Day 1

Meal

Amount

Phe

Pro

Cals

Breakfa
st

Promin Chocolate
Porridge

1 serving

10

225

118 g

58

1.5

105

2 TBS

0.5

230

2 cups

400

Hunts Marinara

cup

40

1.5

61

Glutino Cornbread

1 slice

28

0.5

90

Broccoli, cooked
Cambrook Brookley
Dogs

cup
1 hot dog

44
27

1.5
0.5

14
80

1 bun

16

0.5

200

Real Fruit Bar

1 bar

15

0.5

140

Dietary Specialty
Peanut Butter Flavored
Spread

2 TBS

0.5

230

Formula

133g

40

548

Banana

School
Lunch

Dinner

Dietary Specialty
Peanut Butter Flavored
Spread
Cambrook Pasta Solo
Spaghetti

Cambrook Brookley
Buns

Snack

Shake

Energy Needs: >40 g protein, 2200-2400 calories

Totals: Phe 260 mg, Protein 47 g, Calories 2,323

Day 2

Meal

Amount

Phe mgs

Pro g

Cals

Breakfa
st

Loprofin Cereal Flakes

1 cup

222

Apple

1 medium

11

1.5

105

Dietary Specialty
Peanut Butter Flavored
Spread

2 TBS

0.5

230

cup

25

1 slice

44

260

9 sticks

60

1.5 cups

30

3 TBS

60

6 oz cup

28

0.5

170

Dietary Specialty
Peanut Butter Flavored
Spread

2 TBS

0.5

230

Potatoes Boiled, diced

100 g

97

110

Ghee

1 TBS

135

Imitation Chicken
Nuggets
Formula

10 oz

17

0.5

190

133g

40

548

School
Lunch

Flax Milk
Cambrook Cheese
Pizza
Glutino Breadsticks
Side salad, romaine
lettuce

Snack

Dinner

Shake

Kraft Italian Dressing

So Delicious Coconut
Milk Yogurt Chocolate

Totals: Phe 249 mg, Protein 17 g, Calories 2,349

Day 3
(no specialty
ordered
items)
Breakfast

Meal

Amount

Phe mgs

Pro g

Cals

Rice Dream Milk

-Chocolate

1/2 cup

21

1.5

170

1 waffle

42

100

2 TBS

Natures Path Mesa Sunrise

Waffle
Walden Farms Imitation
Peanut Butter

School Lunch

Snack

Dinner

cup

220

Lyles Golden Syrup

Corn Tortilla Chips

1 oz

100

130

Salsa Chunky Mild

cup

20

20

Cucumber

cup

17

Pineapple
Ener-g Tapioca Loaf

cup
1 slice

13
32

0.5
1

42
80

Ghee

1 TBS

135

Synders Gluten Free

Pretzel Sticks
Sai-fun Noodles

1 oz

55

2 cups

12

380

Kraft Sweet and Sour

Sauce

cup

160

1 oz

140

1 cup

50

Flax Milk
Phenex-2

133g

40

548

Optional: add Coconut Oil

1 TBS

117

Apple Chips

Formula

Totals: Phe 261 mg, Protein 46 g, Calories 2247 (2346 with additional
coconut oil)

PKU Recommendations for NL:

BMI: 29, >97th%ile
1. Limit potatoes to 1 serving per day of 100 g
2. Include more free food items like vegetables and fruits
3. Consume all 18 oz of Phenyl Free 2HP daily
4. Replace soda with Diet Rite Pure Zero Cola and limit sweetened
beverages
5. Include gluten free or low protein cereals at breakfast with low
protein alternative milks (So Delicious Coconut Milk)
6. Monitor portion sizes
7 Encourage physical activity 30 min daily

2. Calculation of new IEM formula and diet prescriptions

a. PKU infant
61g Similac w/ Iron powder
Phe: 280 mg Pro: 6.6 Calories: 321
50 g Phenex
Phe: 0 mg Pro: 7.5 Calories: 240
Total: Phe 280 mg, Protein: 14g (3.5 pro g/kg) Calories 560 (140
kcal/kg)
Recipe:
b. MSUD
Needs: ~120 kcal/kg, 400 total calories and 3-3.5 g pro or 10-12
g total

PKU Cooking Resources:

Cystic Fibrosis Case Questions:

A) Assessment:
Height % age: <3rd%ile (1%)
Weight %: <3rd%ile (1%)
BMI: 13.8 BMI %: <3rd%ile (1%)
Energy Needs: 4000 calories 75 g protein
IBW: ~74lbs
Nutritional Status: Nutrition failure
Nutrition Recommendations:
-Add calories o breakfast by adding peanut butter or nuts to
cereal, and increase juice to 4 oz.
-Use more peanut butter at lunch, and add honey or jam to
sandwich.
-Add to chicken and butter to noodles for snack, or cook it in
cream. Switch to chocolate whole milk and add fat source like heavy
whipping cream.
-For supper increase meat source to 4 oz, add mayo and
avocado. Increase
butter or margarine on items like corn or
potatoes at dinner.
-Have ice cream for after dinner snack, or drink whole milk with
Little Debbie
-Ask about malabsorption and increase enzyme dosage if
necessary.
He is loosing weight so fat due to the extra stress that the cold has put
on his body. The increase in mucus causes his lungs to work harder to
breathe. Because of this, his body expends more calories, and so his
energy needs increase.
B) I would recommend that he space out high fat meals during that day
rather than at one meal. For instance, having 1-2 slices of pizza, and
the rest of the meal be lower in fat. He may also need to increase the
dosage of his medication, assuming he is taking them at the proper
time.
C) Recommendations:
Meal time: Tell the parents to not react negatively to the childs
behavior at
meals, ignore these behaviors. Instead, focus
attention on the child for what
she does eat. Be specific about
what you did like, show excitement, and show love by hugs or touch.
Scheduling: Provide regular meals and snacks a day so that the
child understands meal times are a time for eating. Plan the snack
ahead of time,
and make sure there is enough time between meals
to ensure hunger every
time.

Nutritional: Offer foods you know your child does like. Add in
extra calories
to these foods with butter and other fat sources.
Offer new foods as well.
Including butter at meals may help your
child to enjoy other foods too.
D) Fat: 49 g of fat in 720 mLs of pedisure 1.5
-500-4000 units of lipase/gm fat = 24,500
-Take 1 Creon 24
E) I expect that the child may need to increase the dosage of enzymes
dependent on CF status. Since the feeds are run at night continuously,
it may be difficult to fully cover the feeds.

Current Research:
1. Premise of Research
2. How do the results of the research impact the role of nutrition in
treatment?
3. Will the research have an impact on treatment or quality of life in
the future?
4. If you were to repeat this research, what changes would you make
and why?
IEM
Cystic Fibrosis