| Title: | "Investigation of paediatric PKU breath malodour, comparing glycomacropeptide with phenylalanine free L-amino acid supplements" |
| Author(s): | Tiele A; Daly A; Hattersley J; Pinto A; Evans S; Ashmore C; MacDonald A; Covington JA; |
| Address: | "School of Engineering, University of Warwick, Coventry CV4 7AL, United Kingdom" |
| ISSN/ISBN: | 1752-7163 (Electronic) 1752-7155 (Linking) |
| Abstract: | "In clinical practice, caregivers of children with phenylketonuria (PKU) report that their children have breath malodour. This might be linked to the regular consumption of low phenylalanine (Phe)/Phe-free protein substitutes (PS), which are an essential component of a low-Phe diet. Oral malodour can negatively affect interpersonal communication, lead to bullying, low self-esteem and social isolation. In this longitudinal cross-over study, exhaled volatile organic compounds (VOCs) were measured using gas chromatography-ion mobility spectrometry. 40 children (20 PKU, 20 controls) were recruited. Subjects with PKU took either L-Amino Acid (L-AA) or Casein Glycomacropeptide (CGMP-AA) exclusively for 1 week, in a randomised order. On the seventh day, seven exhaled breath samples were collected over a 10 h period. Subjects then transferred to the other PS for a week and on day seven, provided seven further breath samples. All subjects had a standardised menu using low-Phe food alternatives and all food intake was measured and recorded. In the PKU group, the aim was to collect samples 30 min after consuming PS. In 3 subjects, breath was collected 5 min post-PS consumption. Fasted L-AA and CGMP-AA breath samples contained a similar number of VOC peaks (10-12) as controls. Longitudinal breath testing results demonstrate that there was no significant difference in the number of exhaled VOCs, comparing L-AA or CGMP-AA with controls, or between PS (12-18 VOC peaks). Breath analysed immediately after consumption of PS (n = 3) showed an immediate increase in the number of VOC peaks (25-30), but these were no longer detectable at 30 min post-consumption. This suggests PS have a transient effect on exhaled breath. Measurements taken 30 min after consuming L-AA or CGMP-AA were not significantly different to controls. This indicates that timing food and drinks with PS consumption may be a potential solution for carers to reduce or eliminate unpleasant PS-related breath odours" |
| Keywords: | "Adolescent Breath Tests Caseins/*therapeutic use Child Confounding Factors, Epidemiologic Cross-Over Studies *Dietary Supplements Exhalation Female Gas Chromatography-Mass Spectrometry Humans Longitudinal Studies Male Peptide Fragments/*therapeutic use Ph;" |
| Notes: | "MedlineTiele, Akira Daly, Anne Hattersley, John Pinto, Alex Evans, Sharon Ashmore, Catherine MacDonald, Anita Covington, James A eng Comparative Study England 2019/09/03 J Breath Res. 2019 Oct 21; 14(1):016001. doi: 10.1088/1752-7163/ab4097" |
