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Nutrition and Parkinson's

Ask anyone that has a poor, nutritionally deficient diet how they feel, their response will be tired, lacking energy, constipated, low. Add to this a condition such as Parkinson’s Disease where these are known symptoms then quality of life can be severely impacted. In fact, a recent study found this to be the case, malnourished people with Parkinson’s disease had poorer quality of life compared to those well-nourished. However, importantly when nutritional status was improved there were significant improvements in mobility and day to day activities. These findings are supported by other studies showing that a balanced diet improves motor performance. By eating a healthy diet the side effects of nutritional deficiency are erased, symptoms of Parkinson’s lessened and potentially progression slowed.

Your diet should be based on the Eatwell Plate. Extreme diets are not necessary, however there are considerations that you may want to discuss with your GP or dietician. Starting with protein. Protein is an essential nutrient – you must have it in your diet. However dietary protein reduces the response of levodopa, which is a precursor of dopamine and commonly forms part of drug treatment for people with Parkinson’s disease. Therefore the amount and timing of protein will impact the effectiveness of medication. The recommended nutritional intake of protein for men 19 – 50 years is 55.5g, women 45g, men 51 years or older is 53.3g and women 46.5g – this is approximately a chicken breast and a fillet of fish. Low protein diets and consuming the majority of protein in the evening for most reduce motor fluctuations. However, those in the earlier stages may benefit from eating protein through the day to reduce nausea. Do not change protein intake without discussing with a doctor or dietician that knows your specific circumstances.

Milk has been found to increase the risk of Parkinson’s disease. This is thought to be due to it lowering serum urate, which is a potent antioxidant that protects against oxidative damage in the brain. High serum urate has been associated with a reduced rate of progression in Parkinson’s disease. It is also thought that pesticides ingested by the cows may be involved. It is not the calcium in the milk that is of concern. Calcium is essential to bone density and muscle contraction, if taking milk out of your diet use calcium fortified milk alternatives, other good sources include fish with edible bones – such as tinned sardines, sesame, almonds and green leafy vegetables; also advise your doctor who may prescribe calcium supplements. Milk in the UK is also high in iodine, an essential nutrient for metabolism. Other good sources of iodine are anything that comes from the sea such as fish and seaweed.

Carbohydrate, for example rice, pasta, bread should make up around a third of your diet. Wholegrain versions are higher in fibre (and nutrients) which will help ease constipation. Having a small amount of carbohydrate such as an oatcake with medication will help absorbency and reduce nausea.

Fruit and vegetables. Now these are important, very important. Fruit and vegetables are packed with antioxidants that reduce oxidative stress, free radicals and inflammation in the brain – all thought to be possible causes of Parkinson’s disease. Diets high in antioxidants have been shown to slow progression of the disease. Aim for a minimum of 5 a day, optimally 8 – 2 maximum 3 portions of fruit and the rest from vegetables. This may sound quite daunting but it is easily achievable if you have at least one fruit or vegetable portion with every snack or meal. This will also help with constipation. There is however a negative side to fruit and vegetables and that’s pesticides. Wash thoroughly before consuming, where possible peel and consider a switch to organic produce.

The impact of fat specifically on Parkinson’s disease is less well researched. From fat studies it has been found that saturated fat – predominantly from animal sources and solid at room temperature, causes inflammation and oxidative stress. Unsaturated fat – predominantly from non-animal sources and liquid at room temperature such as rapeseed, olive, nut and seed oils, are high in antioxidants. Of most interest is omega 3 and in particular DHA found in oily fish such as salmon which is anti-inflammatory but also an important constituent of the brain cell membrane. Whilst not proven in Parkinson’s disease Omega 3 appears to be neuroprotective for several other neurodegenerative diseases.

Seid.S. E et al, The Emerging Role of Nutrition in Parkinson’s disease, Frontiers in Aging Neuroscience, volume 6 2014

Studies suggest that certain foods are neuroprotective or neurodegenerative. Foods shown in the red zone in the picture above are thought to cause neurodegeneration, foods and nutrients in the green zone are thought to promote neuroprotection. For the foods and nutrients in the middle yellow section there are conflicting results from studies; research in these areas is inconclusive. For now the strong consensus of opinion is that people with Parkinson disease are going to feel better and possibly slow the progression of Parkinson’s disease if having a healthy diet based on the Eatwell Plate with particular emphasis on foods that are high in antioxidants with possible manipulation of protein intake and replacing milk with other calcium rich foods.

Over the coming weeks and months we will discuss each of the areas mentioned in more detail, keep you updated on new research plus provide practical implementation tips and simple tasty recipes.

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