While there is no special “Parkinson’s diet”, doctors do know that well-balanced nutrition and the timing of meals can help manage some of the most common Parkinson’s disease (PD) symptoms. The challenge is that when it comes to eating and PD, what works for one person may not work for another. Further, dietary tricks that work in the early stages of the disease may not be effective in later stages.
Constipation is a common problem for people with Parkinson’s disease, often due to decreased gastric motility, a slowing of the natural movement of food from the stomach into the intestines.1,3
Foods that may make constipation worse include low-fiber choices such as white rice, white bread, semolina pasta, and any highly processed foods such as frozen pizza and fast food. Bananas and persimmons may also be problematic for people with constipation.
Red meat, such as beef, hot dogs, bacon or sausage, with its high-fat content, can make constipation worse because it is harder to digest than less fatty meats such as chicken or fish. Beverages to avoid include anything with caffeine, such as coffee, tea, or sodas. Alcohol is not recommended because it dehydrates your body, which can make constipation worse.
By eating more fruits with the peel on, vegetables, beans, and whole grains can help you reach the recommended 30-35 grams of dietary fiber per day.2
Nausea is a common side effect of some Parkinson’s medications, namely Levodopa medications, such as Sinemet®, carbidopa/levodopa extended-release capsules (Rytary®) or carbidopa/levodopa/entacapone (Stalevo®). These medicines are best absorbed by the body when taken on an empty stomach, but that tends to make nausea worse.
Doctors often recommend taking these drugs either a half hour before a meal or an hour or more after eating. This helps balance the need to reduce nausea by making sure the drug is metabolized at an optimal level. Some people also find that it helps to eat a few crackers or a piece of bread before taking their drugs.
Drinking plenty of water each day can help with constipation and can also help the body break down and absorb PD medications. Staying hydrated also helps manage blood pressure. Hydration is another reason it’s important to avoid caffeinated beverages, hot liquids, and alcohol, which all encourage dehydration and low blood pressure, which also can be an issue in PD.
Eating more protein, or not
Finding the right balance of how much protein to eat can be difficult for people with PD. You need protein as part of a balanced diet, but too much protein can interfere with the absorption of commonly prescribed drugs such as Levodopa (Sinemet), especially in the later stages of the disease.
Some doctors recommend concentrating your intake of meat, fish, and cheese to dinnertime and focusing on eating carbohydrates and vegetables during the day. Others may find that it works better to divide their protein evenly among smaller meals throughout the day.1,2,3
Limiting fermented foods
People who take MAO-B inhibitors (rasagiline or selegiline) should be careful of how much they eat of foods high in tyramine. MAO-B inhibitors increase tyramine, and the combination could elevate blood pressure. Foods in this category include:
Cured, fermented or air-dried meats and fish
Fermented cabbage such as sauerkraut and kimchi
Soybean products, including soy sauce and edamame
Red wine and tap beer1
Because the nutritional advice for what to eat, or avoid, with Parkinson’s can be so contradictory and confusing, it’s wise to consult your doctor or a dietitian who specializes in helping those with PD. The goal is to manage your symptoms while finding the right combination of foods that give you nourishment, enjoyment, and help you manage your symptoms.
The Michael J. Fox Foundation for Parkinson’s Research. Diet and Parkinson's Disease. Available at: https://www.michaeljfox.org/understanding-parkinsons/living-with-pd/topic.php?nutrition. Accessed 4/5/2019.
Marcason W. What are the primary nutritional issues for a patient with Parkinson's disease? J Am Diet Assoc. 2009 Jul;109(7):1316.