Understanding the role of nutrition and Parkinson’s Disease (July 2024)
In more than two decades of working with various types of clients as a dietitian, I’ve noticed that helping people with Parkinson’s Disease (PD) isn’t often talked about. That raises the question: how can nutrition support Parkinson’s Disease?
Parkinson’s Disease is a progressive neurodegenerative disorder that can cause uncontrollable or unintended movements such as tremors and dementia. Other signs and symptoms include memory impairments, coughing, constipation and difficulty with movement. While unfortunately there’s no cure, it is possible to slow symptom progression by taking into account all aspects of someone’s life, which can include nutrition.
For example, one of my clients with PD has difficulty speaking. She told me she noticed it was becoming a struggle to get her words out and to speak loudly or strongly. Since her ability to speak has been impacted, this has contributed to dry mouth that leads to coughing, which then forces her to pay close attention to the types of foods she eats, especially their texture.
Another example involves protein. When it comes to nutrition and PD, protein intake is a common concern, or perhaps more of a conundrum. On one hand, the most commonly prescribed medication for PD is Levodopa. For those taking this drug, eating protein-based foods can be problematic because the large neutral amino acids that protein foods are comprised of can compete with Levodopa for the same transporters that allow the medication to move from the gut to the brain by crossing the blood-brain barrier.
On the other hand, a protein-restricted diet can contribute to malnutrition in those with PD. People with PD already struggle to eat enough, and while about 6% of people with PD do experience adverse protein interactions with Levodopa, for the 94% who are not experiencing this particular drug-nutrient interaction limiting protein foods might put their nutritional status at risk.
There is so much cutting-edge research on the gut microbiome, and it’s even said that “everything starts in the gut.” With a change in diet of course there is a change in the microbiome. Also, PD and other diseases can cause imbalances in the microbiota due to the disease, and the resulting change in the microbiome could affect dopamine levels in the brain. Dopamine is produced in the brain and in the gut, but gut microbes also play a role in regulating dopamine’s activity and bioavailability. Scientists believe a lack of dopamine causes PD.
Research suggests that our diet in midlife can have an impact on the possible development of PD, but what does this mean, exactly? Current dietary trends emphasize eating more protein, and sometimes more dairy foods, than is needed for optimal health. Research suggests that those foods—in addition to baked goods and fried foods—may increase the risk of developing PD. On the flip side, research suggests that eating a more Mediterranean-style diet (a diet that is based more on produce, beans, nuts and fish) may reduce the chance of developing PD. It’s also a diet that can support the gut microbiome.
That said, research has not identified exactly how what we eat might accelerate or slow down the advancement of PD. It has looked at how particular dietary choices, beverages and supplements may play a role, with mixed results.
For example, there’s conflicting data about how caffeine may either aid the progression of the disease or hinder it. There is a theory that some people have a genetic mutation that impacts the metabolism of caffeine, which might explain why studies are finding conflicting results. It is known that caffeine has antioxidants, which can be beneficial.
Given the current state of the research on diet and PD, it’s best to not have a one-size-fits-all approach and instead approach meals with mindfulness and care, and evaluating what recommendations from the current research work for you.
Resources:
Paknahad Z, Sheklabadi E, Derakhshan Y, Bagherniya M, Chitsaz A. The effect of the Mediterranean diet on cognitive function in patients with Parkinson’s disease: a randomized clinical controlled trial. Complement Ther Med. 2020; 50:102366.
Barichella M, Cereda E, Cassani E, et al. Dietary habits and neurological features of Parkinson’s disease patients: implications for practice. Clin Nutr. 2017; 36:1054-1061.
Agarwal P, Wang Y, Buchman AS, Holland TM, Bennett DA, Morris MC. Dietary antioxidants associated with slower progression of parkinsonian signs in older adults. Nutr Neurosci. 2022;25(3):550-557
Fox DJ, Park SJ, Mischley LK. Comparison of associations between MIND and Mediterranean diet scores with patient-reported outcomes in Parkinson’s disease. Nutrients. 2022;14(23):5185.
Virmani T, Tazan S, Mazzoni P, Ford B, Greene PE. Motor fluctuations due to interaction between dietary protein and levodopa in Parkinson’s disease. J Clin Mov Disord. 2016; 3:8.
