General Health

Parkinson’s Disease(PD): Role of Continuous Dietary Support

We are tirelessly seek for normalcy these days and our health plays a major role in this. It is lesser known that healthy body functioning is majorly governed by our brain’s delicate balance and structuring. For few, this balance gets disturbed and makes life’s routine working not so normal. Parkinson’s disease (PD) is one of these neurological disorders when the levels of dopamine, an important neurochemical, diminishes. PD patients suffer from issues like tremors, rigidity, abdominal gait, difficulty in motor function, constipation, and weight loss.

In 2016, around 6.1 million people worldwide are estimated to have PD. The prevalence in India was roughly reported at 10% of the global burden. PD patients were one of the most vulnerable groups during the COVID-19 pandemic. The pooled prevalence of COVID-19 infection in PD cases was estimated at 5% with hospitalization and mortality rates at 49% and 12% respectively.

It is necessary to remove the fear associated with PD by spreading the right amount of awareness. This will help normalise the disorder and thus help patients lead a better life devoid of fear and judgement. Dr James Parkinson was the first to systematically described 6 people with PD in 1817. To honour his contribution and to spread awareness, 11th April is known as World Parkinson’s Day.

Many researchers support that nutrition plays an important role in PD treatment. The specialists must suggest a simple easy-to-follow dietary regimen to the patients. Firstly, patients should maintain a healthy weight under the guidance of a registered dietician.

The patient’s main energy should be from carbohydrates which also help the absorption of PD medicine, Levodopa. Carbohydrates should make up around 50-60% (6-11 servings) of daily caloric intake. Refined carbohydrates such as white rice and bread can be replaced by complex ones like brown rice and bread. Three to five servings of vegetables and two to four servings of fruits is necessary. This will provide the required fibre and fluids to meals helping to reduce constipation complications.

Protein consumption should make up around 0.8g/kg body weight/day. This will reduce any kind of deficiency, muscle loss, weight loss etc. and help tackle slow wound healing and low immunity. Around three servings of protein-rich foods like dairy products, white meat, legumes, and nuts should be a part of the diet, regularly.

Consumption of good fats can contribute to 30% of total daily calories for PD patients. Good fats like MUFA and PUFA rich foods should be incorporated into the diet instead of high saturated fats and cholesterol rich foods. Essential vitamins like Vit D and antioxidants like Vit C and E should also be included. Antioxidant-rich foods like fresh fruits, vegetables, nuts, soy, green tea, and dark chocolate must be a part of the diet. Good attention should be given to bone benefiting mineral, Calcium and CNS supporting mineral, Iron in the diet.

To reduce eating-related swallowing difficulty in PD, patients can be advised to eat slowly, comfortably and sitting in a proper upright posture. Small frequent simple easy to eat meals should be favoured.

Some dietary components can interfere with the efficacy of PD medication. For a few patients, proteins like milk and milk products, nuts, seeds etc reduce Levodopa absorption. These proteins may delay the reach of the medication reach to active site of the target region. Hence, it is highly recommended that if patients experience bloating, quick fulfilment after eating, or gastrointestinal reflux then they should immediately consult their doctor or dietician.

Low BP complications in PD can be reduced by recommending small low sugar healthy meals. The amount of salt can be increased slightly with adequate amounts of healthy fluids.

For shopping and cooking, the dieticians should suggest practical and easy to follow instructions to PD patients . Advance one-week meal planning, preparing a ready ingredient list, choosing a special shopping trolley, and opting for the meals on the wheels option are a few helpful guidelines. Occupational therapists should offer heal to these patients.

Special care should be given while deciding on dishes and cutlery for PD patients and they should use lightweight, easy hold and grip items. Warm plates and high-lipped plates can be used to reduce spills and make mealtime more enjoyable. With timely medical intervention and continuous dietary support, PD patients will be able to lead their own definition of a healthy normal life. Their caregivers and doctors will also play a crucial role in making this possible.

In the early stages of PD, non-motor symptoms like constipation, depression, and hyposmia may affect dietary choices and lead to impaired nutritional status. To reduce the risk and build good neurological protection, good nutrition is a must.

References
  1. American Parkinson’s Disease Association, 2009
  2. Lancet Neurol 2018;17:939-53
  3. Neurol Sci. 2022. PMID: 34817731 Free PMC article
  4. Frontiers in nutrition ageing, REVIEW ARTICLE published: 07 March, doi:10.3389/fnagi.2014.00036
  5. American Parkinson Disease Association, Inc. Copyright 2005 Revised 2009
  6. parkinsons.org.uk/ordering resources

Author

Aparna Das Parmar

Aparna Das Parmar has over 8.5 years of rich experience in the field of nutrition and healthcare and is currently a corporate nutritionist.

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