Amino Acid Medical Foods Provide a High Dietary Acid Load and Increase Urinary Excretion of Renal Net Acid, Calcium, and Magnesium Compared with Glycomacropeptide Medical Foods in Phenylketonuria
Background. Skeletal fragility is a complication of phenylketonuria (PKU). A diet containing amino acids compared with glycomacropeptide reduces bone size and strength in mice. Objective. We tested the hypothesis that amino acid medical foods (AA-MF) provide a high dietary acid load, subsequently in...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2017-01-01
|
| Series: | Journal of Nutrition and Metabolism |
| Online Access: | http://dx.doi.org/10.1155/2017/1909101 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832552357325438976 |
|---|---|
| author | Bridget M. Stroup Emily A. Sawin Sangita G. Murali Neil Binkley Karen E. Hansen Denise M. Ney |
| author_facet | Bridget M. Stroup Emily A. Sawin Sangita G. Murali Neil Binkley Karen E. Hansen Denise M. Ney |
| author_sort | Bridget M. Stroup |
| collection | DOAJ |
| description | Background. Skeletal fragility is a complication of phenylketonuria (PKU). A diet containing amino acids compared with glycomacropeptide reduces bone size and strength in mice. Objective. We tested the hypothesis that amino acid medical foods (AA-MF) provide a high dietary acid load, subsequently increasing urinary excretion of renal net acid, calcium, and magnesium, compared to glycomacropeptide medical foods (GMP-MF). Design. In a crossover design, 8 participants with PKU (16–35 y) provided food records and 24-hr urine samples after consuming a low-Phe diet in combination with AA-MF and GMP-MF for 1–3 wks. We calculated potential renal acid load (PRAL) of AA-MF and GMP-MF and determined bone mineral density (BMD) measurements using dual X-ray absorptiometry. Results. AA-MF provided 1.5–2.5-fold higher PRAL and resulted in 3-fold greater renal net acid excretion compared to GMP-MF (p=0.002). Dietary protein, calcium, and magnesium intake were similar. GMP-MF significantly reduced urinary excretion of calcium by 40% (p=0.012) and magnesium by 30% (p=0.029). Two participants had low BMD-for-age and trabecular bone scores, indicating microarchitectural degradation. Urinary calcium with AA-MF negatively correlated with L1–L4 BMD. Conclusion. Compared to GMP-MF, AA-MF increase dietary acid load, subsequently increasing urinary calcium and magnesium excretion, and likely contributing to skeletal fragility in PKU. The trial was registered at clinicaltrials.gov as NCT01428258. |
| format | Article |
| id | doaj-art-5bb5275fdfc048329cbb4911901c30e5 |
| institution | Kabale University |
| issn | 2090-0724 2090-0732 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Nutrition and Metabolism |
| spelling | doaj-art-5bb5275fdfc048329cbb4911901c30e52025-02-03T05:58:55ZengWileyJournal of Nutrition and Metabolism2090-07242090-07322017-01-01201710.1155/2017/19091011909101Amino Acid Medical Foods Provide a High Dietary Acid Load and Increase Urinary Excretion of Renal Net Acid, Calcium, and Magnesium Compared with Glycomacropeptide Medical Foods in PhenylketonuriaBridget M. Stroup0Emily A. Sawin1Sangita G. Murali2Neil Binkley3Karen E. Hansen4Denise M. Ney5Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USADepartment of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USADepartment of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USADepartment of Medicine, Divisions of Endocrinology and Geriatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USADepartment of Medicine, Divisions of Rheumatology and Endocrinology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USADepartment of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USABackground. Skeletal fragility is a complication of phenylketonuria (PKU). A diet containing amino acids compared with glycomacropeptide reduces bone size and strength in mice. Objective. We tested the hypothesis that amino acid medical foods (AA-MF) provide a high dietary acid load, subsequently