Nutrition management guideline for maple syrup urine disease: An evidence- and consensus-based approach

• Published in: Molecular genetics and metabolism Vol. 112; no. 3; pp. 210 - 217
• Main Authors: Frazier, Dianne M., Allgeier, Courtney, Homer, Caroline, Marriage, Barbara J., Ogata, Beth, Rohr, Frances, Splett, Patricia L., Stembridge, Adrya, Singh, Rani H.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2014
• Subjects: Age Factors; Diet; Dietary Supplements; Disease Management; Evidence-Based Medicine; Female; Health Care Surveys; Humans; Inborn amino acidopathies; Inborn errors of metabolism; Inherited metabolic disorders; Liver Transplantation; Male; Maple syrup urine disease; Maple Syrup Urine Disease - blood; Maple Syrup Urine Disease - diet therapy; Maple Syrup Urine Disease - surgery; Nutrition therapy/diet therapy; Practice guidelines; Practice Guidelines as Topic; Pregnancy; Kcal; PICO; VAL; ILE; Inborn errors of metabolism; Inborn amino acidopathies; BCKD; BCKA; Allo-ILE; GMDI; MS/MS; PRO; MSUD; TPP; MySQL; NCBI; IMD; SERC; Maple syrup urine disease; MeSH; Inherited metabolic disorders; NAD; Nutrition therapy/diet therapy; CoA; HRSA; Practice guidelines; DRI; LEU; BCAA
• ISSN: 1096-7192; 1096-7206
• DOI: 10.1016/j.ymgme.2014.05.006

In an effort to increase harmonization of care and enable outcome studies, the Genetic Metabolic Dietitians International (GMDI) and the Southeast Regional Newborn Screening and Genetics Collaborative (SERC) are partnering to develop nutrition management guidelines for inherited metabolic disorders (IMD) using a model combining both evidence- and consensus-based methodology. The first guideline to be completed is for maple syrup urine disease (MSUD). This report describes the methodology used in its development: formulation of five research questions; review, critical appraisal and abstraction of peer-reviewed studies and unpublished practice literature; and expert input through Delphi surveys and a nominal group process. This report includes the summary statements for each research question and the nutrition management recommendations they generated. Each recommendation is followed by a standardized rating based on the strength of the evidence and consensus used. The application of technology to build the infrastructure for this project allowed transparency during development of this guideline and will be a foundation for future guidelines. Online open access of the full, published guideline allows utilization by health care providers, researchers, and collaborators who advise, advocate and care for individuals with MSUD and their families. There will be future updates as warranted by developments in research and clinical practice.
•Nutrition management of MSUD was examined by evidence and consensus analysis.•Topics included BCAA levels, thiamin usage, pregnancy, illness and transplantation.•Explanation of the online development of the guideline is given.•Guideline includes summary statements, recommendations with ratings and links.•MSUD background and resources for clinicians and patients are included.