By Brenda Morales, DTR

Parkinson’s disease is the second most common neurodegenerative brain disorder worldwide. Parkinson’s affects nerve cells in the part of the mid-brain, responsible for muscle movement. The result is tremors, rigidity, slow movements and difficulties with balance.

Nutrition is particularly important in patients with Parkinson’s disease for many reasons; the disorder itself often slows transition through the gut and affects absorption of nutrients increasing the risk of malnutrition. Poor nutrition can lead to other health conditions such as hypertension, while good nutrition promotes overall brain health and may have some protective benefit and improve symptoms.
There is no specific singular diet plan to treat Parkinson’s disease or its symptoms, but a healthy well-balanced diet can definitely improve general well-being.

Basics of Healthy Eating for Parkinson’s disease:
• Eat real foods. Include high-fiber foods such as vegetables, legumes, whole-grain foods, and fresh fruit in your diet.
• Choose foods low in saturated fat and cholesterol.
• Limit sugar intake
• Reduce your sodium intake to help reduce your risk of high blood pressure
• Keep hydrated and drink eight 8-ounce glasses of water daily
• Consume calcium-rich foods including dairy products, dark leafy greens, seafood, legumes, tofu and orange juice
• Incorporate foods high in antioxidants, which are important for overall brain health and are present in: vegetables, fruits (especially berries), whole grains, legumes, nuts, and dark chocolate.
• Use a Vitamin D supplement
• Avoid alcoholic beverages (as alcohol may interfere with some medications) and avoid or limit caffeine
• Maintain a healthy weight through a proper balanced diet and exercise.

Nutrient-Drug Interactions
Conventional treatment for Parkinson’s often includes medication. The most common used drug is levodopa (Sinemet®), which is a protein building block so it competes for absorption with other proteins in the diet. Eating a high protein meal reduces the likelihood of effectively absorbing levodopa. If you are currently taking levodopa consider this:
• Take levodopa medication on an empty stomach – 30 minutes before or one hour after a meal – this will allow the drug to reach the small intestine and lead to better and faster absorption. However, if taking medication on an empty stomach makes you nauseous consider taking it with a carbohydrate snack such as crackers, toast, oatmeal, or fruit.
• Allow 30 minutes to one hour before or after taking levodopa to consume a high protein-containing meal (such as meat, fish, poultry and dairy products). But do not use a restricted-protein diet.

If you are taking MAO-B inhibitors (rasagiline or selegiline) you should avoid or limit following high tyramine foods:
• Cured meats or fish
• Aged cheeses including: aged cheddar or Swiss and blue cheese
• Fermented foods including: sauerkraut and kimichi
• Soy-based foods including soy sauce
• Alcohol
MAO-B inhibitors increase tyramine and combining with high tyramine foods could elevate blood pressure. Meanwhile, dopamine agonists (pramipexole and ropinirole) do not require any dietary restrictions or adjustments.

Dietary changes can ease Parksinson’s symptoms
Each person with Parkinson’s will experience symptoms differently. For example, many people experience tremor as their primary symptom, while others may not have tremors, but may have problems with balance. Also, for some people the disease progresses quickly as it is a progressive disease, and in others it does not.

Other common complications with Parkinson’s include: constipation, swallowing problems, depression, cognitive impairment, increased risk of osteoporosis, sleep disorders, vision problems and impaired sense of smell. The following dietary recommendations will help improve quality of life.

Maintain healthy bone health
Individuals with Parkinson’s are prone to osteoporosis, a disease caused by low bone-mineral density. Risk factors for osteoporosis include: older age, low body weight, smoking, excessive alcohol intake, inadequate Vitamin D levels and inadequate intake of calcium.
To maintain healthy bone health, make sure your diet includes plenty of calcium and Vitamin D. Individuals over the age of 50 should consume 1500 mg of calcium daily. The main calcium-rich foods are dairy products, dark leafy greens, seafood, legumes, tofu, and orange juice. Some foods contain limited amounts of Vitamin D such as vitamin D-fortified milk, yogurt and breakfast cereals. However, to obtain adequate amounts of vitamin you need to spend time outdoors regularly or consider using a nutritional supplement.

Constipation Relief
Constipation is common in Parkinson’s disease. Increased fluid and fiber consumption can help maintain regularity. Aim to drink six to eight 8-ounce glasses of water daily. Warm lemon water in the morning can also help stimulate bowel movements. Consume foods high in fiber such as fruits, vegetables, whole grain bread, beans and legumes. Also, stay active and exercise, it will help ease constipation.

Swallowing Problems
Swallowing problems can present as coughing, choking or a sensation of food feeling “stuck.” If you experience this problem try altering the consistency of solids and/or liquids, and take smaller bites at a slower pace.
To help deal with all other symptoms there are no special diets or natural foods that have shown to slow down or improve progression of Parkinson’s disease, but a healthy diet helps.

What should you eat?
Eating natural whole-foods best approach for any healthy life; consume an anti-inflammatory antioxidant-rich diet that includes:
• Fruits and Vegetables.
• Whole grains
• Eggs
• Lean protein (chicken, turkey, fish, limit red meat to only once a week)
• Healthy fats: olive oil, avocado, coconut oil
• Legumes
• Nuts and Seeds
• Dark Chocolate (in moderation)
You may also consume dairy products in moderation if you wish. Milk and milk products are the riches dietary sources of calcium. Limit to two servings per day (one serving is one cup of milk or yogurt, or one and one-half ounces of hard cheese).

The goal of nutrition is to ease your Parkinson’s disease symptoms and prevent the risk of other health issues.

References:
Parkinson’s Disease Foundation. www.pdf.org
The Michael J. Fox Foundation for Parkinson’s Research. www.micharljfox.org

Disclaimer: The data on this document is provided for informational purposes only, it is not tailored to the needs of your specific situation and is not meant to be used, nor should it be used to diagnose or treat any medical condition. This information is not meant to substitute for the advice provided by your own physician or qualified health professional, who should always be consulted before beginning any new diet or other health program.