Taste preferences and feeding behaviour in children with phenylketonuria on a semisynthetic diet

Ōwada, Misao; Aoki, Keiko M.; Kitagawa, Teruo

doi:10.1007/pl00008351

Cited by 21 publications

(19 citation statements)

References 12 publications

(16 reference statements)

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“…30 -32 Because these formulas are unpalatable to adolescents who have not had infant exposure, this relative ease of return could reflect the long-term effects of prior experience. 33 …”

Section: Persistencementioning

confidence: 99%

Flavor Programming During Infancy

2004

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ABSTRACT. Objective. Although individuals differ substantially in their flavor and food preferences, the source of such differences remains a mystery. The present experimental study was motivated by clinical observations that early experience with formulas establishes subsequent preferences.Design. Infants whose parents had chosen to formula-feed them were randomized into 1 of 4 groups by the second week of life. One group was assigned to be fed a milk-based formula (Enfamil), whereas another was assigned to be fed (Nutramigen), a particularly unpleasanttasting protein hydrolysate formula. The remaining groups were assigned to be fed Nutramigen for 3 months and Enfamil for 4 months; the timing of exposure differed between the groups. After 7 months of exposure, infants were videotaped on 3 separate days while feeding, in counterbalanced order, Enfamil, Nutramigen, and Alimentum, a novel hydrolysate formula.Results. For each of the 4 interrelated measures of behavior (intake, duration of formula feeding, facial expressions, and mothers' judgments of infant acceptance), previous exposure to Nutramigen significantly enhanced subsequent acceptance of both Nutramigen and Alimentum. Seven months of exposure led to greater acceptance than did 3 months.Conclusions. The bases for clinical difficulties in introducing hydrolysate formulas during older infancy are clarified in this study. More broadly, variation in formula flavor provided a useful model for demonstrating experimentally the effects of long-term exposure differences on later acceptance. Such early variation, under more species-typical circumstances (eg, via exposure to different flavors in amniotic fluid and mothers' milk), may underlie individual differences in food acceptability throughout the life span.

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“…30 -32 Because these formulas are unpalatable to adolescents who have not had infant exposure, this relative ease of return could reflect the long-term effects of prior experience. 33 …”

Section: Persistencementioning

confidence: 99%

Flavor Programming During Infancy

2004

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“…Compliance with the PKU diet becomes more difficult as children grow older and start school, make their own food choices and develop taste preferences which are often similar to those without PKU [42] . Changes in compliance are usually related to consumption of the AA-based formula.…”

Section: School-aged Children and Adolescencementioning

confidence: 99%

Nutritional Management of Phenylketonuria

MacLeod

Ney²

2010

Ann Nestlé [Engl]

119

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Phenylketonuria (PKU) is caused by deficient activity of the enzyme phenylalanine hydroxylase, needed to convert the essential amino acid (AA) phenylalanine (phe) to tyrosine. In order to prevent neurological damage, lifelong adherence to a low-phe diet that is restricted in natural foods and requires ingestion of a phe-free AA formula to meet protein needs is required. The goal of nutritional management for those with PKU is to maintain plasma phe concentrations that support optimal growth, development, and mental functioning while providing a nutritionally complete diet. This paper reviews developing a lifelong dietary prescription for those with PKU, outcomes of nutritional management, compliance with the low-phe diet across the life cycle, and new options for nutritional management. An individualized dietary prescription is needed to meet nutrient requirements, and the adequacy of phe intake is monitored with assessment of blood phe levels. Elevated phe concentrations may occur due to illness, excessive or inadequate phe intake, or inadequate intake of AA formula. Although normal growth and development occurs with adherence to the low-phe diet, it is important to monitor vitamin, mineral and essential fatty acid status, especially in those who do not consume sufficient AA formula. Given the growing population of adults with PKU, further research is needed to understand the risks for developing osteoporosis and cardiovascular disease. There are promising new options to liberalize the diet and improve metabolic control such as tetrahydrobiopterin therapy or supplementation with large neutral AAs. Moreover, foods made with glycomacropeptide, an intact protein that contains minimal phe, improves the PKU diet by offering a palatable alternative to AA formula. In summary, continued efforts are needed to overcome the biggest challenge to living with PKU – lifelong adherence to the low-phe diet.

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“…The dietary regimen to treat PKU consists of an unpalatable (to unexposed individuals) HC formula with phenylalanine removed. When given a choice, children and adolescents with PKU preferred their bad-tasting formula to that of the new formulation that was more palatable to naive children and adults [35]. In other words, the characteristic flavor of the formula experienced in early life is ‘imprinted’ and remains as a preference for a considerable time.…”

Section: Origin Of Flavor Preferencesmentioning

confidence: 99%

Flavor Perception in Human Infants: Development and Functional Significance

Beauchamp¹,

Mennella²

2011

Digestion

176

114

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Background: Foods people consume impact on their health in many ways. In particular, excess intake of salty, sweet and fatty foods and inadequate intake of fruits and vegetables have been related to many diseases including diabetes, hypertension, cardiovascular disease and some cancers. The flavor of a food determines its acceptability and modulates intake. It is thus critical to understand the factors that influence flavor preferences in humans. Aim: To outline several of the important factors that shape flavor preferences in humans. Methods: We review a series of studies, mainly from our laboratories, on the important role of early experiences with flavors on subsequent flavor preference and food intake. Results and Conclusions: Some taste preferences and aversions (e.g. liking for sweet, salty and umami; disliking for bitter) are innately organized, although early experiences can modify their expression. In utero events may impact on later taste and flavor preferences and modulate intake of nutrients. Both before and after birth, humans are exposed to a bewildering variety of flavors that influence subsequent liking and choice. Fetuses are exposed to flavors in amniotic fluid modulating preferences later in life and flavor learning continues after birth. Experience with flavors that are bitter, sour or have umami characteristics, as well as volatile flavors such as carrot and garlic, occurs through flavorings in breast milk, infant formula and early foods. These early experiences mold long-term food and flavor preferences which can impact upon later health.

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Taste preferences and feeding behaviour in children with phenylketonuria on a semisynthetic diet

Cited by 21 publications

References 12 publications

Flavor Programming During Infancy

Flavor Programming During Infancy

Nutritional Management of Phenylketonuria

Flavor Perception in Human Infants: Development and Functional Significance

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