May 19:Issue 144

Page 12 MENTAL HEALTH: THE IMPORTANCE OF STAFF WELLBEING by Nikki Brierley
1 Health Education England (2019). NHS Staff and Learners’ Mental Wellbeing Commission: www.hee.nhs.uk/sites/default/files/documents/NHS%20%28HEE%29%20-%20Mental%20Wellbeing%20Commission%20Report.pdf
2 Stevenson D, Farmer P (2017). Thriving at work; The independent review of mental health and employers Government review: www.gov.uk/government/publications/thriving-at-work-a-review-of-mental-health-and-employers
3 No Health without Mental Health: A cross- government mental health outcomes strategy for people of all ages (2011): www.gov.uk/government/publications/no-health-without-mental-health-a-cross-government-outcomes-strategy
4 World Health Organisation (2014). Mental Health a State of Wellbeing: www.who.int/features/factfiles/mental_health/en/
5 NHS England: www.england.nhs.uk/mental-health/about/
6 NICE Guidance: Common Mental Health Problems www.nice.org.uk/guidance/cg123/ifp/chapter/common-mental-health-problems
7 Department of Health (2010). Healthy Lives, Healthy People: Our Strategy for Public Health in England
8 Five Year Forward View for Mental Health (2016). Independent Mental Health Task Force: www.england.nhs.uk/wp-content/uploads/2016/02/Mental-Health-Taskforce-FYFV-final.pdf
9 Workplace health: management practices NICE guideline [NG13]. Published date: June 2015 www.nice.org.uk/guidance/ng13/chapter/Recommendations#mental-wellbeing-at-work
10 Health Education England (2019). NHS Staff and Learners’ Mental Wellbeing Commission. www.hee.nhs.uk/sites/default/files/documents/NHS%20%28HEE%29%20-%20Mental%20Wellbeing%20Commission%20Report.pdf
11 The NHS Long Term Plan (2019): www.longtermplan.nhs.uk/wp-content/uploads/2019/01/nhs-long-term-plan.pdf

Page 17 MENTAL HEALTH AND FOOD INSECURITY by Emma Berry
1 Food Foundation. Too Poor to Eat. Food insecurity in the UK (2016). Available at: https://foodfoundation.org.uk/wp-content/uploads/2016/07/FoodInsecurityBriefing-May-2016-FINAL.pdf
2 Mental Health Foundation. Fundamental Facts about Mental Health (2016). Available at: www.mentalhealth.org.uk/sites/default/files/fundamental-facts-about-mental-health-2016.pdf
3 Owen L and Corfe B. The role of diet and nutrition on mental health and wellbeing. Proceedings of the Nutrition Society. 2017. 76(4), 425-426. doi:10.1017/S0029665117001057
4 Pechey R and Monsivais P. Socioeconomic inequalities in the healthiness of food choices: Exploring the contributions of food expenditures. Preventive Medicine. 2016. 88, p 203-209. doi: https://doi.org/10.1016/j.ypmed.2016.04.012
5 Trussell Trust. Disability, Health and Hunger (2018). Available at: https://s3-eu-west-1.amazonaws.com/trusselltrust-documents/Disability-Health-and-Hunger-Report-Jan2018.pdf
6 Trussell Trust. What’s in a Food Parcel? Available at: www.trusselltrust.org/get-help/emergency-food/food-parcel/
7 Trussell Trust. A Nutritional Analysis of the Trussell Trust Emergency Food Parcel (2018). Available at: www.trusselltrust.org/wp-content/uploads/sites/2/2018/06/Food_Parcel_Report_April_2018.pdf
8 Beat Eating Disorders. Emotional Overeating. Available at: www.beateatingdisorders.org.uk/types/emotional-overeating. Accessed: 4th March 2019
9 Kaur J, Lamb M and Ogden C. The Association between Food Insecurity and Obesity in Children – The National Health and Nutrition Examination Survey. Journal of The Academy of Nutrition and Dietetics (2015). 115:751-758
10 Ke J and Ford-Jones E. Food insecurity and hunger: A review of the effects on children’s health and behaviour. Paediatrics & Child Health. 2015. 20(2): 89-91
11 The Guardian. UK hunger survey to measure food insecurity (2019). Available at: www.theguardian.com/society/2019/feb/27/government-to-launch-uk-food-insecurity-index. Accessed: 3rd March 2019

Page 19 COMMUNITY DIETETICS: IS THE FUTURE LOOKING BRIGHT? (SPOILER – YES, IT IS!) by Alice Fletcher
