Nutrition and Parkinson’s Disease

What are the basics of a balanced diet?

Good nutrition plays a particularly critical role for individuals with Parkinson’s disease. A balanced diet helps to maintain your energy, contributes to brain health, maximizes the potential of medications and promotes well-being (American Parkinson’s Disease Association, 2009). Each individual’s needs for nutritional intake will vary, so it is prudent to consult with a doctor to determine what is best. Generally, a balanced diet involves eating regularly and not skipping meals, eating from a variety of food groups and eating to maintain a healthy weight (Traviss, 2007). Following the guidelines provided in Eating Well with Canada’s Food Guide will ensure that you are getting the recommended daily servings you need from each of the four food groups.

While this may seem like simple advice, some people with Parkinson’s may find it challenging to ensure they are eating a balanced diet due to their lifestyle or symptoms, which may affect the ability to shop, prepare food and eat. If you are experiencing difficulties, reach out to your doctor or a registered dietitian for advice. Furthermore, you may find it helpful to seek assistance from others for shopping and meal preparation. When you are shopping, be sure to keep nutritious, easy-to-prepare meals and snacks on hand (Traviss, 2007).

Is there a specific diet to follow for Parkinson’s?

Research has provided some evidence on the possible benefits of certain foods; however, it has not been specific to Parkinson’s disease (Zwickey, 2016). Currently, no singular diet has been shown to treat Parkinson’s disease or its symptoms, but a healthy and balanced diet can improve general well-being (Michael J. Fox Foundation, n.d.). So what can you eat as a part of an informed diet? Look for foods that are neuroprotective, anti-inflammatory and rich in antioxidants.

Neuroprotective foods have been studied for their potential to improve brain health. Nuts have shown the most promise; however, they are high in calories, so your intake should be limited to a handful per day. Consider making a healthy granola for breakfast with chopped nuts and dried fruit, but skip the oatmeal and grains. If you have trouble swallowing, you can incorporate a nut butter into your diet instead. In addition to nuts, some herbs and spices have been shown to keep the brain healthy such as turmeric, ceylon cinnamon and rosemary.

Anti-inflammatory foods may be useful in keeping the brain healthy. The types of fat you consume are important in reducing inflammation. One type of oil that appears to have positive benefits is coconut oil, and you can cook with it as you would with olive oil. Other foods that are considered to have anti-inflammatory properties are dark leafy greens such as kale, spinach and collard greens; soy products; and oily fishes like salmon, tuna and mackerel (Zwickey, 2016).

Antioxidants, according to the Mayo Clinic, are “substances that may protect your cells against the effects of free radicals – molecules produced when your body breaks down food or is exposed to tobacco smoke and radiation.” (n.d.). Essentially, free radicals are toxic substances formed from stressors. When you have too many free radicals, the body is said to be under oxidative stress. A diet high in antioxidants may offset cellular damage and oxidative stress. (Michael J. Fox Foundation, n.d.). Look for fruits that are purple and red, like blueberries and raspberries. These berries contain pigments called anthocyanins, which are well-known antioxidants (Zwickey, 2016).

What impact may diet have on my medications?

Your mealtimes may affect how quickly medications are absorbed into your body. For example, some individuals who take carbidopa-levodopa, or Sinemet®, may find that protein-rich foods increase the time it takes for their medication to kick in, or make it less effective (Zwickey, 2016). If you find that this is an issue for you, try taking your carbidopa-levodopa (Sinemet®) 30 minutes before your meal with a carbohydrate food such as a cracker or biscuit (Parkinson’s UK, 2012).

Pyridoxine, or Vitamin B6, has also been found to reduce the effects of levodopa when levodopa is taken on its own. It is recommended that if you are taking levodopa by itself, you avoid taking vitamin products containing B6 unless specifically discussed and prescribed by your doctor. Foods such as bananas, egg yolks, lima beans, meats, peanuts and whole grain cereals contain large amounts of pyridoxine (B6). Check with your doctor as to how much of these foods should be in your diet while taking levodopa (Mayo Clinic, 2015).

