating. Send to UCDdiet@nucdf.org Thanks Foundation www.cureucd.org 13

Thank you for inviting me into your community Foundation www.cureucd.org 14