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2 NHS Digital. Statistics on obesity, physical activity and diet: England, 2018. https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-obesity-physical-activity-and-diet/statistics-on-obesity-physical-activity-and-diet-england-2018 - accessed 22/2/19
3 National Institute of Diabetes and Digestive and Kidney Diseases. Overweight and obesity statistics. www.niddk.nih.gov/health-information/health-statistics/overweight-obesity - accessed 22/2/19
4 Marchand C and Peckham S (2017). Addressing the crisis of GP recruitment and retention: A systematic review. British Journal of General Practice, 67(657). doi:10.3399/bjgp17x689929
5 www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf - accessed 25/2/19
6 www.longtermplan.nhs.uk - accessed 22/2/19
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9 www.healthwatch.co.uk/report/2018-12-13/our-annual-report-201718 - accessed 22/2/19
10 www.england.nhs.uk/2018/11/very-low-calorie-diets-part-of-nhs-action-to-tackle-growing-obesity-and-type-2-diabetes-epidemic/ - accessed 26/2/19
11 www.england.nhs.uk/ahp/med-project/dietitians/ - accessed 28/2/19
12 www.bda.uk.com/professional/practice/prescribing/practice_guidance_prescribing - accessed 28/2/19

Page 24 SHORT BOWEL SYNDROME by Rebecca Gasche
1 www.shortbowelsyndrome.com (2019). What is Short Bowel Syndrome (SBS)? Online: available at: www.shortbowelsyndrome.com/what-is-sbs. [Accessed 1st March 2019]
2 Lomer M and Stuart A (2014). Advanced nutrition and dietetics in gastroenterology. Chichester, England: Wiley Blackwell
3 Poitras P, Modigliani R, Bernia JJ. Effect of a combination of gastrin, secretin, cholecystokinin, glucagon and gastric inhibitory polypeptide on jejuna absorption in man. Gut. 1980; 21(4), 299-304
4 O’Keefe SJ, Buchman AL, Fishbein TM, Jeejeebhoy KN, Jeppesen PB, Shaffer J. Short bowel syndrome and intestinal failure: consensus, definitions and overview. Clinical Gastroenterology and Hepatology. 2006: 4:6-10
5 Espen.org (2019). Online: available at: www.espen.org/files/ESPEN-Guidelines/1__ESPEN_guidelines_on_chronic_intestinal_failure_in_adults.pdf. [Accessed 1st March 2019]
6 Nightingale JM. Management of a high-output jejunostomy. Nightingale JM(ed) Intestinal failure. London: Greenwich Medical Media, 2001, p 375-392
7 Grischkan D, Steiger E, Fazio V. Maintenance of home hyper-alimentation in patients with high-output jejunostomies. Archives of Surgery. 1979; 114: 838-841
8 Nightingale JM, Lennard-Jones JE, Gertner DJ, Wood SR, Bartram CI. Colonic preservation reduces the need for parenteral therapy, increases the incidence of renal stones, but does not change the high prevalence of gall stones in patients with a short bowel. Gut. 1992; 33: 1493-1497
9 Woolf GM, Miller C, Kurian R, Jeejeebhoy KN. Nutritional absorption in short bowel syndrome. Evaluation of fluid, calorie and divalent cation requirements. Digestive Diseases and Sciences. 1987; 3: 8-15
10 Messing B, Pigot F, Rongier M, Morin MC, Ndeinduon, Rambaud JC. Intestinal absorption of free oral hyperalimentation in the very short bowel syndrome. Gastroenterology. 1991; 100: 1502-1508
11 Crenn P, Morin MC, Joly F, Penven S, Thuillier F, Messing B. Net digestive absorption and adaptive hyperphagia in adult short bowel patients. Gut 2004; 53: 1279-1286
12 American Gastroenterological Association medical position statement: Short bowel syndrome and intestinal transplantation (2003). Gastroenterology, 124(4), p1105-1110
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16 Short Bowel Foundation (2019). Online available at: http://shortbowelfoundation.org [accessed 7th March 2019]
17 Mind.org.uk. (2019). Home | Mind, the mental health charity - help for mental health problems. Online: available at: www.mind.org.uk/ [accessed 7th March 2019]

Page 29 KETOGENIC DIETS FOR EPILEPSY: PAST, PRESENT AND FUTURE by Dr Natasha Schoeler, Kirsty Martin-McGill and Victoria Whiteley
