Parkinson’s Disease & Diet- How A Dietitian Can Help

Parkinson’s disease (PD) is a disorder of the central nervous system where the nerve cells that produce a chemical called dopamine essential for smooth control of muscle movement are damaged. Nutritional considerations may need to be made; dependent on medications and presenting symptoms.

Medications

A common medication used in this population; Levodopa, is absorbed in the same part of the gut as protein in our food. Levodopa competes for absorption and may mean less medication is absorbed when taken at the same time as eating a protein-containing meal or snack such as meat, fish, dairy products (cheese, milk, yoghurt), beans and nuts.

Things to consider:

• Consider separating medication away from meals (ie. 30 minutes before or 2 hours after a meal)
• Protein distribution diet – may not always be helpful if you are struggling to maintain weight. Consult with a Dietitian to work out an individualised meal plan.

Common symptoms that present with PD, where diet may assist

Unintentional weight loss:

• This is common in this population and may be associated with; tremor, bradykinesia, fatigue, dysphagia, fine motor changes, nausea, medication interaction, dyskinesia.
• Some great strategies to reduce the risk include eating small but more frequent meals, pre-packaged meals or bulk food preparation, fortification of foods, eating the protein component of the meal first, replacing energy-poor liquids with energy-dense liquids such as milk-based products. Some high protein/ high energy options include; dairy products, meat and meat alternatives, eggs, nuts and seeds, cakes and biscuits.

Constipation:

• Indicators of constipation include dry hard bowel motions and difficulty passing the stool, fewer than three bowel motions a week, feeling the need to strain on the toilet and feeling the bowel isn’t completely empty after passing a stool.
• 3 tips to consider: fluid, fibre and exercise.
  • Fluid: Aim for 8 glasses of water a day. Whilst water is the best option, other fluids that count include soup, tea, coffee and juice.
  • Fibre: Adequate fibre intake in the diet is a great way to assist with healthy bowel habits. 25 grams for women and 30 grams for men a day is a general guide.
    • Aim to eat 2 servings of fruit and 5 serves of vegetables a day. Sprinkle some high fibre options onto breakfast including all bran, chia seeds, LSA or psyllium.
    • Fibre supplements may also be useful if you are struggling to meet your fibre intake from food sources alone.
    • It is important to not increase fibre intake too quickly as this will result in further constipation and discomfort. A great way is to make a small change each week. Ensure fluid intake is also increased during this time.
  • Exercise: Gentle movement such as a small walk or even chores around the house can assist with bowel regularity.

Swallowing problems:

• For some the ability to swallow may decline due to muscles affected in this area, making it harder for the individual to maintain their weight and meet their nutritional needs. In this instance, it is important to have both the speech pathologist and dietitian involved to ensure both adequate oral intake and appropriate consistencies of food to prevent aspiration pneumonia.
• Thickening liquids or making foods softer are common options to assist with this.

Supplements:

Generally, supplements are not necessary unless blood test results indicate otherwise or the individual is significantly struggling to meet their nutritional needs, where a multivitamin may be indicated. If you are frequently having falls calcium and/or vitamin D supplement may also be of benefit to maximise bone strength and prevent fractures.

Dietary patterns and key takeaways

A Mediterranean style of eating, with an abundance of fruit, vegetables, whole grains, healthy fats, lean meats and moderate amounts of dairy and red meat has shown to promote a healthy gut microbiome, reduce chronic inflammation and most importantly in those with PD, the potential to increase dopamine, which is known to be produced by certain gut bacteria.

This diet approach has been shown to improve symptoms of PD through gut microbiome modulation. Whilst research indicates it may also help reduce blood pressure, cardiovascular disease and constipation due to the diet being high fibre in nature.

This dietary approach is full of antioxidants and has anti-inflammatory/ neuroprotective properties helpful for this population.

Furthermore, omega 3 polyunsaturated fats also appear to be neuroprotective for several neurodegenerative diseases.

Omega 3 sources include fish (especially oily fish such as salmon), nuts and seeds, plant oils (such as flaxseed oil) and fortified foods (such as certain brains of eggs, milk).

A Mediterranean style of eating accounts for regular inclusions of omega 3 containing foods.

This information provided is only brief, in the instance that you or you know someone diagnosed with Parkinson’s Disease it is important for them to receive Dietitian input as everyone is uniquely different and no one diet plan fits.

If you or someone you know may need help with managing their Diabetes get in contact with the Total Rehab Solutions Team and see how our Dietitian Team can help you! 

 admin@totalrehabsolutions.com.au

 1300 685 046

Written By, Dietitian (APD) Rachael Gilholm