increasing urinary excretion of renal net acid, calcium, and magnesium, compared to glycomacropeptide medical foods (GMP-MF). Design. In a crossover design, 8 participants with PKU (16–35 y) provided food records and 24-hr urine samples after consuming a low-Phe diet in combination with AA-MF and GMP-MF for 1–3 wks. We calculated potential renal acid load (PRAL) of AA-MF and GMP-MF and determined bone mineral density (BMD) measurements using dual X-ray absorptiometry. Results. AA-MF provided 1.5–2.5-fold higher PRAL and resulted in 3-fold greater renal net acid excretion compared to GMP-MF (p=0.002). Dietary protein, calcium, and magnesium intake were similar. GMP-MF significantly reduced urinary excretion of calcium by 40% (p=0.012) and magnesium by 30% (p=0.029). Two participants had low BMD-for-age and trabecular bone scores, indicating microarchitectural degradation. Urinary calcium with AA-MF negatively correlated with L1–L4 BMD. Conclusion. Compared to GMP-MF, AA-MF increase dietary acid load, subsequently increasing urinary calcium and magnesium excretion, and likely contributing to skeletal fragility in PKU. The trial was registered at clinicaltrials.gov as NCT01428258.http://dx.doi.org/10.1155/2017/1909101 |
| spellingShingle | Bridget M. Stroup Emily A. Sawin Sangita G. Murali Neil Binkley Karen E. Hansen Denise M. Ney Amino Acid Medical Foods Provide a High Dietary Acid Load and Increase Urinary Excretion of Renal Net Acid, Calcium, and Magnesium Compared with Glycomacropeptide Medical Foods in Phenylketonuria Journal of Nutrition and Metabolism |
| title | Amino Acid Medical Foods Provide a High Dietary Acid Load and Increase Urinary Excretion of Renal Net Acid, Calcium, and Magnesium Compared with Glycomacropeptide Medical Foods in Phenylketonuria |
| title_full | Amino Acid Medical Foods Provide a High Dietary Acid Load and Increase Urinary Excretion of Renal Net Acid, Calcium, and Magnesium Compared with Glycomacropeptide Medical Foods in Phenylketonuria |
| title_fullStr | Amino Acid Medical Foods Provide a High Dietary Acid Load and Increase Urinary Excretion of Renal Net Acid, Calcium, and Magnesium Compared with Glycomacropeptide Medical Foods in Phenylketonuria |
| title_full_unstemmed | Amino Acid Medical Foods Provide a High Dietary Acid Load and Increase Urinary Excretion of Renal Net Acid, Calcium, and Magnesium Compared with Glycomacropeptide Medical Foods in Phenylketonuria |
| title_short | Amino Acid Medical Foods Provide a High Dietary Acid Load and Increase Urinary Excretion of Renal Net Acid, Calcium, and Magnesium Compared with Glycomacropeptide Medical Foods in Phenylketonuria |
| title_sort | amino acid medical foods provide a high dietary acid load and increase urinary excretion of renal net acid calcium and magnesium compared with glycomacropeptide medical foods in phenylketonuria |
| url | http://dx.doi.org/10.1155/2017/1909101 |
| work_keys_str_mv | AT bridgetmstroup aminoacidmedicalfoodsprovideahighdietaryacidloadandincreaseurinaryexcretionofrenalnetacidcalciumandmagnesiumcomparedwithglycomacropeptidemedicalfoodsinphenylketonuria AT emilyasawin aminoacidmedicalfoodsprovideahighdietaryacidloadandincreaseurinaryexcretionofrenalnetacidcalciumandmagnesiumcomparedwithglycomacropeptidemedicalfoodsinphenylketonuria AT sangitagmurali aminoacidmedicalfoodsprovideahighdietaryacidloadandincreaseurinaryexcretionofrenalnetacidcalciumandmagnesiumcomparedwithglycomacropeptidemedicalfoodsinphenylketonuria AT neilbinkley aminoacidmedicalfoodsprovideahighdietaryacidloadandincreaseurinaryexcretionofrenalnetacidcalciumandmagnesiumcomparedwithglycomacropeptidemedicalfoodsinphenylketonuria AT karenehansen aminoacidmedicalfoodsprovideahighdietaryacidloadandincreaseurinaryexcretionofrenalnetacidcalciumandmagnesiumcomparedwithglycomacropeptidemedicalfoodsinphenylketonuria AT denisemney aminoacidmedicalfoodsprovideahighdietaryacidloadandincreaseurinaryexcretionofrenalnetacidcalciumandmagnesiumcomparedwithglycomacropeptidemedicalfoodsinphenylketonuria |