1 Wilder RM. The Effect of Ketonemia on the Course of Epilepsy. Mayo Clinic Bull 1921(2):307
2 Huttenlocher PR, Wilbourn AJ, Signore JM. Medium-chain triglycerides as a therapy for intractable childhood epilepsy. Neurology. 1971;21(11):1097-103
3 Schwartz RM, Boyes S, Aynsley-Green A. Metabolic effects of three ketogenic diets in the treatment of severe epilepsy. Dev Med Child Neurol. 1989;31(2):152-60
4 Vining EP, Freeman JM, Ballaban-Gil K, Camfield CS, Camfield PR, Holmes GL, et al. A multicenter study of the efficacy of the ketogenic diet. Arch Neurol. 1998;55(11):1433-7
5 Kossoff EH, Krauss GL, McGrogan JR, Freeman JM. Efficacy of the Atkins diet as therapy for intractable epilepsy. Neurology. 2003;61:1789-91
6 Kossoff EH, McGrogan JR, Bluml RM, Pillas DJ, Rubenstein JE, Vining EP. A modified Atkins diet is effective for the treatment of intractable pediatric epilepsy. Epilepsia. 2006;47(2):421-4
7 Pfeifer HH, Thiele EA. Low-glycemic-index treatment: a liberalized ketogenic diet for treatment of intractable epilepsy. Neurology. 2005;65(11):1810-2
8 Neal EG, Chaffe H, Schwartz RH, Lawson MS, Edwards N, Fitzsimmons G, et al. The ketogenic diet for the treatment of childhood epilepsy: a randomised controlled trial. Lancet neurology. 2008;7:500-6
9 Neal EG, Chaffe H, Schwartz RH, Lawson MS, Edwards N, Fitzsimmons G, et al. A randomized trial of classical and medium-chain triglyceride ketogenic diets in the treatment of childhood epilepsy. Epilepsia. 2009;50:1109-17
10 Magrath G, MacDonald A, Whitehouse W. Dietary practices and use of the ketogenic diet in the UK. Seizure. 2000;9(2):128-30
11 Lord K, Magrath G. Use of the ketogenic diet and dietary practices in the UK. J Hum Nutr Diet. 2010;23(2):126-32
12 National Institute for Health and Clinical Excellence. The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care (update).2012
13 Martin-McGill KJ, Jackson CF, Bresnahan R, Levy RG, Cooper PN. Ketogenic diets for drug-resistant epilepsy. Cochrane Database Syst Rev. 2018;11:CD001903.
14 Smith G, Press CA. Ketogenic Diet in Super-Refractory Status Epilepticus. Pediatr Neurol Briefs. 2017;31(3):8
15 IJff D, Postulart D, Lambrechts D, Majoie M, de Kinderen RJA, Hendriksen JGM, et al. Cognitive and behavioral impact of the ketogenic diet in children and adolescents with refractory epilepsy: A randomized controlled trial. Epilepsy Behav. 2016;60:153-7
16 Kossoff EH, Zupec-Kania BA, Auvin S, Ballaban-Gil KR, Christina Bergqvist AG, Blackford R, et al. Optimal clinical management of children receiving dietary therapies for epilepsy: Updated recommendations of the International Ketogenic Diet Study Group. Epilepsia Open. 2018;3(2):175-92
17 Zare M, Okhovat AA, Esmaillzadeh A, Mehvari J, Najafi MR, Saadatnia M. Modified Atkins diet in adult with refractory epilepsy: A controlled randomized clinical trial. Iran J Neurol. 2017;16(2):72-7
18 Kverneland M, Molteberg E, Iversen PO, Veierod MB, Tauboll E, Selmer KK, et al. Effect of modified Atkins diet in adults with drug-resistant focal epilepsy: A randomized clinical trial. Epilepsia. 2018;59(8):1567-76
19 van der Louw E, van den Hurk D, Neal E, Leiendecker B, Fitzsimmon G, Dority L, et al. Ketogenic diet guidelines for infants with refractory epilepsy. Eur J Paediatr Neurol. 2016;20(6):798-809
20 Titre-Johnson S, Schoeler N, Eltze C, Williams R, Vezyroglou K, McCullagh H, et al. Ketogenic diet in the treatment of epilepsy in children under the age of 2 years: study protocol for a randomised controlled trial. Trials. 2017;18(1):195
21 Martin-McGill KJ, Srikandarajah N, Marson AG, Tudur Smith C, Jenkinson MD. The role of ketogenic diets in the therapeutic management of adult and paediatric gliomas: a systematic review. CNS Oncol. 2018;7(2):CNS17
22 Sremanakova J, Sowerbutts AM, Burden S. A systematic review of the use of ketogenic diets in adult patients with cancer. J Hum Nutr Diet. 2018;31(6):793-802.
