Improved growth and nutrition status in children with methylmalonic or propionic acidemia fed an elemental medical food

Steven Yannicelli, Phyllis B. Acosta, Antonio Velazquez, Hans Georg Bock, Barbara Marriage, Thaddeus W. Kurczynski, Marvin Miller, Mark Korson, Robert D. Steiner, Lane Rutledge, Laurie Bernstein, Jeffrey Chinsky, Patricia Galvin-Parton, Georgianne L. Arnold

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


Background: Failure-to-thrive (FTT) has been described in patients with organic acidemias treated with low protein diets. Objective: To determine if patients with methylmalonic (MMA) or propionic acidemia (PA) can achieve normal growth and nutrition status. Methods: A 6-month multicenter outpatient study was conducted with infants and toddlers treated with Propimex-1 Amino Acid-Modified Medical Food With Iron (Ross Products Division, Abbott Laboratories, Columbus, OH). Main outcome measures were anthropometrics, protein status indices, plasma retinol, and α-tocopherol. Results: Sixteen patients completed the study. Mean baseline age was 0.54±0.02 years (range 0.03-3.00 years). By study end, mean National Center for Health Statistics (NCHS) weight centile increased from 26 to 49%; mean crown-heel length centile from 25 to 33%; and mean head circumference centile from 43 to 54%. Mean (±SE) protein and energy intakes by <6-month-old, 6<12-month-old, and 1<4-year-old patients were 15.3±0.9g and 645±10kcal; 18.3±1.1g and 741±92kcal; and 25.1±2. 46g and 1062±100kcal, respectively. Plasma glycine concentrations were significantly and negatively correlated with energy intake (r=-0.77, p<0.0005). No correlation was found between dietary protein intakes and plasma ammonia concentrations. Protein status indices, retinol and α-tocopherol concentrations were within reference ranges at study end. Conclusions: Propimex-1 improved growth and nutrition status in patients with MMA or PA in just 6 months when fed in sufficient amounts. Providing energy and protein for patients with FTT at intakes recommended for catch-up growth may have resulted in even better growth.

Original languageEnglish (US)
Pages (from-to)181-188
Number of pages8
JournalMolecular genetics and metabolism
Issue number1-2
StatePublished - 2003


  • Growth
  • Methylmalonic acidemia
  • Nutrition
  • Propionic acidemia
  • Retinol
  • α-Tocopherol

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Molecular Biology
  • Genetics
  • Endocrinology


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