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Studies regarding the physical development usually cover a short period of time, do not include dietary information, and results are contradictory. The aim of this study is to determine whether the patients with PKU have a normal growth, the incidence of obesity and the relationship of these parameters with diet and nutritional intake.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Material and methods<\/jats:title>\n            <jats:p>This is a retrospective, multicenter, multinational study including patients with PKU from 8 centers from different countries. Data of growth parameters and dietary regimes were collected from birth until the age of 18\u00a0years. Anthropometric tools of the WHO (Anthro version 3.2.2 and Anthro plus) were used to calculate z-score for weight-for-age, height-for-age and body mass index (BMI).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Data from 182 patients with classical PKU were included. The median height z-scores for both male and female patients showed a normal growth pattern according to the WHO charts. Significant positive correlation\u00a0 was observed between height z-score and the Phe (mg\/day) and natural protein (g\/day) intakes in all ages, especially in children younger than 11\u00a0years. The amount of Phe-free amino acid mixture did not affect the height, but lower intakes were negative correlated with the BMI. Also, we detected a positive correlation between the median Phe levels and BMI, meaning that the poorer metabolic control was correlated with higher BMI.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>An objective of PKU is that patients have satisfactory final physical development; the height prognosis seems to be associated with Phe and natural protein intake and therefore should be optimized. It is important to collect longitudinal growth data throughout childhood and adolescence in PKU that considers any change in growth in relationship to dietary patterns.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s13023-025-03946-3","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T18:32:23Z","timestamp":1754332343000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multicenter study on long-term growth in patients with phenylketonuria"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0340-4580","authenticated-orcid":false,"given":"S.","family":"Stanescu","sequence":"first","affiliation":[]},{"given":"A.","family":"Belanger-Quintana","sequence":"additional","affiliation":[]},{"given":"J. C.","family":"Rocha","sequence":"additional","affiliation":[]},{"given":"M. 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She has received speaker and travel honoraria from Nutricia, Vitaflo and Sanofi. ABQ has no conflict of interest in relation to\u00a0the content of this study. She is participating in several clinical essays relating to PKU and has been part of advisory boards for PTC Therapeutics, BioMarin and Nutricia regarding this disease. She has received speaker honoraria, travel, investigation or meeting funds from these companies, as well as from Danone, Recordati Rare Diseases, Grand Fontaine and other industries not related to PKU. JCR was a member of the European Nutritionist Expert Panel (Biomarin), the Advisory Board for Applied Pharma Research, Vitaflo, Synlogic, Biomarin, PTC and Nutricia, and received honoraria as speaker from APR, Merck Serono, Biomarin, Nutricia, Vitaflo, Cambrooke, PIAM and Lifediet. The rest of the authors have no conflict of interest to declare in relation to this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"400"}}