23 Wlodarek D. Role of Ketogenic Diets in Neurodegenerative Diseases (Alzheimer's Disease and Parkinson's Disease). Nutrients. 2019;11(1)
24 Taylor MK, Sullivan DK, Mahnken JD, Burns JM, Swerdlow RH. Feasibility and efficacy data from a ketogenic diet intervention in Alzheimer's disease. Alzheimers Dement (N Y). 2018;4:28-36
25 Doenyas C. Dietary interventions for autism spectrum disorder: New perspectives from the gut-brain axis. Physiol Behav. 2018;194:577-82
26 Barbanti P, Fofi L, Aurilia C, Egeo G, Caprio M. Ketogenic diet in migraine: rationale, findings and perspectives. Neurol Sci. 2017;38(Suppl 1):111-5
27 Di Lorenzo C, Coppola G, Di Lenola D, Evangelista M, Sirianni G, Rossi P, et al. Efficacy of Modified Atkins Ketogenic Diet in Chronic Cluster Headache: An Open-Label, Single-Arm, Clinical Trial. Front Neurol. 2018;9:64
28 Augustin K, Khabbush A, Williams S, Eaton S, Orford M, Cross JH, et al. Mechanisms of action for the medium-chain triglyceride ketogenic diet in neurological and metabolic disorders. Lancet Neurol. 2018;17(1):84-93
29 Khabbush A, Orford M, Tsai YC, Rutherford T, O'Donnell M, Eaton S, et al. Neuronal decanoic acid oxidation is markedly lower than that of octanoic acid: A mechanistic insight into the medium-chain triglyceride ketogenic diet. Epilepsia. 2017;58(8):1423-9
30 Augustin K, Williams S, Cunningham M, Devlin AM, Friedrich M, Jayasekera A, et al. Perampanel and decanoic acid show synergistic action against AMPA receptors and seizures. Epilepsia. 2018;59(11):e172-e8
31 Calvert S, Barwick K, Par M, Ni Tan K, Borges K. A pilot study of add-on oral triheptanoin treatment for children with medically refractory epilepsy. Eur J Paediatr Neurol. 2018;22(6):1074-80
32 Lindefeldt M, Eng A, Darban H, Bjerkner A, Zetterstrom CK, Allander T, et al. The ketogenic diet influences taxonomic and functional composition of the gut microbiota in children with severe epilepsy. NPJ Biofilms Microbiomes. 2019;5:5
33 Schoeler NE, Leu C, Balestrini S, Mudge JM, Steward CA, Frankish A, et al. Genome-wide association study: Exploring the genetic basis for responsiveness to ketogenic dietary therapies for drug-resistant epilepsy. Epilepsia. 2018;59(8):1557-66
34 Ko A, Jung DE, Kim SH, Kang HC, Lee JS, Lee ST, et al. The Efficacy of Ketogenic Diet for Specific Genetic Mutation in Developmental and Epileptic Encephalopathy. Front Neurol. 2018;9:530
35 Falco-Walter JJ, Roehl K, Ouyang B, Balabanov A. Do certain subpopulations of adults with drug-resistant epilepsy respond better to modified ketogenic diet treatments? Evaluation based on prior resective surgery, type of epilepsy, imaging abnormalities, and vagal nerve stimulation. Epilepsy Behav. 2019
36 Schoeler NE, Bell G, Yuen A, Kapelner AD, Heales SJR, Cross JH, et al. An examination of biochemical parameters and their association with response to ketogenic dietary therapies. Epilepsia. 2017;58(5):893-900
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Page 32 PROBIOTICS AND PAEDIATRIC GUT HEALTH by Farihah Choudhury
1 Sender R, Fuchs S, Milo R (2016). Revised Estimates for the Number of Human and Bacteria Cells in the Body. PLoS Biol 14(8)
2 National Institute of Health Human Microbiome Project. Available: https://hmpdacc.org
3 FAO/WHO (2002). Joint FAO/WHO Working Group Report on Drafting Guidelines for the Evaluation of Probiotics in Food. London, Canada: FAO/WHO
4 Chambers ES, Viardot A, Psichas A (2015). Effects of targeted delivery of propionate to the human colon on appetite regulation, body weight maintenance and adiposity in overweight adults. Gut 64: 1744-1754
5 Windey K, De Preter V and Verbeke K (2012). Relevance of protein fermentation to gut health. Mol Nutr Food Res. 56: 184-196
6 Corpet DE, Yin Y, Zhang XM, Rémésy C, Stamp D, Medline A, Thompson L, Bruce WR, Archer MC (1995). Colonic protein fermentation and promotion of colon carcinogenesis by thermolyzed casein. Nutrition and cancer, 23(3): 271-81
