Table 1.

Variation in dietary advice given to patients by BIMDG dietitians

Areas of variation in dietary advice given to patients by BIMDG dietitians:

Use of different terminology to describe low protein foods that could be incorporated into the diet without measurement.

Inconsistent advice to parents about the calculation of 1 g protein exchanges (equivalent to 50 mg phenylalanine) from protein labelling analysis of individual food portions i.e. dietitians were either rounding protein values > or < 1 g to the nearest 0.5 exchange.

Use of different upper protein ‘cut off’ points for foods that could be given in the diet without measurement (exchange-free). There was inconsistent allocation of the following foods: herbs and spices; fats/oils; soya sauce; gravy; cooking sauces; vegetable crisps; sweets; and processed vegetables/vegetable sauces with protein containing ingredients (e.g. milk/wheat).

Inconsistent allocation of manufactured foods that contained low protein (exchange-free) ingredients.

Inconsistent allocation of special low protein foods that contained low protein (exchange-free) ingredients.

Inconsistent allocation of fruits and vegetables (containing phenylalanine from 50 to 100 mg/100 g weight) in the diet. Some dietitians were allowing certain fruits and vegetables in the diet without measurement; others were permitting in restricted amounts only.

Inconsistent interpretation of manufactured food labelling: e.g. some foods are labelled as containing 0 g protein even though some of the ingredients are protein sources. This includes foods containing protein ≤0.5 g/100 g (permissible by European law: Regulation (EU) No 1169/2011) [4] or protein < 1 g/100 g (permissible by USA law).