Individuals with severe forms of PAH deficiency and low PHE tolerance often rely on modified low-protein foods to provide energy and variety in their diets.15 Modified low-protein foods, including low-protein breads and pasta, use the starch portion of the grain rather than the higher-protein flour.62 It is important to note that these products do not have the usual vitamin enrichment found in regular grain products. As a source of energy, these products can help to prevent weight loss, catabolism, and the resulting elevated blood PHE.15 Third-party reimbursement for modified low-protein foods is not universally available.52