Nutrition and Parkinson's Disease
By: Lacey Gammon, MPH, RD, LD
Parkinson’s Disease, or PD, is a chronic movement disorder that progressively worsens over time. It’s most commonly characterized by tremors, stiffness in muscles, and slow movements such as shuffling when walking, little to no facial movements, or temporary “freezing” of a muscle mid-movement. While nutrition and diet will not reverse these PD symptoms, it can, however improve other PD related symptoms such as depression, constipation, fatigue, among many others.
There has not been enough evidence or research to determine a specific diet that benefits individuals with Parkinson’s Disease. However, following a well-balanced diet with a variety of fruits, vegetables, whole grains, and lean protein has shown improvements in non-motor symptoms of PD. The USDA’s ChooseMyPlate is a great resource for general, healthy diet information. The Mediterranean Diet has been shown to increase cognitive function and decrease risk for dementia. For more details about Parkinson’s Disease and symptoms, visit https://www.parkinson.org/.
Get your medical team involved! Before making any major changes, consult with a physician. People with PD may eat less than usual because of difficulty chewing, swallowing, feeding, or due to nausea from medications. To address these issues, consider contacting a Speech-Language Pathologist (SLP) to help modify the textures of food for easier and safer chewing or swallowing. An Occupational Therapist (OT) can help find the right feeding tool to improve independence. Tools such as a swivel spoon, Liftware, a utensil strap, or weighted utensils, cups, and straws may be just the solution for successful, low stress feeding.
Meeting with a Registered Dietitian (RD) may be beneficial if the person with PD has weight loss or had a decreased sensation of taste and smell. Adding foods healthy fats like avocado, nuts, and certain oils to foods can aid in slow, healthy weight gain. Additionally, adding salt-free spices and intense flavors to foods can also increase appetite. It’s also recommended that protein be eaten at the end of the day as not to interfere with medication absorption. There are no significant benefits to a low protein diet. Medications should be taken 30-60 minutes before a meal. There are certain foods, however, that can ease non-motor related symptoms. See the list below of foods to eat and foods to avoid for the person with PD.
Eat these foods:
1. Omega 3’s
Omega 3’s help to decrease inflammation in the body. Swapping olive oil for butter when cooking is an easy change that can make a big impact on your health. Walnuts, almonds, and cashews are high in Omega 3 fatty acids among many other nutrients. ¼ cup of unsalted nuts daily can decrease inflammation in the body and can decrease risk of dementia. Ground flax seed is an inexpensive, high fiber Omega 3 that can be sprinkled into a variety of foods without having a major impact on taste. Sprinkle it onto cereal, into smoothies, mix in with your pancake batter for an easy added benefit. Oily fish like tuna, mackerel, salmon should be eaten at least once a week. These fish are high in protein, healthy fats, and important vitamins and minerals that have anti-inflammatory properties.
Antioxidants, especially from red and purple produce like raspberries and blueberries, protect neurons from disease progression. Phytochemicals in fruits and veggies can reverse some of the changes that happen in PD. Studies have shown that a variety of colorful fruit and veggies that have a variety of these phytochemicals can decrease dementia and depression. The fiber content in these foods is an added bonus to combat the common symptom of constipation. Furthermore, foods high in antioxidants decrease the odds of developing a preventive chronic disease, such as heart disease, obesity, and stroke.
Our bodies are 60% water. Water helps to keep your body systems working well, it helps to prevent kidney stones, UTI’s, and constipation. Your body loses water all the time through urination, bowel movements, and sweating. If you lose more water than you take in, you can become dehydrated. Dehydration causes dizziness, headaches, or even changes in mood and memory! All fluid counts, even in foods. Increase fluid intake by eating juicy produce like tomatoes, cucumbers, oranges, pears, zucchini, even sugar-free jell-o and popsicles are a good choice. Pale yellow or clear urine is good indicator of proper hydration.
