Diet and Nutrition Considerations for Parkinson’s Disease

Healthy and intentional eating is vital to living well with Parkinson’s disease (PD). Though there is no special diet for PD, there are important considerations regarding food choices, especially when taking a common PD medication. Weight loss is debilitating in PD and contributory symptoms respond to dietary interventions. It is best to seek expert help to individualize a nutrition plan as the condition progresses.

Parkinson’s and nutrition: the basics

Nutrition refers to how our biological systems use food to maintain homeostasis — the steady and optimal state of our body. PD challenges nutrition because of its neurodegenerative mechanism.

Dopamine is a specific chemical messenger that is essential for everyday cellular communication. Its levels diminish due to PD. Inadequate dopamine levels impede several physiological processes including movement, appetite, and digestion.

The risk of developing PD increases with age; most people are over 50 at the time of diagnosis. There is no prescriptive diet or supplements for PD, but weight loss is common over time and leads to lower quality of life.

Eating well-balanced meals and following general nutritional guidelines for adults is best, with a focus on proper hydration. Here are some highlights from the USDA Food and Nutrition Service’s current dietary recommendations for adults:

• Protein sources include seafood, lean meats, poultry, beans, peas, lentils, nuts, and eggs.
• Choose options that are full of nutrients, especially fiber, calcium, and vitamin D.
• Drink at least 64 oz or 8 glasses of water daily in addition to the fluid you get through meals.
• Limit the intake of added sugars, saturated fat, and sodium.

But take into consideration that impaired mobility makes getting to the restroom more difficult in the later stages of PD. Try drinking fluids earlier in the day or when assistance is available.

Additionally, keep in mind that because of chronic low blood pressure related to PD, some people will actually benefit from more salt in their diet.

Levodopa and protein

Here's everything you need to know about levodopa and protein.

The protein effect

Levodopa is a common medication given to those with PD. It converts to dopamine once ingested, increasing a person’s functional capacity for the duration of the medication. The duration is about 4–6 hours, meaning the drug typically must be taken multiple times during the day.

Levodopa competes with other proteins for absorption. This is referred to as the protein effect. Experts suggest avoiding eating protein-rich foods at the same time as taking the medication.

Protein intake strategies

The protein effect does not affect everyone with PD in the same way. No one with PD should avoid protein as a solution, as it is essential to build and repair tissue such as muscle and bones. The American Parkinson Disease Association recommends the following strategies:

• Eat the bulk of protein later in the day. This way, the levodopa has a better chance of working well while you are most active.
• Divide the amount of daily protein evenly between meals and snacks. This way, even if there is some competition, the bioavailability of levodopa will be steady because of the scheduled ingestion of protein. This approach should be planned out with the help of a clinician, such as a registered dietician.

Reducing Parkinson’s disease symptoms through diet

For the sake of this article, diet refers to an individual’s specific food choices and what is consumed on a daily basis. Maintaining weight can be easier than regaining it in PD. The key is balancing fuel intake, energy output, and medications. Some possible side effects.

• Nausea. Levodopa can cause nausea, so taking it with food can help; carbohydrates are a good choice. Examples are whole wheat crackers, veggie or fruit slices, or pasta. Let your healthcare provider know when nausea becomes a problem.
  
• Constipation. Fiber and water should be staples in a PD diet. Fibrous foods include oatmeal, prunes, dark green and leafy vegetables, and beans.
  
• Dysphagia. Later in the disease, choking is a risk due to difficulty swallowing. When this occurs, your healthcare team should be consulted. They may advise smaller, softer, higher-calorie meals as well as a referral to a speech therapist.
  
• Anorexia. For a host of reasons, appetite fades as PD progresses. Food may smell or taste differently. Improving hunger and interest in eating depends on your personal circumstances and preferences. Ask for help from a trusted clinician and seek reliable information from PD groups like the Parkinson’s Foundation.
  

Nutritional recommendations for those with PD are generally the same as for all adults. Levodopa is a common medication used in PD to help improve movement and function, but it has interactions that impact protein food choices. Solutions involve timing protein intake at regular intervals or eating protein at less active times. When symptoms such as nausea, poor appetite, and constipation arise, it is necessary to create individualized diet strategies with your healthcare team.