Conclusion: This audit identified a number of gaps in caregiver knowledge and awareness about diet and PKU. It is essential that caregiver understanding is regularly tested and reviewed with education updates given. Objective: Oxidative stress (OS) has been associated with chronic diseases. The concomitance of phenylketonuria (PKU) and hiperphenylalaninemia (Hphe) could increase the OS risk and its consequences. The aim waw to describe and compare oxidant and antioxidant biomarkers in individuals with PKU in adequate metabolic control, Hphe in follow-up and healthy controls. Design: Forty-five individuals (15 PKU, 15 Hphe and 15 controls) between 6 and 12-years-old participated; family smoking habits; anthropometric measurements; selenium (Se) and tocopherol intake along with thiobarbituric acid reactive species (TBARS), total antioxidant capacity (TAC), glutathione peroxidase (GSH-Px) activity and plasmatic tocopherol were assessed. Results: Tocopherol intake was significantly higher in PKU individuals (p<0.0001); however, plasmatic measurement did not differ between groups. Se intake had a tendency to be higher in PKU (p=0.0573) nonetheless the GSH-Px activity was significantly lower in comparison to Hphe and controls (p = 0.0056) as well as TAC (p < 0.0001). Nevertheless TBARS did not show any difference (p=0.5803). Conclusions: Even though TBARS is not affected, the antioxidant capacity is lower in PKU patients. The elevated Se intake in PKU did not correlate with low GSH-Px activity: thus, Se nutritional status must be studied. Hphe individuals should be monitored closely throughout life hence their nutritional risk. The availability of medications and new metabolic formulas for the management of PKU in some cases has permitted the liberalization of the PKU diet. During this transition we recognized a need for nutrition focused educational material. We analyzed 3 day diet records to assess macronutrients and evaluated BMI's at baseline and post diet modifications.The diet analysis of >40% of our patient population that fell within this group revealed poor macronutrient profiles. In response to these analyses, we developed a series of educational modules to assist patients in making healthy, nutrient dense choices while maintaining their restricted and liberalized diets. Initially, a Foundations module was created to provide a base of information on healthy eating and became the template for the following modules: Early Childhood, Teenager, Adult, Pregnancy and Keeping it Simple (Low Literacy) . These modules emphasized the importance of incorporating colorful fruits/ vegetables, healthy fats and fiber in the diet. Recipes, menus, and snack suggestions provided guidance for patients appropriate for any level of dietary restriction. 3 day diet records post introduction of these modules revealed an improvement in nutrient profiles and a decrease in percent of weight gain.