What is the Role of Nutrition and Diet with Parkinson's?
A balanced diet and proper nutrition is important for overall health and functioning, and in people with Parkinson’s disease (PD), good nutrition is essential and may help with the management of symptoms. Diet and the timing of meals can also impact medication schedules, as well as the effectiveness of medications for PD. As PD is a chronic, progressive disease, the nutritional needs of the individual may change over time.1
Nutritional assessments for Parkinson’s disease
A registered dietitian, or nutritionist, is an important part of the healthcare team for people with Parkinson’s. Registered dietitians are food and nutrition experts and they can provide helpful advice to cope with some of the symptoms of PD, like difficulty swallowing, constipation, or changes in weight.
Registered dietitians can provide a nutritional assessment, which includes an evaluation of the individual’s food and nutrient intake, their lifestyle, and their medical history. Nutritional assessments should be performed routinely in people with PD, as their needs frequently change as the disease progresses. Nutritional advice can contribute to the improvement of PD symptoms and increase health-related quality of life.1,2
Nutritional issues in Parkinson’s disease
In addition to the characteristic motor symptoms of PD, as PD progresses people can develop 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). In addition, 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. Unintentional weight loss is also common among people with PD, and can result in a decrease in overall health and increase the risk of death.3
Nutritional goals for people with PD include improving fiber intake to reduce constipation, maintaining hydration, providing adequate energy to prevent weight loss or excessive weight gain, and preventing bone thinning and vitamin D deficiency. In the later stages of PD, medications may be given three or more times a day, and protein-rich foods can become an issue.
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.1,3,4
General nutrition recommendations for people with Parkinson’s disease
PD is a highly variable disease, with each person experiencing their own unique combination of symptoms and individual progression. Nutritional advice should be individualized to treat the specific needs of the person. However, there are some general guidelines for nutrition for people with PD:
- Eating a balanced diet with a variety of foods. A balanced diet includes foods from all the food groups (vegetables, fruit, dairy, grains, protein).
- Drinking plenty of water each day. It’s important to drink at least 1,500 mL, or about 51 ounces, each day.
- Getting enough fiber each day (30-35 g/day). Fiber is found in foods such as fruits with the peel, vegetables, beans, and whole grains. Adequate fiber intake is important in reducing constipation, a frequent symptom of PD.1,3