Sugar continues to be a hot topic at the moment, especially with the impending sugar tax on high sugar drinks. There is concern about the effect of sugar on the teeth causing dental caries, as well as the calories it provides contributing to weight gain. These concerns are the same for someone with PKU who follows a low protein diet.
Dietitians are not in favour of demonising one nutrient and take a whole diet approach when it comes to a balanced diet and lifestyle. However, the bottom line is we are eating too much sugar and reducing the amount we consume can only be a good thing.
A new document, produced by the Scientific and Advisory Committee on Carbohydrates was released in 2015 advising us on the amount of sugar we should be consuming. For everybody aged 2 years and over, only 5% of dietary energy should come from added sugar. Therefore, if you are a woman consuming 2000 calories a day; no more than 100 calories should come from added sugar. This equates to about 5 teaspoons and is around 200mls of a full sugar fizzy drink. For a man consuming 2500 calories; this is around 6 teaspoons of sugar and 125 calories, equating to 300mls of a full sugar fizzy drink. Not a lot really. Big changes are needed by the population as a whole to ensure we cut down our sugar intake, including people with PKU. Following a strict low protein diet can make it hard to follow advice given to the general population. However, it is possible to make some changes to reduce your sugar consumption. Every little change will help.
Here are some of the common questions and dilemmas we may hear from people with PKU and our solutions. Please bear in mind this advice may not be suitable for children and anyone on the preconception diet and those already pregnant. Please speak with your Dietitian first before making any changes.
It is commonly said you can feel hungrier if you have PKU. This is thought to be due to eating less whole, natural protein, which has been shown to be the most filling nutrient, not very useful for someone with PKU. It is often easier to grab allowed sweets and both normal and low protein biscuits and cakes to keep full. These are unfortunately, the foods that contain a lot of sugar. Instead try fruit, low protein crackers and low protein cheese, low protein toast and spread, vegetable crudités and low protein dips, homemade vegetable soup and low protein bread, low protein pasta salad or see if you can adapt some low protein baking recipes to reduce the sugar content. Ask your Dietitian for some tips.
This is a statement we do hear quite regularly. Breakfast can be a tricky time, as in fact many normal breakfast cereals do have a lot of added sugar too. It is important to have your protein substitute in the morning to provide an initial dose of protein, vitamins and minerals. Low sugar options include: low protein toast and spread and/or tomatoes or mushrooms, low protein pancakes with fruit, exchanges of normal cereal, such a Weetabix or Shredded Wheat which is lower in sugar, with chopped fruit (banana, berries, apple, pear) and LP milk. If you have adequate exchanges, you could have weigh out some porridge oats with low protein milk and fruit for a filling start to the day.
Certain brands of protein substitute do contain sugar; with this amount varying between the flavours. This will be to aid the palatability of your protein substitute and help you take them regularly. It is very important you take your protein substitute as it contains all the amino acids you need, apart from phenylalanine and all your essential vitamins and minerals. However, there are new ready to drink brands that contain much less sugar. There are also powders and tablet options that contain less sugar than some of the ready to drink options. Please speak to your Dietitian for more advice on this.
Disclaimer: This article is for information, please speak to your dietitian about making changes to your diet.