High fiber foods include whole grains like brown or wild rice, whole grain bread, fresh fruits and vegetables, seeds, and nuts. Most people need 30-40g of fiber a day. When shopping in the grocery store, check the label for fiber content. If a label shows that is has 5 grams or more of fiber per serving, it’s concerned an excellent source. Studies have shown that there is a connection between gut health and Parkinson’s Disease. Getting both soluble and insoluble fiber in the diet help to feed the bacteria in your gut for a healthy gut microbiome and can ease symptoms of constipation. Eating foods that break down into in short chain fatty acids, like whole grains, not only help to feed these good bacteria, but also decrease inflammation, lower risk for certain cancers, and help to absorb nutrients from food.
5. Vitamin D
Vitamin D is an essential vitamin that helps with the absorption of calcium and phosphorus in the body to build strong bones to prevent osteoporosis and strong teeth to prevent cavities and decay. Vitamin D also helps muscles function and allows the brain and body to communicate through nerves. And the immune system needs vitamin D to fight off invading bacteria and viruses. Very few foods naturally contain adequate amounts of Vitamin D, which is why it’s sometimes called the “Sunshine Vitamin”. Skin converts sunlight into usable Vitamin D. Vitamin D deficiency is common among individuals with Parkinson’s Disease. It’s unclear if this is due to the disease itself, or if individuals with PD are spending less time outside. Supplementation may be the solution for low levels of Vitamin D. Be sure to consult with a healthcare provider before adding a supplement to your daily routine.
Limit these foods:
A diet high in added salt or processed foods is linked to increased inflammation thus progressing the nature of Parkinson’s Disease. The Dietary Guidelines for Americans suggests consuming no more than 2,300mg of sodium daily. That’s less than a teaspoon of table salt per day! Limit processed foods like cheese, soda, canned foods, and frozen entrees. Filling up on fresh fruits and veggies is a great way to cut down on sodium intake. Using herbs and spices while cooking offers a flavor profile that may decrease the need for that salty bite.
2. Saturated fat
Saturated fats are usually solid at room temperature or are fats that come from animals like butter, cream, full-fat dairy products, or the white streaks in red meat called marbling. Saturated fats not only increase risk for developing heart disease, diabetes, and certain cancers, but they also increase inflammation causing joint pain and decreased mobility. Instead, choose fats that are liquid at room temperature like olive oil or vegetable oil, leaner meats with less fat like poultry or fish, and yummy foods like nuts and avocado to help keep you full.
Alcohol can be drunk in moderation. That’s 1 drink for women, 2 drinks for men. Alcohol is a depressant in the brain, meaning it slows down brain functioning and cognition. Alcohol is also linked to depression and memory loss, exacerbating two of the same underlying symptoms of Parkinson’s Disease. Excessive alcohol intake can decrease the hormone dopamine in the brain which leads to issues with movement. If you’re going to drink alcohol, drink a glass that has proven benefits, like a glass of red wine. Red wine is packed with the antioxidant resveratrol which has been proved to have protective heart benefits.
4. Added sugars
Foods high in added sugar like cakes, sweets, and sodas spike blood sugars contributing to a burst of energy followed by fatigue. Spikes in blood sugar also lead to increased inflammation which progresses the Parkinson’s Disease. Furthermore, because difficulty sleeping in a common symptom of PD, avoid sugary foods before bed. Instead opt for well-rounded snacks that have carbohydrates, healthy fats, and protein, like an apple with peanut butter, Greek yogurt with berries, or carrots and hummus.
5. Excess protein
Everyone needs protein in their bodies for tissue growth and repair, bones, muscle, skin, and blood. Healthy sources of protein include, chicken, eggs, plain yogurt, edamame, nuts, fish, and beans. However, the absorption of some common Parkinson’s Disease medications is inhibited when eaten with protein, causing the drug to kick in more slowly or be less effective. Eat high protein snacks, such as the ones in the example above, throughout the day or save a big protein meal to be the last one of the day. Furthermore, eating too much protein can cause a buildup of Lewy bodies (an abnormal clumping of protein) in the brain which can lead to dementia. A Registered Dietitian can help determine the right amount of protein for you and how you can get enough throughout the day to fit your lifestyle.