Special low protein foods for phenylketonuria: availability in Europe and an examination of their nutritional profile

Background Special low protein foods (SLPF) are essential in the nutritional management of patients with phenylketonuria (PKU). The study objectives were to: 1) identify the number of SLPF available for use in eight European countries and Turkey and 2) analyse the nutritional composition of SLPF available in one of these countries. Methods European Nutritionist Expert Panel on PKU (ENEP) members (Portugal, Spain, Belgium, Italy, Germany, Netherlands, UK, Denmark and Turkey) provided data on SPLF available in each country. The nutritional composition of Portuguese SLPF was compared with regular food products. Results The number of different SLPF available in each country varied widely with a median of 107 [ranging from 73 (Portugal) and 256 (Italy)]. Food analysis of SLPF available from a single country (Portugal) indicated that the mean phenylalanine content was higher in low protein baby cereals (mean 48 mg/100 g) and chocolate/energy bars/jelly (mean 41 mg/100 g). The energy content of different foods from a sub-group of SLPF (cookies) varied widely between 23 and 96 kcal/cookie. Low protein bread had a high fat content [mean 5.8 g/100 g (range 3.7 to 10)] compared with 1.6 g/100 g in regular bread. Seven of the 12 SLPF sub-groups (58 %) did not declare any vitamin content, and only 4 (33 %) identified a limited number of minerals. Conclusions Whilst equal and free access to all SLPF is desirable, the widely variable nutritional composition requires careful nutritional knowledge of all products when prescribed for individual patients with PKU. There is a need for more specific nutritional standards for special low protein foods.

Salt content of processed foods available in the Portuguese market

Evidence suggests that current levels of salt consumption across Europe are linked with several chronic diseases. In recent decades, high blood pressure has increased, together with the consumption of processed foods. World Health Organization (WHO) recommends a salt intake of less than 5 g/day for the prevention of cardiovascular disease. The aim of this study was to evaluate the salt content of processed foods available in the Portuguese market and to compare the determined values with the recommended daily intake established by WHO. Categories of processed foods that contribute to a higher intake of salt were identified: pastry, bakery, fast-food, snacks, ready-to-eat meals, nuts, seeds, soups, cereals, sauces, patties, among others. Between 2013 and 2015, 267 processed food samples were acquired in food chains and restaurants from Lisbon region (Portugal) and the salt content was quantified using Charpentier-Volhard method. High amounts of salt were quantified in the analysed processed foods, namely snacks, fast-food, patties, meals and bakery products. If we consider one portion of a curd cheese pie (193 g), the intake of salt can reach 45% of the recommended value. For snacks, regular portion size is 35 g. One portion of a salty snack can contribute with 31% of the salt recommended daily intake. Up to now food industry has developed efforts to decrease the salt content of some food products, namely bread. However, there still exist foods with high salt content and from a nutritional point of view this should be a priority area of intervention. The obtained results are an effective assessment of current salt content in foods which will be important for further reformulation strategies and to monitor progress in the next years.