7 Mowat (2003). Nature Reviews Immunology 3: 331-41
8 Thomas and Versalovic (2010). Probiotics - host communication: Modulation of signalling pathways in the intestine. Gut Microbes 1, 148-163
9 Wu et al. (2011). Linking Long-Term Dietary Patterns with Gut Microbial Enterotypes. Science
10 Gordon M, Stone J, Thomas A and Akobeng A (2016). Probiotics for the management of functional abdominal pain in children: A Cochrane systematic review.
11 Saavedra JM, Bauman NA, Oung I, Perman JA, Yolken RH (1994). Feeding of Bifidobacterium bifidum and Streptococcus thermophilus to infants in hospital for prevention of diarrhoea and shedding of rotavirus. Lancet 344, 1046-1049
12 Isolauri E et al (1991). A Human Lactobacillus Strain (Lactobacillus Casei sp strain GG) Promotes Recovery from Acute Diarrhoea in Children. Pediatrics 88, 90-97
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14 Hao Q, Dong BR, Huang CQ, Wu T (2011). Probiotics for preventing acute upper respiratory tract infections. Cochrane Database of Systematic Reviews 9
15 Gareau MG, Sherman PM and Walker WA (2010). Probiotics and the gut microbiota in intestinal health and disease. Nature reviews. Gastroenterology & hepatology, 7(9): 503-14
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17 Kalliomaki M et al. (2003) Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebo-controlled trial. Lancet 361, 1869-1871
18 Dogra S et al (2015). Dynamics of Infant Gut Microbiota Are Influenced by Delivery Mode and Gestational Duration and Are Associated with Subsequent Adiposity. Gut Microbes. Singaporean GUSTO birth cohort
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20 Isolauri E (2004). The role of probiotics in paediatrics. Current Paediatrics, 14(2): 104-109
21 Foster JA, Rinaman L, Cryan JF (2017). Stress and the gut-brain axis: Regulation by the microbiome, Neurobiology of Stress 7: 124-136
22 Montiel-Castro AJ, González-Cervantes RM, Bravo-Ruiseco G and Pacheco-López G (2013). The microbiota-gut-brain axis: neurobehavioral correlates, health and sociality. Frontiers in integrative neuroscience, 7, 70

Page 35 INTUITIVE EATING by Jessica English
1 Polivy J. Psychological Consequences of Food Restriction. J Am Diet Assoc. 1996; 96: 589-592
2 Tribole E, Resch E, Tylka TL. Foreword: The Intuitive Eating Workbook: Ten Principles for Nourishing a Healthy Relationship with Food (A New Harbinger Self-Help Workbook). Oakland, CA, New Harbinger Publications; Workbook edition (2017)
3 Tylka TL, Kroon Van Diest AM. The Intuitive Eating Scale-2: item refinement and psychometric evaluation with college women and men. J Couns Psychol. 2013 Jan;60(1): 137-53
4 Tylka TL (2006). Development and psychometric evaluation of a measure of intuitive eating. Journal of Counseling Psychology, 53(2), 226-240
5 Saunders JF et al. Psychometric properties of the intuitive eating scale-2 (IES-2) in a culturally diverse Hispanic American sample. Eat Behav. 2018 Jan; 28:1-7
6 Ross et al. Changing the endpoints for determining effective obesity management. Prog Cardiovasc Dis. 2015 Jan-Feb; 57(4): 330-6
7 Bacon L et al. Size Acceptance and Intuitive Eating Improve Health for Obese, Female Chronic Dieters, J Am Diet Assoc. 2005; 105: 929-936
8 KH Pietiläinen et al. Does dieting make you fat? A twin study. International Journal of Obesity volume 36, pages 456-464 (2012)
9 Anderson LM et al. Contributions of mindful eating, intuitive eating and restraint to BMI, disordered eating and meal consumption in college students. Eat Weight Disord. 2016 Mar; 21(1): 83-90
10 Tylka TL, Calogero RM, Daníelsdóttir S. Is intuitive eating the same as flexible dietary control? Their links to each other and wellbeing could provide an answer. Appetite. 2015 Dec; 95: 166-75. Epub 2015 Jul 8
