more is known on this topic, the best approach is to limit Foods NOT ALLOWED in Foods TO LIMIT in vegetable oils that are high in PUFAs to the amount required to ILE-, MET-, THR-, and VAL- ILE-, MET-, THR-, and VAL- provide essential fatty acids. Coconut oil, palm oil, and peanut oil restricted meals restricted meals are low in PUFAs and may be used as energy (calorie) sources. • Bread with added calcium • Breast milk & infant formula Ask your metabolic doctor or dietitian which is best for your propionate or sodium • Bread child. propionate • Crackers TIPS • Butter • Fruit • Keep a list of your individualized goals (set by you and your • Cheese and dairy products • Fruit juices health care team) on the inside front cover of this guide (write • Chicken fat • Low-protein cereals in pencil). • Dried beans and peas • Popcorn • How do you know if products are ILE-, MET-, THR-, and • Eggs • Potato chips VAL-free by reading the label? • Fish and other seafood • Special low-protein foods — A label may state that a food contains “0” protein. • Fish oils • Vegetables The zero or “0” is a rounded figure, and the product may • Lard • Vegetable juices contain up to 0.49 grams of protein per serving. Check • Meat with your dietitian or look to see if any of the ingredients • Nuts may contain ILE, MET, THR, or VAL. • Olive oil • For greatest accuracy, weigh foods on a scale that reads in • Nut butters grams. If a scale is not available, use approved measuring cups • Poultry and spoons for measuring portion sizes. Table 2 lists equiva- • Seeds lents. Odd-Chain Fatty Acids. Food fats that contain fatty acids with an uneven number of carbons are called odd-chain fatty acids. These fats produce some propionic acid when they are used in the body. Food fats that contain a small amount of odd-chain fatty acids include butter, chicken fat, cream, some fish oils, lard, and olive oil. Therefore, these foods may be restricted for your child. Avoidance of fasting is very important, as fasting leads to a build-up of odd-chain fatty acids. The higher level of a substance called “propionyl-CoA” acts as a “starter” for the production of odd-chain fatty acids. PUFAs. Vegetable oils such as canola, corn, safÒower, and soy contain large amounts of polyunsaturated fatty acids (PUFAs). According to some reports, when large amounts of PUFAs are eaten, a small portion of each PUFA is broken down to propionic acid. Not everyone agrees with these reports. However, until 6 7