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Open AccessArticle

Inconsistencies in the Nutrition Management of Glutaric Aciduria Type 1: An International Survey

1
Department of Pediatrics, Section of Medical Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
2
Nutricia North America, Rockville, MD 20850, USA
3
Met Ed Co, Boulder, CO 80302, USA
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(10), 3162; https://doi.org/10.3390/nu12103162
Received: 16 September 2020 / Revised: 9 October 2020 / Accepted: 12 October 2020 / Published: 16 October 2020
(This article belongs to the Section Clinical Nutrition)
Glutaric aciduria type 1 (GA-1) is a cerebral organic aciduria characterized by striatal injury and progressive movement disorder. Nutrition management shifted from a general restriction of intact protein to targeted restriction of lysine and tryptophan. Recent guidelines advocate for a low-lysine diet using lysine-free, tryptophan-reduced medical foods. GA-1 guideline recommendations for dietary management of patients over the age of six are unclear, ranging from avoiding excessive intake of intact protein to counting milligrams of lysine intake. A 22–question survey on the nutrition management of GA-1 was developed with the goal of understanding approaches to diet management for patients identified by newborn screening under age six years compared to management after diet liberalization, as well as to gain insight into how clinicians define diet liberalization. Seventy-six responses (25% of possible responses) to the survey were received. Nutrition management with GA-1 is divergent among surveyed clinicians. There was congruency among survey responses to the guidelines, but there is still uncertainty about how to counsel patients on diet optimization and when diet liberalization should occur. Ongoing clinical research and better understanding of the natural history of this disease will help establish stronger recommendations from which clinicians can best counsel families. View Full-Text
Keywords: glutaric aciduria type 1; glutaric acidemia type 1; nutrition; diet; lysine-restricted; protein glutaric aciduria type 1; glutaric acidemia type 1; nutrition; diet; lysine-restricted; protein
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Bernstein, L.; Coughlin, C.R.; Drumm, M.; Yannicelli, S.; Rohr, F. Inconsistencies in the Nutrition Management of Glutaric Aciduria Type 1: An International Survey. Nutrients 2020, 12, 3162.

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