11 Healthy Weight Grampian, NHS Scotland. Available online at: www.healthyweightgrampian.scot.nhs.uk/psychological-support/our-relationship-with-food/the-hunger-scale/ (accessed 28th February 2019)
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13 BJ. Wheeler at al. Intuitive eating is associated with glycaemic control in adolescents with Type 1 diabetes mellitus. Appetite Volume 96, 1 January 2016, Pages 160-165
14 Willig AL. et al. Intuitive Eating Practices among African-American Women Living with Type 2 Diabetes: A Qualitative Study. Journal of the Academy of Nutrition and Dietetics. Volume 114, Issue 6, June 2014, p 889-896
15 Richards PS et al. Can patients with eating disorders learn to eat intuitively? A 2-year pilot study. Eat Disord. 2017 Feb 2: 1-15
16 Denny KN et al. Intuitive eating in young adults. Who is doing it, and how is it related todisordered eating behaviours? Appetite. Jan; 60(1): 13-9
17 Schaefer JT, Magnuson AB. A review of interventions that promote eating by internal cues. J Acad Nutr Diet. 2014 May; 114(5): 734-760
18 Bruce JL et al. Appetite, A systematic review of the psychosocial correlates of intuitive eating among adult women. Volume 96, 1 January 2016, p 54-472
19 Young S. Promoting healthy eating among college women: Effectiveness of an intuitive eating intervention. Iowa State University, 2011, Dissertation 147 pages; AAT 3418683. Available online at: http://lib.dr.iastate.edu/cgi/viewcontent.cgi?article=2340&context=etd (Accessed 21/02/2019)

Page 39 PHENYLALANINE NEUROTOXICITY AND THE CHALLENGE OF ‘DIET FOR LIFE’ IN PKU* by Suzanne Ford
1 Horner FA et al (1962). Termination of dietary treatment of phenylketonuria. New England Journal of Medicine. 266(2): 79-81
2 Vandeman PR (1963). Termination of dietary treatment for phenylketonuria. American Journal of Diseases of Children. 106(5): 492-5
3 Holtzman NA et al (1975) Termination of restricted diet in children with phenylketonuria: a randomised controlled study. New England Journal of Medicine. 293(22): 1121-4
4 Johnson CF (1972). What is the best age to discontinue the low phenylalanine diet in phenylketonuria? A presentation of some contributory data. Clinical pediatrics. 11(3): 148-56
5 Pueschel S et al (1977). Discontinuing the phenylalanine-restricted diet in young children with PKY. Psychosocial aspects. Journal of the American Dietetic Association. 70(5): 506-9
6 van Wegberg AMJ et al (2017). The complete European guidelines on phenylketonuria: diagnosis and treatment. Orphanet Journal of Rare Diseases. 12: 162
7 Channon S et al (2007). Effects of dietary management of phenylketonuria on long-term cognitive outcome. Archives of Disease in Childhood. 92(3): 213-8
8 Didycz B and Bik-Multanowski M (2018). Blood phenylalanine instability strongly correlates with anxiety in phenylketonuria. Molecular Genetics and Metabolism Reports. 14: 80-2
9 Moyle J et al (2007). Meta-analysis of neuropsychological symptoms of adolescents and adults with PKU. Neuropsychology Review. 17(2): 91-101
10 Romani C et al (2017). The impact of phenylalanine levels on cognitive outcomes in adults with phenylketonuria: Effects across tasks and developmental stages. Neuropsychology. 31(3): 242
11 ten Hoedt AE et al (2011). High phenylalanine levels directly affect mood and sustained attention in adults with phenylketonuria: a randomised, double-blind, placebo-controlled, crossover trial. Journal of Inherited Metabolic Disease. 34(1): 165-71
12 Bilder DA et al (2013). Psychiatric Symptoms in adults with Phenylketonuria. Molecular Genetics and Metabolism. 108(3): 155-60
13 Huijbregts S et al (2002). Sustained attention and inhibition of cognitive interference in treated phenylketonuria: associations with concurrent and lifetime phenylalanine concentrations. Neuropsychologia. 40(1): 7-15
14 Weglage J et al (2013). Neurocognitive Functioning in Adults with Phenylketonuria: Results of a Long Term Study. Molecular Genetics and Metabolism. 110 :S44-S8.
