nutrition and health

Aproteic and hypoproteic foods

Definition

Protein foods are dietary products classified as foods for special medical purposes, ie as products intended for a particular diet and therefore:

  • To be used under medical supervision;
  • Intended for the complete or partial feeding of patients with limited or disturbed ability to take, digest, absorb, metabolize or excret the foods of current use or some nutrients or metabolites contained in them;
  • Intended for the complete or partial feeding of patients whose dietary treatment cannot be achieved through the modification of the normal diet or with the use of other dietary products that are not foods for special medical purposes.

More precisely, citing the ministerial Circular of November 5, 2009, substitute aproteic / hypoproteic products are defined, with a protein residue of no more than 1%, of foods of current use with significant protein content, of vegetable derivation such as bread, pasta, biscuits, baked goods and the like .

This category also includes foods with protein residue between 1 and 2%, and substitutes for source drinks or rich in proteins, also of animal origin, with a protein residue of no more than 0.5%.

Labeling

Nutritional values ​​per 100 grams of pasta

Aproteica Pasta

Common semolina pasta

Energy value

1528 KJ / 360 Kcal

1553 KJ / 371 Kcal

Protein

0.5 g

13.04 g

Phenylalanine

17 mg

668 mg

Tyrosine

<15 mg

243 mg

Carbohydrates

86.3 g

74.67 g

Starch

86.1 g

62.45 g

Sugars

0.20 g

2.67 g

polyalcohol

0 g

0 g

Grassi

1.3 g

1.51 g

Saturated

1.0 g

800 mg

Trans

0 g

0 g

Fiber

0.5 g

3.2 g

Sodium

9 mg

9 mg

Potassium

6 mg

223 mg

Phosphorus as P

22 mg

190 mg

Given the importance of these foods in the therapeutic management of patients suffering from chronic and congenital diseases, it is essential that all products meet specific composition and labeling requirements that allow the user to assess the ingredients present and the ingredients with the maximum transparency. relative concentrations.

More precisely, on the label must be defined the concentrations of "nutrients" indicating, if necessary, that of specific amino acids, sugars, fatty acids or other substances useful for safeguarding the health of the patient as well as:

  • Indications for use both dietetic and clinical;
  • Warnings regarding the use of the product under medical supervision;
  • Warnings concerning the avoidance of the use of the food in question as a sole food source, given the dietary-nutritional incompleteness;
  • Warnings related to the risk of using the product in patients not suffering from the disorders and the pathologies for which instead their use is indicated.

Directions for use

Why are apoproteic foods used?

The use of aproteic dietetic foods is indicated in particular congenital pathological conditions characterized by altered absorption, digestion, metabolism or excretion of specific amino acids, as in the case of chronic diseases such as chronic renal failure. The latter represents the main indication for the use of aproteic foods, contextualized in a more general hypoprotein dietary regime, which limits the daily intake of proteins to 0.6 - 0.8 gr / kg.

Despite the reduced protein intake, dictated by obvious physio-pathological conditions, it is advisable that the nutritionist in any case be able to meet the amino acid needs of the patient, thus using high biological value proteins such as those derived from foods of animal origin. It is precisely for this reason that it is fundamental to resort to the use of aproteic foods, in such a way as to reduce as much as possible the consumption of low biological value proteins, such as those present in flour, cereals and derived products; in this way it will be possible to easily compensate the plastic and structural needs of the organism by resorting to the specific integration of essential amino acids.

Despite the important dietary protein restrictions, in order for the patient suffering from chronic renal failure to preserve his state of health, slowing down the progressive deterioration of renal function, it is advisable that this pay the utmost attention also to the consumption of foods rich in potassium, given the reduced excretion capacity and the consequent risk of hyperpotassemia, of phosphorus, therefore note the altered homeostasis, and calcium, whose concentrations tend to decrease significantly given the reduced renal activity in the hydroxylation of vitamin D.

Different studies have shown that compliance with these dietary norms can significantly improve the quality of life of patients suffering from chronic renal failure, delaying the deterioration of renal function and significantly reducing the incidence of clinically relevant diseases such as osteoporosis, acidosis systemic and especially cardiovascular diseases.

redeemability

Given the importance of dietary aproteic foods in the management of renal pathology, the national health system has provided for a reimbursement system, commensurate with the financial capacity of the patient and his family, for the expenses incurred for the purchase of these products currently included in Band C, so until recently it is entirely the responsibility of the citizen.

This mechanism has triggered an important virtuous system, as shown by the various studies, able to increase the patient's therapeutic compliance, thus improving their quality of life while lengthening their duration.

News from the scientific world

Very interesting are the results published in the literature concerning the use of aproteic dietetic foods, in the context of hypo or aproteic diets, outside the normal clinical prescriptions.

In particular, the study of hormonal responses has shown how hypoprotein diets can induce:

  • Hypoinsulinemia, with consequent alteration of glucose homeostasis and increase of noradrenergic tone;
  • Significant reduction in blood concentrations of testosterone, luteinizing hormone and stimulating follicle hormone, thus compromising reproductive capacity, fortunately in a reversible and transient manner;
  • Significant reduction of lean mass, and in particular skeletal muscle mass;
  • Alteration of adrenergic / noradrenergic control with significant vascular and cardiac disorders.

From these evidences it is easy to see the importance of the correct protein intake in safeguarding the functional and structural integrity of entire tissues, organs, systems and systems, thus banning dietary tendencies, without scientific support, which significantly limit, in the absence of pathological conditions which require it, protein consumption.