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This study evaluates the role of nutritional counseling in promoting adherence to the Mediterranean diet among Italian patients with phenylketonuria treated with Pegvaliase. Patients exhibited comparable Mediterranean Diet Scores to the general population, meeting most macronutrient recommendations but showing deficiencies in zinc, iron, selenium, and certain vitamins. The findings suggest that regular nutritional counseling improves dietary habits, though further interventions are needed for micronutrient adequacy.
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