15 Anwar M et al. (2013). Neurological improvement following reinstitution of a low phenylalanine diet after 20 years in established phenylketonuria. BMJ case reports. bcr2013010509
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18 Anderson PJ and Leuzzi V (2010). White matter pathology in phenylketonuria. Molecular Genetics and Metabolism. 99: S3-19.
19 Mastrangelo M et al (2015). The outcome of white matter abnormalities in early treated phenylketonuric patients: A retrospective longitudinal long-term study. Molecular Genetics and Metabolism. 116(3): 171-7
20 Cleary MA et al (1995). Magnetic resonance imaging in phenylketonuria: reversal of cerebral white matter change. The Journal of Pediatrics. 127(2): 251-5
21 Pardridge WM (1998). Blood-Brain Barrier Carrier-Mediated Transport and Brain Metabolism of Amino Acids. Neurochemical Research. 23(5): 635-44
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23 Broer S (2008). Amino Acid Transport Across Mammalian Intestinal and Renal Epithelia. Physiological Reviews. 88(1): 249-86
24 Pietz J et al (1999). Large neutral amino acids block phenylalanine transport into brain tissue in patients with phenylketonuria. The Journal of Clinical Investigation. 103(8): 1169-78
25 Schindeler S et al (2007). The effects of large neutral amino acid supplements in PKU: an MRS and neuropsychological study. Molecular Genetics and Metabolism. 91(1): 48-54
26 Ahring K et al (2011). Blood phenylalanine control in phenylketonuria: a survey of 10 European centres. European Journal of Clinical Nutrition. 65(2): 275
27 Jurecki E et al (2017). Adherence to clinic recommendations among patients with phenylketonuria in the United States. Molecular Genetics and Metabolism. 120(3): 190-7
28 MacDonald A et al (2010). The reality of dietary compliance in the management of phenylketonuria. Journal of Inherited Metabolic Disease. 33(6): 665-70
29 Walter J et al (2002). How practical are recommendations for dietary control in phenylketonuria? The Lancet. 2002; 360(9326): 55-7
30 Ford S et al (2018). Living with Phenylketonuria: Lessons from the PKU community; Molecular Genetics and Metabolism Reports. 17: 57-63
31 Bik-Multanowski et al. (2008). Quality of life in non-compliant adults with phenylketonuria after resumption of diet. Journal of Inherited Metabolic Disease. 31(2): 415-8

Page 42 - A FOOD-FIRST APPROACH TO EATING AND DRINKING WELL by Gill Hooper
1 www.bapen.org.uk/malnutrition-undernutrition/introduction-to-malnutrition?showall=&start=4 (accessed Jan 2019)
2 www.bapen.org.uk/pdfs/economic-report-full.pdf (accessed Jan 2019)
3 www.bapen.org.uk/resources-and-education/tools/commissioning-toolkit/23-about-malnutrition (accessed Jan 2019)
4 www.malnutritiontaskforce.org.uk/prevention-programme/ (accessed Jan 2019)
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6 www.ageuk.org.uk/salford/ (accessed Jan 2019)
7 www.srft.nhs.uk/for-patients/patient-leaflets/a-z-dept/?categoryesctl1043533=1000 (accessed Jan 2019)
8 www.ageuk.org.uk/salford/about-us/improving-nutrition-and-hydration/our-resources/ (accessed Jan 2019)
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1 Scottish Oral Nutritional Supplements Short Life Working Group (ONS SLWG) Report and recommendations. April 2018
2 The Herald, 15/6/18, page 2
3 CMO annual report: Realistic medicine. Scottish government ISBN: 978-1-78544-947-5