Nutrition Challenges in Parkinson's

People with Parkinson’s disease (PD) have unique nutritional challenges, and their nutritional needs frequently change over time as their disease progresses. PD is most well known for its motor symptoms: tremor, rigidity, bradykinesia (slowed movement), and postural instability (balance impairment). As PD progresses, people can develop additional symptoms including depression, trouble chewing, difficulty swallowing, constipation, dehydration, excessive salivation, and decreased gastric motility (a slowing of the natural movement of food from the stomach into the intestines). These non-motor symptoms can impact dietary needs and may lead to additional complications, like unintended weight loss.1,2

Difficulty preparing and eating food

The motor symptoms of PD, such as tremor and bradykinesia, may make it difficult for someone to prepare their own food. Side effects from medication, like nausea, may also impact the desire to prepare or eat food. Additional symptoms caused by PD, like difficulty swallowing, can impact a person’s ability to eat. These complications can lead to unintended weight loss.1,2

Weight changes in Parkinson’s disease

PD may cause a person to gain weight or to lose weight. Changes to weight (in either direction) can have negative effects on a person’s overall health. Weight gain, which may occur due to lack of movement and exercise, can lead to being overweight, increasing the risk of heart disease and high blood pressure, as well as putting extra stress on joints. Weight loss can lead to losing muscle mass and strength and may increase the risk of infection or osteoporosis. Progressive, unintended weight loss is a major feature of the progression of PD.2,3

There are several strategies that can help people with PD to manage their weight, including eating a balanced diet with a variety of foods and getting regular exercise. A doctor or registered dietician can provide specific strategies aimed at either gaining or losing weight.3

Diet and medications for Parkinson’s disease

Many of the medications used to treat PD can cause side effects that impact diet, such as dry mouth, nausea, vomiting, appetite loss, insomnia, fatigue, and/or anxiety.

Amino acids, found in protein sources of food like meat, fish, poultry, and dairy products, can interfere with the absorption of the medication levodopa, causing the medication to not be as effective in managing symptoms of PD. This can be avoided by taking medication 30 minutes before meals, eating protein-containing foods at dinner rather than at breakfast or lunch, and ensuring that the recommended amount of protein is being consumed. Many people consume significantly more protein than is recommended. A good rule to remember is that the protein should be about the size and depth of a deck of cards.1,3

Adequate hydration

Some medications used to treat PD can raise the risk of dehydration. Proper hydration is critical for health, and dehydration can lead to confusion, weakness, balance problems, respiratory failure, and even death.4

Bladder or urinary difficulties are common in people with PD, and those who experience urinary incontinence or an urgent need to urinate frequently may tend to limit their fluid intake. Because proper hydration is critical in people with PD, those who experience urinary incontinence should talk to their doctor about possible treatments that can help with urinary issues.3

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Written by: Emily Downward | Last reviewed: November 2020