What is the Role of Nutrition and Diet with Parkinson's?
A balanced diet and proper nutrition is important for overall health and functioning. In people with Parkinson’s disease (PD), good nutrition is essential and may help them better manage their symptoms. Diet and the timing of meals can also impact drug schedules, as well as the effectiveness of drugs for PD. PD is a chronic, progressive disease, so the nutritional needs of each person may change over time.1
Nutritional assessments for Parkinson’s disease
A registered dietitian (RD) or nutritionist is an important part of the care team for people with PD. Registered dietitians are food and nutrition experts. They can provide helpful advice to cope with some of the symptoms of PD, like difficulty swallowing, constipation, or changes in weight.
RDs can provide a nutritional assessment. This includes an evaluation of the person's food and nutrient intake, their lifestyle, and their medical history. Nutritional assessments should be regularly performed in people with PD. This is because their needs often change as the disease progresses. Nutritional advice can help improve PD symptoms and increase health-related quality of life.1,2
Nutritional issues in Parkinson’s disease
While motor symptoms of PD are a key symptom of the condition, it can also cause other nutritional issues as the disease progresses, including:3
- Trouble chewing
- Difficulty swallowing
- Excessive salivation
- Decreased gastric motility (slowing of the natural movement of food from the stomach into the intestines)
Plus, many of the drugs used to treat PD can cause side effects that impact diet, including:3
- Dry mouth
- Nausea, vomiting
- Appetite loss
Unintentional weight loss is also common among people with PD. This can result in a decrease in overall health and increase the risk of death.3
Nutritional goals for people with PD include:1,3,4
- Improving fiber intake to reduce constipation
- Maintaining hydration
- Providing enough energy to prevent weight loss or excessive weight gain
- Preventing bone thinning and vitamin D deficiency
In the later stages of PD, drugs may be given 3 or more times a day, and protein-rich foods can become an issue.1,3,4
Amino acids found in protein-rich foods like meat, fish, poultry, and dairy products can interfere with the absorption of the drug levodopa. This causes the drug to be less effective in managing PD symptoms. This can be avoided by:1,3,4
- Taking the drug 30 minutes before meals or 1 hour after meals
- Eating protein-containing foods at dinner rather than at breakfast or lunch
- Ensuring the recommended amount of protein is being eaten
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. Each person has their own unique combination of symptoms and progression. Nutritional advice should be customized 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.
- Getting enough fiber each day. Fiber is found in foods like fruits with the peel, vegetables, beans, and whole grains. Fiber intake is important in reducing constipation, which is a frequent symptom of PD.1,3