Are there any changes I can make in my diet to help with constipation?

Constipation occurs when stools are hard and difficult to pass, or when a person has a bowel movement less frequently than they have before. It is a common symptom of Parkinson’s disease, and may cause poor absorption of medication (Parkinson’s UK, 2013). While you may feel that this is a difficult or embarrassing issue to raise, it is critical to discuss it with your healthcare provider as severe constipation can lead to bowel obstruction, a potentially life-threatening condition. There are, however, some steps you can take to help relieve constipation.

Incorporate more fibre-rich foods into your diet. Foods such as whole grain bread, pasta, brown rice, breakfast cereals containing wheat bran or oats, vegetables and fruits, will absorb fluid and form a soft stool that can be passed more easily. Although you may think it is an easy fix to add loose extra bran to your food, it is not recommended as this can lead to bloating and reduce absorption of vitamins and minerals.

Drink more fluids to help fibre do its work. It is recommended that you drink 8 to 10 cups of water every day. You can count any fluid intake from healthy fruit juices, milk and tea towards this amount. Try to avoid fizzy drinks as they cause some people to feel bloated (Parkinson’s UK, 2012).

I’ve heard that people with Parkinson’s are prone to osteoporosis. Is this true? If so, is there anything I can do to help reduce my risk?

Osteoporosis is caused by a low bone-mineral density. Risk factors include old age, low body weight, smoking, excessive alcohol consumption, limited exposure to sunlight, inadequate intake of vitamin D and calcium and lack of weight-bearing exercise.

Calcium can be obtained through milk and milk products including yogurt and cheese. Although there are additional calcium-rich foods such as tofu, soy-based beverages, orange juice and dark leafy greens, calcium from non-dairy sources may not be well-absorbed.

Vitamin D can be obtained by getting outdoors and consuming vitamin D rich foods. These foods include vitamin D fortified milk, yogurt or breakfast cereals and fatty fish.

Due to the fact that individuals with Parkinson’s disease are at an increased risk of falling, having osteoporosis can be particularly worrisome. Talk to your doctor about having your bone-mineral density checked, as medical treatments may be available (Traviss, 2007).

Sources

American Parkinson Disease Association. (2009). Good Nutrition and Parkinson's Disease. Retrieved February 15, 2016, from http://www.apdaparkinson.org/uploads/files/Good-Nutrition-book-iEQ.pdf 

Mayo Clinic. (2015). Drugs and Supplements, Levodopa (Oral Route): Proper Use. Retrieved February 22, 2016 from http://www.mayoclinic.org/drugs-supplements/levodopa-oral-route/proper-use/drg-20064498 

Mayo Clinic. (n.d.). Antioxidants: Why are they important? Retrieved February 17, 2016, from http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/multimedia/antioxidants/sls-20076428?s=1 

Michael J. Fox Foundation. (n.d.). Good Nutrition for Parkinson's Patients. Retrieved February 15, 2016, from https://www.michaeljfox.org/understanding-parkinsons/living-with-pd/topic.php?nutrition 

Parkinson’s UK. (2012). Diet and Parkinson’s. Retrieved February 22, 2016, from http://www.parkinsons.org.uk/sites/default/files/publications/download/english/b065_dietandparkinsons.pdf 

Parkinson’s UK. (2013). Looking after your bladder and bowels when you have Parkinson’s. Retrieved February 22, 2016, from http://www.parkinsons.org.uk/sites/default/files/publications/download/english/b060_bladderandbowels.pdf 

Traviss, Karol. (2007). Nutrition and Parkinson's Disease: What Matters Most? Retrieved February 15, 2016, from http://www.pdf.org/en/winter06_07_Nutrition_and_Parkinson 

Zwickey, H. (2016). Nutritional Strategies for Living With Parkinson's. Retrieved February 15, 2016, from http://www.pdf.org/winter16_nutrition 

This content was published in the Spring 2016 edition of our quarterly magazine, Viewpoints. The content was accurate as of this publication date.